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Diet and Nutrition in Critical Care pp 49–61Cite as

Nutrition and Acute Lung Injury in Critical Care: Focus on Nutrition Care Process

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Abstract

Acute lung injury (ALI) remains a significant source of morbidity and mortality in patients hospitalized in critical care units. Nutrition therapy can play a critical role in the management of patients with ALI. The nutrition care process for ALI patients involves nutrition screening, nutrition assessments, nutrition interventions, and monitoring of nutritional parameters. Nutrition screening can help identify patients early in the hospitalization who have existing nutrition deficits, so timely assessment and intervention can take place. Consequences of nutrition-related issues such as malnutrition and catabolism can be profound in this population; therefore, nutrition assessments to estimate energy and protein requirements are an integral part of patient management. Nutrition interventions in this patient population are targeted at preventing cumulative calorie deficits; identifying, preventing, and treating malnutrition; avoiding loss of lean body mass and the resulting deterioration of respiratory muscle strength; and modulating the inflammatory response associated with ALI. The careful monitoring of nutritional parameters in ALI patients is critical in order to quantify the progress made toward meeting the goals of nutrition therapy.

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Abbreviations

ALI:

Acute lung injury

APACHE:

Acute Physiology and Chronic Health Evaluation

ASPEN/SCCM:

American Society for Enteral and Parenteral Nutrition/Society of Critical Care Medicine

BMI:

Body mass index

CO2:

Carbon dioxide

COPD:

Chronic obstructive pulmonary disease

DEXA:

Dual-energy X-ray absorptiometry

EN:

Enteral nutrition

EPA:

Eicosapentaenoic acid

FIO2:

Fraction of inspired oxygen

GLA:

γ-Linolenic acid

IC:

Indirect calorimetry

NPO:

Nil per os

REE:

Resting energy expenditure

RQ:

Respiratory quotient

SEMICYUC-SENPE:

Spanish Society of Intensive Care Medicine and Coronary Units and Spanish Society of Parenteral and Enteral Nutrition

SNAQ:

Short nutritional assessment questionnaire

SOFA:

Sequential organ failure assessment

VAP:

Ventilator-acquired pneumonia

VO2:

Maximal oxygen consumption

References

  • Ajemian MS, Nirmul GB, Anderson MT, Zirlen DM, Kwasnik EM. Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management. Arch Surg. 2001;136(4):434–7.

    Article  CAS  PubMed  Google Scholar 

  • American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the american society of anesthesiologists committee on standards and practice parameters. Anesthesiology. 2011;114(3):495–511.

    Article  Google Scholar 

  • Bastarache JA, Ware LB, Girard TD, Wheeler AP, Rice TW. Markers of inflammation and coagulation may be modulated by enteral feeding strategy. JPEN J Parenter Enteral Nutr. 2012;36(6):732–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Budweiser S, Meyer K, Jorres RA, Heinemann F, Wild PJ, Pfeifer M. Nutritional depletion and its relationship to respiratory impairment in patients with chronic respiratory failure due to COPD or restrictive thoracic diseases. Eur J Clin Nutr. 2008;62(3):436–43.

    Article  CAS  PubMed  Google Scholar 

  • Calder PC, Jensen GL, Koletzko BV, Singer P, Wanten GJ. Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions. Intensive Care Med. 2010;36(5):735–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chailleux E, Laaban JP, Veale D. Prognostic value of nutritional depletion in patients with COPD treated by long-term oxygen therapy: data from the ANTADIR observatory. Chest. 2003;123(5):1460–6.

    Article  PubMed  Google Scholar 

  • DeMichele SJ, Wood SM, Wennberg AK. A nutritional strategy to improve oxygenation and decrease morbidity in patients who have acute respiratory distress syndrome. Respir Care Clin N Am. 2006;12(4):547–66, vi.

    PubMed  Google Scholar 

  • Doley J, Mallampalli A, Sandberg M. Nutrition management for the patient requiring prolonged mechanical ventilation. Nutr Clin Pract. 2011;26(3):232–41.

    Article  PubMed  Google Scholar 

  • Falciglia HS, Johnson JR, Sullivan J, Hall CF, Miller JD, Riechmann GC, et al. Role of antioxidant nutrients and lipid peroxidation in premature infants with respiratory distress syndrome and bronchopulmonary dysplasia. Am J Perinatol. 2003;20(2):97–107.

    Article  PubMed  Google Scholar 

  • Fasano E, Serini S, Piccioni E, Innocenti I, Calviello G. Chemoprevention of lung pathologies by dietary n-3 polyunsaturated fatty acids. Curr Med Chem. 2010;17(29):3358–76.

    Article  CAS  PubMed  Google Scholar 

  • Frankenfield DC, Rowe WA, Smith JS, Cooney RN. Validation of several established equations for resting metabolic rate in obese and nonobese people. J Am Diet Assoc. 2003;103(9):1152–9.

    Article  PubMed  Google Scholar 

  • Gadek JE, DeMichele SJ, Karlstad MD, Pacht ER, Donahoe M, Albertson TE, et al. Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. enteral nutrition in ARDS study group. Crit Care Med. 1999;27(8):1409–20.

    Article  CAS  PubMed  Google Scholar 

  • Grau Carmona T, Lopez Martinez J, Vila Garcia B, Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE). Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the spanish society of intensive care medicine and coronary units-spanish society of parenteral and enteral nutrition (SEMICYUC-SENPE): respiratory failure. [Recomendaciones para el soporte nutricional y metabolico especializado del paciente critico. Actualizacion. Consenso SEMICYUC-SENPE: insuficiencia respiratoria]. Med Intens/Sociedad Espanola De Medicina Intensiva y Unidades Coronarias. 2011;35 Suppl 1:38–41.

    Article  Google Scholar 

  • Haugen HA, Chan LN, Li F. Indirect calorimetry: a practical guide for clinicians. Nutr Clin Pract. 2007;22(4):377–88.

    Article  PubMed  Google Scholar 

  • Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011;15(6):R268.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jeng L, Yamshchikov AV, Judd SE, Blumberg HM, Martin GS, Ziegler TR, et al. Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis. J Transl Med. 2009;7(1):28.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnson ER, Matthay MA. Acute lung injury: epidemiology, pathogenesis, and treatment. J Aerosol Med Pulm Drug Deliv. 2010;23(4):243–52.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kostopanagiotou G, Kalimeris K, Arkadopoulos N, Karakitsos P, Smyrniotis V, Pandazi A. Role of lipid emulsion administration in acute lung injury during liver transplant rejection: a case report. Transplant Proc. 2008;40(10):3823–5.

    Article  CAS  PubMed  Google Scholar 

  • Krzak A, Pleva M, Napolitano LM. Nutrition therapy for ALI and ARDS. Crit Care Clin. 2011;27(3):647–59.

    Article  PubMed  Google Scholar 

  • Landbo C, Prescott E, Lange P, Vestbo J, Almdal TP. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;160(6):1856–61.

    Article  CAS  PubMed  Google Scholar 

  • Leder SB, Cohn SM, Moller BA. Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients. Dysphagia. 1998;13(4):208–12.

    Article  CAS  PubMed  Google Scholar 

  • Lev S, Singer P. N-3 fatty acids and gamma-linolenic acid supplementation in the nutritional support of ventilated patients with acute lung injury or acute respiratory distress syndrome. World Rev Nutr Diet. 2013;105:136–43.

    Article  PubMed  Google Scholar 

  • Lyons KA, Brilli RJ, Wieman RA, Jacobs BR. Continuation of transpyloric feeding during weaning of mechanical ventilation and tracheal extubation in children: a randomized controlled trial. JPEN J Parenter Enteral Nutr. 2002;26(3):209–13.

    Article  PubMed  Google Scholar 

  • Mackenzie S, Zygun D, Whitmore B, Doig CJ, Hameed SM. Implementation of a nutrition support protocol increases the proportion of mechanically ventilated patients reaching enteral nutrition targets in the adult intensive care unit. J Parenter Enteral Nutr. 2005;29(2):74–80.

    Article  Google Scholar 

  • McClave S, Parrish C. Checking gastric residuals volumes. Nutr Iss Gastroenterol. 2008;67:46.

    Google Scholar 

  • McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009;33(3):277–316.

    Article  PubMed  Google Scholar 

  • McClintock D, Zhuo H, Wickersham N, Matthay MA, Ware LB. Biomarkers of inflammation, coagulation and fibrinolysis predict mortality in acute lung injury. Crit Care. 2008;12(2):R41.

    Article  PubMed  PubMed Central  Google Scholar 

  • McElroy LM, Codner PA, Brasel KJ. A pilot study to explore the safety of perioperative postpyloric enteral nutrition. Nutr Clin Pract. 2012;27(6):777–80.

    Article  PubMed  Google Scholar 

  • Meduri GU, Headley S, Kohler G, Stentz F, Tolley E, Umberger R, et al. Persistent elevation of inflammatory cytokines predicts a poor outcome in ARDS. plasma IL-1 beta and IL-6 levels are consistent and efficient predictors of outcome over time. Chest. 1995;107(4):1062–73.

    Article  CAS  PubMed  Google Scholar 

  • Mizock B. Nutritional support in acute lung injury and acute respiratory distress syndrome. Nutr Clin Pract. 2001;16(6):319–28.

    Article  Google Scholar 

  • Montejo JC et al. Gastric residual volume during the enteral nutrition in ICU patients: the REGANE study. Intensive Care Med. 2010;36:1386–93.

    Article  CAS  PubMed  Google Scholar 

  • Nutrition care manual. Retrieved 23 April 2013 from www.nutritioncaremanual.org

  • Pacht ER, DeMichele SJ, Nelson JL, Hart J, Wennberg AK, Gadek JE. Enteral nutrition with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants reduces alveolar inflammatory mediators and protein influx in patients with acute respiratory distress syndrome. Crit Care Med. 2003;31(2):491–500.

    Article  CAS  PubMed  Google Scholar 

  • Parsons PE, Eisner MD, Thompson BT, Matthay MA, Ancukiewicz M, Bernard GR, et al. Lower tidal volume ventilation and plasma cytokine markers of inflammation in patients with acute lung injury. Crit Care Med. 2005;33(1):1–6. discussion 230–2.

    Article  CAS  PubMed  Google Scholar 

  • Plurad D, Green D, Inaba K, Belzberg H, Demetriades D, Rhee P. A 6-year review of total parenteral nutrition use and association with late-onset acute respiratory distress syndrome among ventilated trauma victims. Injury. 2009;40(5):511–15.

    Article  PubMed  Google Scholar 

  • Pontes-Arruda A, Aragao AM, Albuquerque JD. Effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock. Crit Care Med. 2006;34(9):2325–33.

    Article  CAS  PubMed  Google Scholar 

  • Pontes-Arruda A, Demichele S, Seth A, Singer P. The use of an inflammation-modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta-analysis of outcome data. JPEN J Parenter Enteral Nutr. 2008;32(6):596–605.

    Article  CAS  PubMed  Google Scholar 

  • Prabhakaran P, Ware LB, White KE, Cross MT, Matthay MA, Olman MA. Elevated levels of plasminogen activator inhibitor-1 in pulmonary edema fluid are associated with mortality in acute lung injury. Am J Physiol Lung Cell Mol Physiol. 2003;285(1):L20–8.

    Article  CAS  PubMed  Google Scholar 

  • Prescott E, Almdal T, Mikkelsen KL, Tofteng CL, Vestbo J, Lange P. Prognostic value of weight change in chronic obstructive pulmonary disease: results from the copenhagen city heart study. Euro Respir J. 2002;20(3):539–44.

    Article  CAS  Google Scholar 

  • Raguso CA, Dupertuis YM, Pichard C. The role of visceral proteins in the nutritional assessment of intensive care unit patients. Curr Opin Clin Nutr Metab Care. 2003;6(2):211–16.

    Article  CAS  PubMed  Google Scholar 

  • Rice TW, Wheeler AP, Thompson BT, deBoisblanc BP, Steingrub J, Rock P. Enteral omega-3 fatty acid, gamma-linolenic acid, and antioxidant supplementation in acute lung injury. JAMA. 2011;306(14):1574–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Savalle M, Gillaizeau F, Maruani G, Puymirat E, Bellenfant F, Houillier P, et al. Assessment of body cell mass at bedside in critically ill patients. Am J Physiol Endocrinol Metab. 2012;303(3):E389–96.

    Article  CAS  PubMed  Google Scholar 

  • Schols AM, Broekhuizen R, Weling-Scheepers CA, Wouters EF. Body composition and mortality in chronic obstructive pulmonary disease. Am J Clin Nutr. 2005;82(1):53–9.

    CAS  PubMed  Google Scholar 

  • Singer P, Theilla M, Fisher H, Gibstein L, Grozovski E, Cohen J. Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury. Crit Care Med. 2006;34(4):1033–8.

    Article  CAS  PubMed  Google Scholar 

  • Soguel L, Revelly JP, Schaller MD, Longchamp C, Berger MM. Energy deficit and length of hospital stay can be reduced by a two-step quality improvement of nutrition therapy: the intensive care unit dietitian can make the difference. Crit Care Med. 2012;40(2):412–19.

    Article  PubMed  Google Scholar 

  • Solomon SM, Kirby DF. The refeeding syndrome: a review. JPEN J Parenter Enteral Nutr. 1990;14(1):90–7.

    Article  CAS  PubMed  Google Scholar 

  • Stapleton RD, Dixon AE, Parsons PE, Ware LB, Suratt BT. The association between BMI and plasma cytokine levels in patients with acute lung injury. Chest. 2010;138(3):568–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Stapleton RD, Martin TR, Weiss NS, Crowley JJ, Gundel SJ, Nathens AB, et al. A phase II randomized placebo-controlled trial of omega-3 fatty acids for the treatment of acute lung injury. Crit Care Med. 2011;39(7):1655–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Turner KL, Moore FA, Martindale R. Nutrition support for the acute lung injury/adult respiratory distress syndrome patient: a review. Nutr Clin Pract. 2011;26(1):14–25.

    Article  PubMed  Google Scholar 

  • Vestbo J. Clinical assessment, staging, and epidemiology of chronic obstructive pulmonary disease exacerbations. Proc Am Thorac Soc. 2006;3(3):252–6.

    Article  PubMed  Google Scholar 

  • Villet S, Chiolero RL, Bollmann MD, Revelly JP, Cayeux RNMC, Delarue J. Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr. 2005;24(4):502–9.

    Article  PubMed  Google Scholar 

  • Wang G, Lai X, Yu X, Wang D, Xu X. Altered levels of trace elements in acute lung injury after severe trauma. Biol Trace Elem Res. 2012;147(1–3):28–35.

    Article  CAS  PubMed  Google Scholar 

  • Ware LB, Fang X, Matthay MA. Protein C and thrombomodulin in human acute lung injury. Am J Physiol Lung Cell Mol Physiol. 2003;285(3):L514–21.

    Article  CAS  PubMed  Google Scholar 

  • Ware LB, Matthay MA, Parsons PE, Thompson BT, Januzzi JL, Eisner MD, et al. Pathogenetic and prognostic significance of altered coagulation and fibrinolysis in acute lung injury/acute respiratory distress syndrome. Crit Care Med. 2007;35(8):1821–8.

    PubMed  PubMed Central  Google Scholar 

  • Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109(1–2):1–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wijnhoven HA, Schilp J, van Bokhorst-de van der Schueren MA, de Vet HC, Kruizenga HM, Deeg DJ, et al. Development and validation of criteria for determining undernutrition in community-dwelling older men and women: the short nutritional assessment questionnaire 65+. Clin Nutr. 2012;31(3):351–8.

    Article  PubMed  Google Scholar 

  • Wooley JA, Sax HC. Indirect calorimetry: applications to practice. Nutr Clin Pract. 2003;18(5):434–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. School of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Corrine Hanson

  2. Program Development Center, Centre of Expertise for Chronic Organ Failure, 4080, Horn, The Netherlands

    Eric P. A. Rutten

  3. Memorial Medical Center, 701 N. First St, Springfield, IL, 62563, USA

    Christina Rollins

  4. Thomas Jefferson University Hospital, Willow Grove, PA, 19107, USA

    Stephanie Dobak

Authors
  1. Corrine Hanson
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  2. Eric P. A. Rutten
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  3. Christina Rollins
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  4. Stephanie Dobak
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Corresponding author

Correspondence to Corrine Hanson .

Editor information

Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Hanson, C., Rutten, E.P.A., Rollins, C., Dobak, S. (2015). Nutrition and Acute Lung Injury in Critical Care: Focus on Nutrition Care Process. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_34

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_34

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