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Review
. 2023 Apr 1;29(2):101-107.
doi: 10.1097/MCC.0000000000001016. Epub 2023 Jan 27.

Current insights in ICU nutrition: tailored nutrition

Anoek Jacqueline Hubertine Hermans  1   2 , Babette Irene Laarhuis  1 , Imre Willemijn Kehinde Kouw  2 , Arthur Raymond Hubert van Zanten  1   2
Affiliations
Review

Current insights in ICU nutrition: tailored nutrition

Anoek Jacqueline Hubertine Hermans et al. Curr Opin Crit Care. .

Abstract

Purpose of review: To summarize recent research on critical care nutrition focusing on the optimal composition, timing, and monitoring of enteral feeding strategies for (post)-ICU patients. We provide new insights on energy and protein recommendations, feeding intolerance, and describe nutritional practices for coronavirus disease 2019 ICU patients.

Recent findings: The use of indirect calorimetry to establish individual energy requirements for ICU patients is considered the gold standard. The limited research on optimal feeding targets in the early phase of critical illness suggests avoiding overfeeding. Protein provision based upon the absolute lean body mass is rational. Therefore, body composition measurements should be considered. Body impedance analysis and muscle ultrasound seem reliable, affordable, and accessible methods to assess body composition at the bedside. There is inadequate evidence to change our practice of continuous enteral feeding into intermittent feeding. Finally, severe acute respiratory syndrome coronavirus 2 patients are prone to underfeeding due to hypermetabolism and should be closely monitored.

Summary: Nutritional therapy should be adapted to the patient's characteristics, diagnosis, and state of metabolism during ICU stay and convalescence. A personalized nutrition plan may prevent harmful over- or underfeeding and attenuate muscle loss. Despite novel insights, more research is warranted into tailored nutrition strategies during critical illness and convalescence.

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Conflict of interest statement

Professor Van Zanten reported receiving honoraria for advisory board meetings, lectures, research, and travel expenses from Abbott, AoP Pharma, Baxter, Cardinal Health, Danone-Nutricia, Dim-3, Fresenius Kabi, GE Healthcare, Medcaptain, Mermaid, Nestle-Novartis, Lyric, and Rousselot. The other authors have nothing to declare.

Figures

Box 1
Box 1
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FIGURE 1
FIGURE 1
Overview of multifactorial causes contributing to inadequate post-ICU nutritional intake. Created with biorender.com. License ARH van Zanten: agreement number: UI24KC5DCW. ICU, intensive care unit.
See this image and copyright information in PMC

References

    1. Ridley EJ, Lambell K. Nutrition before, during and after critical illness. Curr Opin Crit Care 2022; 28:395–400. - PubMed
    1. Chapple LS, Plummer MP, Chapman MJ. Gut dysfunction in the ICU: diagnosis and management. Curr Opin Crit Care 2021; 27:141–146. - PubMed
    1. Boelens YFN, Melchers M, van Zanten ARH. Poor physical recovery after critical illness: incidence, features, risk factors, pathophysiology, and evidence-based therapies. Curr Opin Crit Care 2022; 28:409–416. - PMC - PubMed
    1. Singer P, Blaser AR, Berger MM, et al. . ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019; 38:48–79. - PubMed
    1. Compher C, Bingham AL, McCall M, et al. . Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr 2022; 46:12–41. - PubMed