II. Risk Factors: ICU Malnutrition
- Prolonged ICU admission
- Intubation or Tracheostomy (may interfere with Swallowing)
- Prolonged period of poor oral intake (bowel mucosa atrophy)
- Sepsis
III. Management
- See Enteral Nutrition
- See Enteral Tube Feeding
- See Total Parenteral Nutrition (Enteral Tube Feeding is preferred)
- Early initiation of Enteral Tube Feeding is preferred (first 24-48 hours of ICU admission)
IV. Complications: ICU Malnutrition
-
Acalculous Cholecystitis
- Poor lipid intake results in bile stasis
- High mortality (up to 50%) in delayed diagnosis
-
Muscle wasting
- Total body Protein loss exceeds 2 pounds for a 3 week ICU admission
- Initial (first 10 days): Skeletal Muscle is primary source of lost Protein
- Later (after 10 days): Visceral Muscle is lost
- Plank (1998) Ann Surg 228(2): 146-58 [PubMed]
V. Resources
- Internet Book of Critical Care (EM-Crit, Farkas)
VI. References
- Marino (2014) The ICU Book, p. 859-73
- Volk (2009) Am Fam Physician 79(6): 459-64 [PubMed]