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Enternal and Parenteral Nutrition in the Critical Care Setting Essay

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Enteral and Parenteral Nutrition in the Critical Care Setting
Management of patient nutrition has long been a topic of controversy. Questing of timing, route of administration and composition of feeding solution constituents are several variables that share a lack of consensus.
     There is a 50% rate of malnutrition cited in hospitalized patients.
     Many states associated with critical care admissions have altered metabolic rates. Some examples of increased catabolism are multiple injury trauma, sepsis, organ failure (CHF, ARF, RF), and ventilator dependent status. It is important to assess for a history of such hyper- or altered metabolic states like Diabetes Melitus, Alcoholism, Renal Failure, and COPD.
     Over feeding is associated with: immunosuppression, hyperglycemia, liver dysfunction and refeeding syndrome.



Enteral     No associated immune suppression, no associated infection complications, easier to maintain electrolyte balance.

Parenteral     Immune suppression (the converse is also true- malnutrition also causes immune suppression), fatty liver, potential for pneumothorax, line infections, loss of gut barrier, hyperosmolality, refeeding syndrome

Feeding tubes – great option, if the gut works, use it.


Prealbumin (2-3 day t1/2)
Transferrin (8-10 day t1/2)
Albumin (14-20 day t1/2)

Nitrogen balance studies can aid in the clinica...


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