Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Oct 18:5:2531.
doi: 10.12688/f1000research.9278.1. eCollection 2016.

Nutrition in critical illness: a current conundrum

L John Hoffer  1 , Bruce R Bistrian  2
Affiliations
Review

Nutrition in critical illness: a current conundrum

L John Hoffer et al. F1000Res. .

Abstract

Critically ill people are unable to eat. What's the best way to feed them? Nutrition authorities have long recommended providing generous amounts of protein and calories to critically ill patients, either intravenously or through feeding tubes, in order to counteract the catabolic state associated with this condition. In practice, however, patients in modern intensive care units are substantially underfed. Several large randomized clinical trials were recently carried out to determine the clinical implications of this situation. Contradicting decades of physiological, clinical, and observational data, the results of these trials have been claimed to justify the current practice of systematic underfeeding in the intensive care unit. This article explains and suggests how to resolve this conundrum.

Keywords: ICU nutrition; catabolic; crtically ill; enteral nutrition; parenteral nutrition.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests. No competing interests were disclosed. No competing interests were disclosed.

References

    1. Clowes GH, Jr, Hirsch E, George BC, et al. : Survival from sepsis. The significance of altered protein metabolism regulated by proteolysis inducing factor, the circulating cleavage product of interleukin-1. Ann Surg. 1985;202(4):446–58. - PMC - PubMed
    1. Beal AL, Cerra FB: Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. JAMA. 1994;271(3):226–33. - PubMed
    1. Gabay C, Kushner I: Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448–54. 10.1056/NEJM19990211340060 - DOI - PubMed
    1. Douglas RG, Shaw JH: Metabolic response to sepsis and trauma. Br J Surg. 1989;76(2):115–22. 10.1002/bjs.1800760205 - DOI - PubMed
    1. Wilmore DW: From Cuthbertson to fast-track surgery: 70 years of progress in reducing stress in surgical patients. Ann Surg. 2002;236(5):643–8. - PMC - PubMed

LinkOut - more resources