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KMID : 1034120130050010015
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Journal of Clinical Nutrition
2013 Volume.5 No. 1 p.15 ~ p.19
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Nutritional Support in Critically Ill Surgical Patients
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Park Chi-Min
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Abstract
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Malnutrition is associated with poor clinical outcomes in critically ill surgical patients and nutritional support has emerged as an important component in the management of these patients. The purpose of this study is to review the general nutritional support in critically ill surgical patients. Enteral nutrition (EN) is found to be the preferred method over parenteral nutrition (PN) for feeding the critically ill patient. EN should be started early within the first 24∼48 hours after admission as soon as the patient is hemodynamically stable and have functioning gastrointestinal tract. PN, if indicated, should also be initiated within 24∼48 hours after intensive care unit admission; however, there is controversy and further investigation is needed regarding the early start of PN. After gastrointestinal surgery, Studies have shown that EN is associated with fewer complications compared with PN and early enteral feeding may be of benefit in the patients following gastrointestinal surgery, even in emergency. During the acute phase, target dose of EN should be 20∼25 kcal/kg/day, whereas during the recovery phase, the dose is increased to 25∼30 total kcal/kg/day. Care must be taken to avoid overfeeding and development of refeeding syndrome in critically ill surgical patients.
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KEYWORD
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Nutrition therapy, Critical illness, Intensive care unit, General surgery
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