Mitochondrial Dysfunction in Critical Illness: Implications for Nutritional Therapy.
Journal Article (Journal Article;Review)
PURPOSE OF THE REVIEW: This paper will review the evidence for mitochondrial dysfunction in critical illness, describe the mechanisms which lead to multiple organ failure, and detail the implications of this pathophysiologic process on nutritional therapy. RECENT FINDINGS: Mitochondria are particularly sensitive to increased oxidative stress in critical illness. The functional and structural abnormalities which occur in this organelle contribute further to the excessive production of reactive oxygen species and the reduction in generation of adenosine triphosphate (ATP). To reduce metabolic demand, mitochondrial dysfunction develops (a process likened to hibernation), which helps sustain the life of the cell at a cost of organ system failure. Aggressive feeding in the early phases of critical illness might inappropriately increase demand at a time when ATP production is limited, further jeopardizing cell survival and potentiating the processes leading to multiple organ failure. Several potential therapies exist which would promote mitochondrial function in the intensive care setting through support of autophagy, antioxidant defense systems, and the biogenesis and recovery of the organelle itself. Nutritional therapy should supplement micronutrients required in the mitochondrial metabolic pathways and provide reduced delivery of macronutrients through slower advancement of feeding in the early phases of critical illness. A better understanding of mitochondrial dysfunction in the critically ill patient should lead to more innovative therapies in the future.
Full Text
Duke Authors
Cited Authors
- McClave, SA; Wischmeyer, PE; Miller, KR; van Zanten, ARH
Published Date
- December 2019
Published In
Volume / Issue
- 8 / 4
Start / End Page
- 363 - 373
PubMed ID
- 31713718
Electronic International Standard Serial Number (EISSN)
- 2161-3311
Digital Object Identifier (DOI)
- 10.1007/s13668-019-00296-y
Language
- eng
Conference Location
- United States