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REVIEW ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 3  |  Page : 478-486

Nutritional support in critically ill adult patients


Department of Anesthesia, ICU and Pain Management, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Ahmed M Ragab
MBBCh, El Helal Hospital, Health Insurance Organization, El Menoufia Branch, Garwan Village, El Bagour, Menoufia Governorate, 32871
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.198655

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Objective The aim of this study was to conduct a review of nutritional support in critically ill adult patients. Data analysis Data source: medical textbooks, medical journals, and medical websites with recent research studies having the keyword nutritional support in the title of the paper were searched. Study selection: systemic reviews that addressed nutritional support and studies that addressed support in critically ill adult patients were selected. Data extraction: a special search was conducted at midline with the keywords nutritional and support in the title of the paper, and suitable studies meeting the criteria were extracted and their quality and validity assessed. Data synthesis: each study was reviewed independently. The data were translated into the language most comfortable for the researcher and arranged in topics throughout the article. Recent findings Early nutritional support (within 48 h) is advocated in critically ill patients. The normal policy is to start with enteral nutrition (EN). If not feasible or not able to provide complete nutrition, parenteral nutrition is started to supplement EN. The caloric balance can be maintained by providing 25-35 kcal/kg/day. Nutrition should be personalized for each patient taking into consideration the state of disease and the present nutritional status of the patient. The patient's nutritional adequacy and possible side effects should be assessed regularly. Conclusion Early EN has been suggested to be beneficial in the critically ill. But depending on the enteral route alone might lead to underfeeding. Therefore, many patients may need a combination of EN and parenteral nutrition, adjusted as tolerance to EN increases.


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