Controversies and Misconceptions in Intensive Care Unit Nutrition

Michael H Hooper; Paul E Marik

doi:10.1016/j.ccm.2015.05.013

Controversies and Misconceptions in Intensive Care Unit Nutrition

Clin Chest Med. 2015 Sep;36(3):409-18. doi: 10.1016/j.ccm.2015.05.013. Epub 2015 Jul 9.

Authors

Michael H Hooper¹, Paul E Marik²

Affiliations

¹ Eastern Virginia Medical School, Department of Internal Medicine, 825 Fairfax Avenue, Suite 410, Norfolk, VA 23507, USA. Electronic address: hoopermh@evms.edu.
² Eastern Virginia Medical School, Department of Internal Medicine, 825 Fairfax Avenue, Suite 410, Norfolk, VA 23507, USA.

PMID: 26304278
DOI: 10.1016/j.ccm.2015.05.013

Abstract

The early initiation of enteral nutrition remains a fundamental component of the management of critically ill and injured patients in the intensive care unit. Trophic feeding is equivalent, if not superior, to full-dose feeding. Parenteral nutrition has no proved benefit over enteral nutrition, which is the preferred route of nutritional support in intensive care unit patients with a functional gastrointestinal tract. Continuous enteral and parental nutrition inhibits the release of important enterohormones. These changes are reversed with intermittent bolus feeding. Whey protein, which is high in leucine, has a greater effect on insulin release and protein synthesis than does a soy- or casein-based enteral formula.

Keywords: Critical care nutrition; Enteral nutrition; ICU nutrition; Nutrition; Parenteral nutrition; Trophic feeding.

Publication types

Review

MeSH terms

Humans
Intensive Care Units / organization & administration*
Parenteral Nutrition / methods*