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Early or Late Feeding after ICU Admission?

The feeding of critically ill patients has recently become a controversial issue, as several studies have provided unexpected and contradictory results. Earlier beliefs regarding energy requirements in critical illness—especially during the initial phase—have been challenged. In the current review,...

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Detalles Bibliográficos
Autores principales: Reintam Blaser, Annika, Berger, Mette M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748729/
https://www.ncbi.nlm.nih.gov/pubmed/29168739
http://dx.doi.org/10.3390/nu9121278
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author Reintam Blaser, Annika
Berger, Mette M.
author_facet Reintam Blaser, Annika
Berger, Mette M.
author_sort Reintam Blaser, Annika
collection PubMed
description The feeding of critically ill patients has recently become a controversial issue, as several studies have provided unexpected and contradictory results. Earlier beliefs regarding energy requirements in critical illness—especially during the initial phase—have been challenged. In the current review, we summarize existing evidence about fasting and the impact of early vs. late feeding on the sick organism’s responses. The most important points are the non-nutritional advantages of using the intestine, and recognition that early endogenous energy production as an important player in the response must be integrated in the nutrient prescription. There is as of yet no bedside tool to monitor dynamics in metabolism and the magnitude of the endogenous energy production. Hence, an early “full-feeding strategy” exposes patients to involuntary overfeeding, due to the absence of an objective measure enabling the adjustment of the nutritional therapy. Suggestions for future research and clinical practice are proposed.
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spelling pubmed-57487292018-01-07 Early or Late Feeding after ICU Admission? Reintam Blaser, Annika Berger, Mette M. Nutrients Review The feeding of critically ill patients has recently become a controversial issue, as several studies have provided unexpected and contradictory results. Earlier beliefs regarding energy requirements in critical illness—especially during the initial phase—have been challenged. In the current review, we summarize existing evidence about fasting and the impact of early vs. late feeding on the sick organism’s responses. The most important points are the non-nutritional advantages of using the intestine, and recognition that early endogenous energy production as an important player in the response must be integrated in the nutrient prescription. There is as of yet no bedside tool to monitor dynamics in metabolism and the magnitude of the endogenous energy production. Hence, an early “full-feeding strategy” exposes patients to involuntary overfeeding, due to the absence of an objective measure enabling the adjustment of the nutritional therapy. Suggestions for future research and clinical practice are proposed. MDPI 2017-11-23 /pmc/articles/PMC5748729/ /pubmed/29168739 http://dx.doi.org/10.3390/nu9121278 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Reintam Blaser, Annika
Berger, Mette M.
Early or Late Feeding after ICU Admission?
title Early or Late Feeding after ICU Admission?
title_full Early or Late Feeding after ICU Admission?
title_fullStr Early or Late Feeding after ICU Admission?
title_full_unstemmed Early or Late Feeding after ICU Admission?
title_short Early or Late Feeding after ICU Admission?
title_sort early or late feeding after icu admission?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748729/
https://www.ncbi.nlm.nih.gov/pubmed/29168739
http://dx.doi.org/10.3390/nu9121278
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