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Review
. 2018 Jan;34(1):107-125.
doi: 10.1016/j.ccc.2017.08.008. Epub 2017 Oct 13.

Nutrition Therapy in Sepsis

Paul E Wischmeyer  1
Affiliations
Review

Nutrition Therapy in Sepsis

Paul E Wischmeyer. Crit Care Clin. 2018 Jan.

Abstract

Sepsis is characterized by early massive catabolism, lean body mass (LBM) loss, and escalating hypermetabolism persisting for months to years. Early enteral nutrition should attempt to correct micronutrient/vitamin deficiencies, deliver adequate protein and moderated nonprotein calories, as well-nourished patients can generate reasonable endogenous energy. After resuscitation, increasing protein/calories are needed to attenuate LBM loss and promote recovery. Malnutrition screening is essential, and parenteral nutrition can be safely added when enteral nutrition is failing based on preillness malnutrition. Following discharge from intensive care unit, significantly increased protein/calorie delivery is required for months to years to facilitate functional and LBM recovery.

Keywords: Calories; Enteral nutrition; Lean body mass; Lipids; Parenteral nutrition; Protein.

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Figures

Figure 1
Figure 1
Proposal for Targeted Nutrition Delivery in Sepsis
Figure 2
Figure 2
Early Acute Phase Catabolic Response to Sepsis: Adapted from Adapted from: Anesthesiology 2015; 123:1455–72.
See this image and copyright information in PMC

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