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A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice
The preferential use of the oral/enteral route in critically ill patients over gut rest is uniformly recommended and applied. This article provides practical guidance on enteral nutrition in compliance with recent American and European guidelines. Low-dose enteral nutrition can be safely started wit...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669237/ https://www.ncbi.nlm.nih.gov/pubmed/34906215 http://dx.doi.org/10.1186/s13054-021-03847-4 |
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author | Preiser, Jean-Charles Arabi, Yaseen M. Berger, Mette M. Casaer, Michael McClave, Stephen Montejo-González, Juan C. Peake, Sandra Reintam Blaser, Annika Van den Berghe, Greet van Zanten, Arthur Wernerman, Jan Wischmeyer, Paul |
author_facet | Preiser, Jean-Charles Arabi, Yaseen M. Berger, Mette M. Casaer, Michael McClave, Stephen Montejo-González, Juan C. Peake, Sandra Reintam Blaser, Annika Van den Berghe, Greet van Zanten, Arthur Wernerman, Jan Wischmeyer, Paul |
author_sort | Preiser, Jean-Charles |
collection | PubMed |
description | The preferential use of the oral/enteral route in critically ill patients over gut rest is uniformly recommended and applied. This article provides practical guidance on enteral nutrition in compliance with recent American and European guidelines. Low-dose enteral nutrition can be safely started within 48 h after admission, even during treatment with small or moderate doses of vasopressor agents. A percutaneous access should be used when enteral nutrition is anticipated for ≥ 4 weeks. Energy delivery should not be calculated to match energy expenditure before day 4–7, and the use of energy-dense formulas can be restricted to cases of inability to tolerate full-volume isocaloric enteral nutrition or to patients who require fluid restriction. Low-dose protein (max 0.8 g/kg/day) can be provided during the early phase of critical illness, while a protein target of > 1.2 g/kg/day could be considered during the rehabilitation phase. The occurrence of refeeding syndrome should be assessed by daily measurement of plasma phosphate, and a phosphate drop of 30% should be managed by reduction of enteral feeding rate and high-dose thiamine. Vomiting and increased gastric residual volume may indicate gastric intolerance, while sudden abdominal pain, distension, gastrointestinal paralysis, or rising abdominal pressure may indicate lower gastrointestinal intolerance. |
format | Online Article Text |
id | pubmed-8669237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86692372021-12-14 A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice Preiser, Jean-Charles Arabi, Yaseen M. Berger, Mette M. Casaer, Michael McClave, Stephen Montejo-González, Juan C. Peake, Sandra Reintam Blaser, Annika Van den Berghe, Greet van Zanten, Arthur Wernerman, Jan Wischmeyer, Paul Crit Care Review The preferential use of the oral/enteral route in critically ill patients over gut rest is uniformly recommended and applied. This article provides practical guidance on enteral nutrition in compliance with recent American and European guidelines. Low-dose enteral nutrition can be safely started within 48 h after admission, even during treatment with small or moderate doses of vasopressor agents. A percutaneous access should be used when enteral nutrition is anticipated for ≥ 4 weeks. Energy delivery should not be calculated to match energy expenditure before day 4–7, and the use of energy-dense formulas can be restricted to cases of inability to tolerate full-volume isocaloric enteral nutrition or to patients who require fluid restriction. Low-dose protein (max 0.8 g/kg/day) can be provided during the early phase of critical illness, while a protein target of > 1.2 g/kg/day could be considered during the rehabilitation phase. The occurrence of refeeding syndrome should be assessed by daily measurement of plasma phosphate, and a phosphate drop of 30% should be managed by reduction of enteral feeding rate and high-dose thiamine. Vomiting and increased gastric residual volume may indicate gastric intolerance, while sudden abdominal pain, distension, gastrointestinal paralysis, or rising abdominal pressure may indicate lower gastrointestinal intolerance. BioMed Central 2021-12-14 /pmc/articles/PMC8669237/ /pubmed/34906215 http://dx.doi.org/10.1186/s13054-021-03847-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Preiser, Jean-Charles Arabi, Yaseen M. Berger, Mette M. Casaer, Michael McClave, Stephen Montejo-González, Juan C. Peake, Sandra Reintam Blaser, Annika Van den Berghe, Greet van Zanten, Arthur Wernerman, Jan Wischmeyer, Paul A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
title | A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
title_full | A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
title_fullStr | A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
title_full_unstemmed | A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
title_short | A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
title_sort | guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669237/ https://www.ncbi.nlm.nih.gov/pubmed/34906215 http://dx.doi.org/10.1186/s13054-021-03847-4 |
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