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Timing and Indication for Parenteral Nutrition in the Critically Ill

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Nutrition Support for the Critically Ill

Part of the book series: Nutrition and Health ((NH))

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Abstract

The paradigm of improved vital and functional outcome by optimized artificial feeding early in critical illness has been recently challenged by several large RCT's. Artficial feeding is unable to attenuate muscle catabolism. At higher doses and particularly when given intravenously early feeding even induces morbidity. In this chapter we will review the history of feeding, the observational data supporting early enhanced feeding and the evidence from RCT's pleading against it. Finally we will discuss the mechanisms -particularly inhibition of autophagy- that may explain the failure of early (parenteral) nutrition in the critically ill.

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Authors and Affiliations

  1. Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium

    Jan Gunst MD, PhD & Michael P. Casaer MD, PhD

  2. Burn Unit, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium

    Michael P. Casaer MD, PhD

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  1. Jan Gunst MD, PhD
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  2. Michael P. Casaer MD, PhD
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Correspondence to Michael P. Casaer MD, PhD .

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Editors and Affiliations

  1. Institute of Human Nutrition, Columbia University College of Physicians and Surgeons, New York, New York, USA

    David S. Seres

  2. Department of Surgery, University of Missouri, Kansas City, Kansas City, Missouri, USA

    Charles W. Van Way, III

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Gunst, J., Casaer, M.P. (2016). Timing and Indication for Parenteral Nutrition in the Critically Ill. In: Seres, D., Van Way, III, C. (eds) Nutrition Support for the Critically Ill. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-21831-1_6

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  • DOI: https://doi.org/10.1007/978-3-319-21831-1_6

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