Overcoming challenges to enteral nutrition delivery in critical care.

Journal Article (Journal Article;Review)

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.

Full Text

Duke Authors

Cited Authors

  • Wischmeyer, PE

Published Date

  • April 1, 2021

Published In

Volume / Issue

  • 27 / 2

Start / End Page

  • 169 - 176

PubMed ID

  • 33395086

Pubmed Central ID

  • PMC8276753

Electronic International Standard Serial Number (EISSN)

  • 1531-7072

Digital Object Identifier (DOI)

  • 10.1097/MCC.0000000000000801


  • eng

Conference Location

  • United States