Why is hypocaloric feeding better- Casear
Doesn’t kill nor saves lives
May avoid infections and enhance recovery
Doesn’t compromise recovery
Reduction of ICU acquired weakness
Early nutrient restriction and hypocalorific feeding are harmless and may enhance recovery
Early nutrient restriction avoids early suppression of autophagy in skeletal muscle
The optimal duration of nutrient restriction and role of different macro nutrients needs to be further eleucidated
Should autophagy be respected or activated?
Feeding and Chronically Critically ill-Guttormsem
What does chronically critically ill mean:
- Presence of tracheostomy
- On ICU>7 days
- How much energy to give?
- Hypocaloric or isocalorific- different targets in different phases of the ICU/hospital stay
How much protein to give- need to see energy, protein and muscle as unity.
Is it possible to identify the critically ill patient at nutritional deficiency?
Energy demands may double in the rehabilitation phase of critical illness. They are back on the ward then.
When pt out of bed (i.e. rehabilitation phase) feed to put on weight (muscle mass)