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Nutrients 2017, 9(12), 1278; doi:10.3390/nu9121278

Early or Late Feeding after ICU Admission?

1
Department of Anaesthesiology and Intensive Care, University of Tartu, 51014 Tartu, Estonia
2
Department of Intensive Care Medicine, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland
3
Service of Intensive Care and Burns, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
*
Author to whom correspondence should be addressed.
Received: 2 October 2017 / Revised: 6 November 2017 / Accepted: 6 November 2017 / Published: 23 November 2017
(This article belongs to the Special Issue Nutritional Approach to Critically Ill Patients)
View Full-Text   |   Download PDF [763 KB, uploaded 23 November 2017]   |  

Abstract

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. View Full-Text
Keywords: enteral nutrition; early feeding; parenteral nutrition; starvation; critical illness enteral nutrition; early feeding; parenteral nutrition; starvation; critical illness
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Reintam Blaser, A.; Berger, M.M. Early or Late Feeding after ICU Admission? Nutrients 2017, 9, 1278.

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