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Energy, Protein, Carbohydrate, and Lipid Intakes and Their Effects on Morbidity and Mortality in Critically Ill Adult Patients: A Systematic Review
A. Patkova, V. Joskova, E. Havel, M. Kovarik, M. Kucharova, Z. Zadak, M. Hronek,
Language English Country United States
Document type Journal Article, Review
NLK
Free Medical Journals
from 2010 to 1 year ago
PubMed Central
from 2010
Europe PubMed Central
from 2010 to 1 year ago
Open Access Digital Library
from 2010-11-01
ROAD: Directory of Open Access Scholarly Resources
from 2010
PubMed
28710148
DOI
10.3945/an.117.015172
Knihovny.cz E-resources
- MeSH
- Dietary Proteins administration & dosage MeSH
- Dietary Carbohydrates administration & dosage MeSH
- Dietary Fats administration & dosage MeSH
- Adult MeSH
- Energy Metabolism MeSH
- Energy Intake * MeSH
- Enteral Nutrition MeSH
- Insulin blood MeSH
- Intensive Care Units MeSH
- Blood Glucose metabolism MeSH
- Critical Illness epidemiology therapy MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Morbidity MeSH
- Mortality MeSH
- Nutritional Requirements MeSH
- Parenteral Nutrition MeSH
- Observational Studies as Topic MeSH
- Randomized Controlled Trials as Topic MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality. Enteral nutrition (EN) is generally recommended over parenteral nutrition (PN) and is beneficial when administered within 24-48 h after ICU admission. In contrast, early PN does not provide substantial advantages in terms of morbidity and mortality, and the time when it is safe and beneficial remains unclear. The most advantageous recommendation seems to be administration of a hypocaloric (<20 kcal · kg-1 · d-1), high-protein diet (amino acids at doses of ≥2 g · kg-1 · d-1), at least during the first week of critical illness. Another important factor for reducing morbidity is the maintenance of blood glucose concentrations at 120-150 mg/dL, which is accomplished with the use of insulin and lower doses of glucose of 1-2 g · kg-1 · d-1, because this prevents the risk of hypoglycemia and is associated with a better prognosis according to recent studies. A fat emulsion is used as a source of required calories because of insulin resistance in the majority of patients. In addition, lipid oxidation in these patients is ∼25% higher than in healthy subjects.
Departments of Biological and Medical Sciences and Departments of Research and Development and
Departments of Research and Development and
Surgery University Hospital Hradec Kralove Hradec Kralove Czech Republic
References provided by Crossref.org
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