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Nutritional Requirements in Intensive Care Unit

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Metabolic Disorders and Critically Ill Patients

Abstract

The goals of nutritional support in the ICU are to minimize weight loss, loss of protein during the initial phase, and to provide nutrients to support the immune system and healing. Both underfeeding and overfeeding are deleterious. Clinical evaluation of energy needs can be performed with equations, but the reference values are obtained by indirect calorimetry, especially interesting for extreme BMI. Indeed, all formulas are weight based, and actual weight is not always a correct denominator. Energy provision recommended by guidelines is 20–25 kcal/kg body weight/day in the acute phase and 25–30 kcal/kg body weight/day in the recovery phase. It needs to take into account patient obesity and the risk of refeeding syndrome in malnourished people. Carbohydrates and lipids represent 65–70% and 30–35% of energy provision, respectively. The recommended protein provision is 1.3–1.5 g proteins/kg ideal body weight/day or 1.2–2.0 g/kg actual body weight/day. Finally, there is an increased need for most micronutrients that needs to be covered with commercial admixtures; some micronutrients have to be adapted for each patient with a possibility to supplement some with selenium and vitamin C.

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  1. Gastroentérologie et Nutrition Clinique, Centre Hospitalier Universitaire de Nice, 151 route de Saint-Antoine, 06200, Nice, France

    Marie-Pier Bachand, Xavier Hébuterne & Stéphane M. Schneider

  2. Faculté de Médecine, Université de Nice Sophia-Antipolis, Université Côte d’Azur, 29 avenue de Valombrose, 06100, Nice, France

    Marie-Pier Bachand, Xavier Hébuterne & Stéphane M. Schneider

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  1. Marie-Pier Bachand
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  2. Xavier Hébuterne
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  1. Intensive Care Unit, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France

    Carole Ichai

  2. Intensive Care Unit, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France

    Hervé Quintard

  3. Intensive Care Unit, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France

    Jean-Christophe Orban

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Bachand, MP., Hébuterne, X., Schneider, S.M. (2018). Nutritional Requirements in Intensive Care Unit. In: Ichai, C., Quintard, H., Orban, JC. (eds) Metabolic Disorders and Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-64010-5_18

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