Metabolic and nutritional support of critically ill patients: consensus and controversies

• Published in: Critical care (London, England) Vol. 19; no. 1; p. 35
• Main Authors: Preiser, Jean-Charles, van Zanten, Arthur R H, Berger, Mette M, Biolo, Gianni, Casaer, Michael P, Doig, Gordon S, Griffiths, Richard D, Heyland, Daren K, Hiesmayr, Michael, Iapichino, Gaetano, Laviano, Alessandro, Pichard, Claude, Singer, Pierre, Van den Berghe, Greet, Wernerman, Jan, Wischmeyer, Paul, Vincent, Jean-Louis
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.01.2015; BioMed Central
• Subjects: Amino acids; Antioxidants; Carbohydrates; Consensus; Critical care; Critical Illness - therapy; Cytokines; Dietary Proteins - administration & dosage; Energy Intake; Enteral Nutrition - methods; Health aspects; Hormones; Humans; Hyperglycemia; Illnesses; Insulin; Intensive care; Medical equipment and supplies industry; Medical test kit industry; Medicin och hälsovetenskap; Meta-analysis; Metabolism; Nutrition; Parenteral nutrition; Parenteral Nutrition - methods; Prevention; Probiotics; Protein synthesis; Proteins; Review; Sepsis; Ventilators; Germany
• ISSN: 1364-8535; 1466-609X; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-015-0737-8

The results of recent large-scale clinical trials have led us to review our understanding of the metabolic response to stress and the most appropriate means of managing nutrition in critically ill patients. This review presents an update in this field, identifying and discussing a number of areas for which consensus has been reached and others where controversy remains and presenting areas for future research. We discuss optimal calorie and protein intake, the incidence and management of re-feeding syndrome, the role of gastric residual volume monitoring, the place of supplemental parenteral nutrition when enteral feeding is deemed insufficient, the role of indirect calorimetry, and potential indications for several pharmaconutrients.