2025 Multiprofessional Critical Care Review: Adult Online-Nutrition Support in the ICU

Video Transcription

Video Summary

This lecture discusses nutritional management during critical illness, emphasizing the gut’s central role in immune function and metabolism. In the acute phase, patients are hypermetabolic with gut dysfunction and disrupted microbiota within 48 hours, leading to risks like bacterial translocation and organ failure. Early enteral nutrition (EN) is preferred over parenteral but should start slowly at trophic rates to protect gut integrity and avoid overfeeding, which can cause harm. Nutritional risk is assessed using validated tools like the modified nutrition risk score and malnutrition criteria. Refeeding syndrome is a key concern, requiring electrolyte monitoring. Studies show no mortality benefit with early full feeding; lower calorie and protein provision reduces complications and improves tolerance. Nutrition should be progressively increased as patients recover. Parenteral nutrition is reserved for failed EN, but small amounts of EN should continue to maintain gut function. The importance of individualized assessment, monitoring tolerance, and adjusting nutrition with clinical recovery is stressed throughout.

Keywords

nutritional management

critical illness

gut integrity

early enteral nutrition

refeeding syndrome

nutrition risk assessment

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