Importance of Nutrition in the critical patient

Question 1

Why is nutrition an essential component in managing sick patients?

Answer 1

Critical illness creates physiological stress and inflammatory responses
Promotes protein catabolism and impairs healing
Poor nutrition results in poorer outcomes and increased complication rates

Question 2

How can nutrition be assessed in the critically ill patient?

Answer 2

Muscle condition score - assesses lean mass
Repeat sequentially on a daily basis to monitor rate of loss

Question 3

What is the difference between anorexia and hyporexia?

Answer 3

Anorexia = no intake
Hyporexia = <75% RER daily

Question 4

When should nutritional support be provided?

Answer 4

Begin nutritional support at the latest:
3 days of anorexia
7 days of hyporexia

Question 5

In what situation must nutritional support be given immediately?

Answer 5

Check biochemistry – if hypoalbuminaemic (e.g. septic patients)