Nutrition In Critical Care

Provides comprehensive and practical guidance for managing the nutritional requirements of critically ill patients and thereby improving prognosis.

A complete state-of-the-art manual on nutritional support for ICU patients, the present book, written by internationally renowned specialists, addresses fundamental aspects of the pathophysiological response to injury as well as practical issues of nutritional care. New features include an analysis of gene polymorphism and its possible consequences for the survival of traumatized patients. A better understanding of this process could become a basis for defining new nutritional strategies. Hence the discussion on indications for immune-enhancing diets. Of special interest is the research on copathologies (i.e. obesity) which can change the prognosis of ICU patients who thus require specific nutritional support. Entirely new is the merging of the recommendations of international and national societies (e.g. ASPEN, ESPEN), first realized for this publication. This book is a basic tool for any professional in the field of nutritional care for ICU patients: intensivists, surgeons, pharmacists, dieticians, and PhD students.

Deals with nutritional support of critically ill patients. Discusses nutritional assessment, fuel metabolism, and macronutrient (protein, fat, carbohydrate, nucleic acid, mineral) and micronutrient (vitamins, trace element) metabolism. Discusses the route and timing of nutritional support, enteral feeding, parenteral nutrition, wound healing, inflammatory mediators, immunity, the gut barrier, bacterial translocation, and use of growth factors. Also discusses nutritional support of common disease states treated in critical care units, such as trauma, neuroinjury, sepsis, burns, gastrointestinal disease, respiratory and heart failure, renal failure, liver failure, AIDS, and diabetes mellitus.

Finding all the information necessary to treat or meet the nutritional requirements of patients who are severely ill or establish new protocols has historically been problematic. This is addressed in Diet and Nutrition in Critical Care. This major reference work encapsulates the latest treatments and procedures to meet the dietary and nutritional needs of the critically ill. Where evidence is available this is presented. However, where evidence is absent, the authors highlight this and provide guidance based on their analysis of other available data and their clinical experience. Diet and Nutrition in Critical Care is a three volume set which addresses the needs of all those concerned with diet and nutrition in the critically ill and covers General Aspects, Enteral Aspects, and Parenteral Aspects. Each volume is stand alone and is further divided into separate sections. The Sections in the General Aspects are: General conditions in the severely ill General metabolic effects and treatments Assessment protocols General nutritional aspects Specific nutrients Adverse aspects The next two volumes Enteral Aspects and Parenteral Aspects contain the following sections: General aspects and methods Specific nutrients Specific conditions Adverse aspects and outcomes Comparisons or dual parenteral and enteral support or transitions Preclinical studies The authors recognise the limitations in simplistic divisions and there is always difficulty in categorising treatment regimens. For example, some regimens involve transitions from one feeding protocol to another or the development of co-morbid conditions and in some cases enteral support may be supplemented with parenteral support. This complexity however, is addressed by the excellent indexing system. Contributors are authors of international and national standing, leaders in the field and trendsetters. Emerging fields of science and important discoveries relating to artificial support will also be incorporated into Diet and Nutrition in Critical Care. This volume represents a one stop shop of material related to enteral and parenteral support and is essential reading for those specialising in intensive and critical care, dietitians, nutritionists, gastroenterologists, cardiologists, pharmacologists, health care professionals, research scientists, molecular or cellular biochemists, general practitioners as well as those interested in diet and nutrition in general.

Reaching beyond traditional nutrition support The care of ICU patients has seen many improvements over the years, both with regard to technical aspects and supportive measures. The first part of this book analyzes nutritional support at various levels, ranging from the cell level to the whole-body aspect; drawing on recent prospective randomized studies, the authors propose a new approach for oral, enteral and/or parenteral nutrition. The second part underlines the interference between nutrition and outcome to reach recovery, giving to this field an increased importance for better short and long term management: The best glucose control, individualized nutritional support and the avoidance of harmful interferences is extensively discussed. The final part deals with patients suffering from multi-organ failure and the need for a better understanding of the interactions between disease and nutrition. Identification of the metabolic condition of the patient, existence or not of evidence-based medicine, expert opinion, treatment opportunities and the case manager recognizing threats are all integrated to reach the appropriate decision. This last part will help the reader to untangle the complexity of the ICU patient of the 21st century and to propose a personalized nutritional support process.

This book offers a pragmatic approach to day-to-day metabolic and nutritional care based on physiological considerations. Due to the numerous controversial trials published in the last 15 years, there is no clear guidance for intensive care physicians regarding the metabolic and nutritional management of patients. This has resulted in a return to underfeeding and related complications in most ICUs worldwide as shown by the latest Nutrition Day data. Using a structured, logical approach, the book examines practical solutions for artificial feeding in complex areas of critical care (brain injuries, burns, cardiac failure, ECMO, intestinal failure, long term patient, renal failure, metabolic diseases, obesity, old patients) and discusses measurement of the results of metabolic interventions. It also includes dedicated chapters focusing on specific problems, in order to avoid complications. Critical Care Nutrition Therapy for Non-nutritionists is a valuable resource for all general ICUs and ICU subspecialties such as cardiovascular, neuro, gastrointestinal and burns ICUs.

Nutrition is an important aspect of care for any patient entering the hospital, but the patient admitted to the intensive care unit (ICU) is at an even higher risk for nutritional compromise. Nutrition affects all ages, from the neonate to the geriatric patient, and all patient populations. Evidence-based practice guidelines regarding appropriate nutritional support within the critical care setting are published. Yet, researchers continue to identify that despite published evidence, countless ICU patients continue to lack adequate and timely nutritional support on admission. Each of the authors in this issue promotes nutrition in their careers and individual practice areas, which brings knowledge from many different arenas throughout the nation. This issue discusses nutrition throughout the lifespan, special patient populations, implementation of guidelines, and how nutrition is being utilized as medical therapy.