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Non-Pulmonary Complications of Critical Care pp 165–185Cite as

Nutritional and Endocrinologic Complications

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Abstract

Nutrition support plays an important role in the management of critical illness. Our understanding of the difference between the impact of catabolism and that of nourishment in critical illness continues to evolve. In this chapter we will discuss the new diagnostic criteria for malnutrition in the setting of uncontrolled catabolism of critical illness.

Numerous recent studies have investigated the role that adjunctive nutritional therapies may play in ameliorating the metabolic response to stress as seen in critical illness. We will discuss the role of micronutrient deficiencies and attempts at supplementation, and critically analyze their effectiveness.

Both parenteral and enteral nutrition have important roles to play in the ICU. The route, timing and potential risks of each strategy will be discussed in depth. Particular attention will be made to refeeding syndrome, a potentially life-threatening condition when not recognized or anticipated.

Lastly, we will address aspects of the management of endocrine-related issues in the critically ill patient. Management of blood glucose, thyroid disease and adrenal insufficiency will be discussed at length.

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Authors and Affiliations

  1. Division of Preventative Medicine and Nutrition, Department of Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 9-501, New York, NY, 10032, USA

    Eoin Slattery M.D.

  2. Boston Medical Center, Nutrition and Weight Management Center, Boston University of Medicine, 88 East Newton Street, Robinson 4400, Boston, MA, 02118, USA

    Dong Wook Kim M.D.

  3. College of Physicians and Surgeons and Institute of Human Nutrition, Columbia University, 630 West 168th Street, New York, NY, 10032, USA

    David S. Seres M.D., Sc.M., P.N.S.

  4. Medical Nutrition and Nutrition Support Service, Division of Preventative Medicine and Nutrition, Department of Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 9-501, New York, NY, 10032, USA

    David S. Seres M.D., Sc.M., P.N.S.

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  1. Eoin Slattery M.D.
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  3. David S. Seres M.D., Sc.M., P.N.S.
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Correspondence to Eoin Slattery M.D. .

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Editors and Affiliations

  1. Pulmonary, Critical Care, and Sleep, Harvard Medical School Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Jeremy B. Richards

  2. Pulmonary and Critical Care, University of Vermont College of Medicine, Burlington, Vermont, USA

    Renee D. Stapleton

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Slattery, E., Kim, D.W., Seres, D.S. (2014). Nutritional and Endocrinologic Complications. In: Richards, J., Stapleton, R. (eds) Non-Pulmonary Complications of Critical Care. Respiratory Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0873-8_7

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