Review of evolution and current status of protein requirements and provision in acute illness and critical care
| Autor: | Reto Stocker, Julie Roth Jakubowski, Elisabeth De Waele, Paul E. Wischmeyer |
|---|---|
| Přispěvatelé: | Clinical sciences, Intensive Care |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Calorie Critical Care Critical Illness 030209 endocrinology & metabolism Parenteral Nutrition Solutions Parenteral nutrition solutions Critical Care and Intensive Care Medicine Enteral administration law.invention 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) law Protein Deficiency medicine Humans enteral nutrition Intensive care unit Medical nutrition therapy Intensive care medicine 030109 nutrition & dietetics Nutrition and Dietetics business.industry Nutritional Support Nutritional Requirements Parenteral nutrition Review article Acute Disease Dietary Proteins business protein |
| Popis: | Nutrition therapy, by enteral, parenteral, or both routes combined, is a key component of the management of critically ill, surgical, burns, and oncology patients. Established evidence indicates overfeeding (provision of excessive calories) results in increased risk of infection, morbidity, and mortality. This has led to the practice of "permissive underfeeding" of calories; however, this can often lead to inadequate provision of guideline-recommended protein intakes. Acutely ill patients requiring nutritional therapy have high protein requirements, and studies demonstrate that provision of adequate protein can result in reduced mortality and improvement in quality of life. However, a significant challenge to adequate protein delivery is the current lack of concentrated protein solutions. Patients often have fluid administration restrictions and existing protein solutions are frequently not sufficiently concentrated to deliver a patient's protein requirements. This has led to the development of new enteral and parenteral nutrition solutions incorporating higher levels of protein in smaller volumes. This review article summarizes current evidence supporting the role of higher protein intakes, especially during the early phases of nutrition therapy in acute illness, methods for assessing protein requirements, as well as, the currently available high-protein enteral and parenteral nutrition solutions. There is sufficient evidence (albeit limited from true randomized, controlled studies) to indicate that earlier provision of guideline-recommended protein intakes may be key to improving patient outcomes and that nutritional therapy that tailors caloric and protein intake to the patients' needs should be considered a desired standard of care. |
| Databáze: | OpenAIRE |
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