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Overcoming challenges to enteral nutrition delivery in critical care.

Publication ,  Journal Article
Wischmeyer, PE
Published in: Curr Opin Crit Care
April 1, 2021

PURPOSE OF REVIEW: Existing data and all ICU nutrition guidelines emphasize enteral nutrition (EN) represents a primary therapy leading to both nutritional and non-nutritional benefits. Unfortunately, iatrogenic malnutrition and underfeeding is virtually ubiquitous in ICUs worldwide for prolonged periods post-ICU admission. Overcoming essential challenges to EN delivery requires addressing a range of real, and frequently propagated myths regarding EN delivery. RECENT FINDINGS: Key recent data addresses perceived challenges to EN including: Adequately resuscitated patients on vasopressors can and likely should receive trophic early EN and this was recently associated with reduced mortality; Patients paralyzed with neuromuscular blocking agents can and should receive early EN as this was recently associated with reduced mortality/hospital length of stay; Proned patients can safely receive EN; All ICU nutrition delivery, including EN, should be objectively guided by indirect calorimetry (IC) measures. This is now possible with the new availability of a next-generation IC device. SUMMARY: It is the essential implementation of this new evidence occurs to overcome real and perceived EN challenges. This data should lead to increased standardization/protocolization of ICU nutrition therapy to ensure personalized nutrition care delivering the right nutrition dose, in the right patient, at the right time to optimize clinical outcome.

Duke Scholars

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Published In

Curr Opin Crit Care

DOI

EISSN

1531-7072

Publication Date

April 1, 2021

Volume

27

Issue

2

Start / End Page

169 / 176

Location

United States

Related Subject Headings

  • Nutritional Status
  • Length of Stay
  • Intensive Care Units
  • Humans
  • Enteral Nutrition
  • Emergency & Critical Care Medicine
  • Critical Illness
  • Critical Care
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Wischmeyer, P. E. (2021). Overcoming challenges to enteral nutrition delivery in critical care. Curr Opin Crit Care, 27(2), 169–176. https://doi.org/10.1097/MCC.0000000000000801
Wischmeyer, Paul E. “Overcoming challenges to enteral nutrition delivery in critical care.Curr Opin Crit Care 27, no. 2 (April 1, 2021): 169–76. https://doi.org/10.1097/MCC.0000000000000801.
Wischmeyer PE. Overcoming challenges to enteral nutrition delivery in critical care. Curr Opin Crit Care. 2021 Apr 1;27(2):169–76.
Wischmeyer, Paul E. “Overcoming challenges to enteral nutrition delivery in critical care.Curr Opin Crit Care, vol. 27, no. 2, Apr. 2021, pp. 169–76. Pubmed, doi:10.1097/MCC.0000000000000801.
Wischmeyer PE. Overcoming challenges to enteral nutrition delivery in critical care. Curr Opin Crit Care. 2021 Apr 1;27(2):169–176.

Published In

Curr Opin Crit Care

DOI

EISSN

1531-7072

Publication Date

April 1, 2021

Volume

27

Issue

2

Start / End Page

169 / 176

Location

United States

Related Subject Headings

  • Nutritional Status
  • Length of Stay
  • Intensive Care Units
  • Humans
  • Enteral Nutrition
  • Emergency & Critical Care Medicine
  • Critical Illness
  • Critical Care
  • 3202 Clinical sciences
  • 1103 Clinical Sciences