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Nutritional support in critically ill patients.

Publication ,  Journal Article
Grant, JP
Published in: Ann Surg
November 1994

OBJECTIVE: The author reviews the newer nutritional substrates in use or under investigation for enteral and parenteral nutrition. Management of the critically ill patient remains a significant challenge to clinicians, and it is hoped that dietary manipulations, such as those outlined, may augment host barriers and immune function and improve survival. SUMMARY BACKGROUND DATA: The role of nutrition in patient well-being has long been recognized, but until the past 25 years, the technology to artificially provide nutrients when patients could not eat was not developed. With current, new methods for enteral and vascular access, patients can be fed nonvolitionally with little difficulty. Continued efforts have been directed toward identifying optimal feeding formulations, which have resulted in a multitude of commercially available products. In the past several years, attention has been turned to evaluation of four specialized nutrients and the use of other substrates as pharmacologic agents. METHODS: Pertinent laboratory and clinical data were reviewed to present the pros and cons for each nutritive substrate. CONCLUSIONS: Medium-chain fatty acids, branched-chain amino acids, and glutamine have been shown to be of clinical benefit and should be in common use in the near future. Short-chain fatty acids still are under investigation. Albumin, vitamins E and C, arginine, glutamine, and omega-3 fatty acids show great promise as pharmacologic agents to manipulate the stress response. Nucleotides remain investigational. CONTENTS SUMMARY: The application of some new nutritional substrates for use in critically ill patients, both as caloric sources and as pharmacologic agents, are reviewed.

Duke Scholars

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

November 1994

Volume

220

Issue

5

Start / End Page

610 / 616

Location

United States

Related Subject Headings

  • Vitamin E
  • Surgery
  • Nutritional Support
  • Nucleotides
  • Humans
  • Glutamine
  • Fatty Acids
  • Critical Illness
  • Ascorbic Acid
  • Arginine
 

Citation

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Grant, J. P. (1994). Nutritional support in critically ill patients. Ann Surg, 220(5), 610–616. https://doi.org/10.1097/00000658-199411000-00003
Grant, J. P. “Nutritional support in critically ill patients.Ann Surg 220, no. 5 (November 1994): 610–16. https://doi.org/10.1097/00000658-199411000-00003.
Grant JP. Nutritional support in critically ill patients. Ann Surg. 1994 Nov;220(5):610–6.
Grant, J. P. “Nutritional support in critically ill patients.Ann Surg, vol. 220, no. 5, Nov. 1994, pp. 610–16. Pubmed, doi:10.1097/00000658-199411000-00003.
Grant JP. Nutritional support in critically ill patients. Ann Surg. 1994 Nov;220(5):610–616.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

November 1994

Volume

220

Issue

5

Start / End Page

610 / 616

Location

United States

Related Subject Headings

  • Vitamin E
  • Surgery
  • Nutritional Support
  • Nucleotides
  • Humans
  • Glutamine
  • Fatty Acids
  • Critical Illness
  • Ascorbic Acid
  • Arginine