Nutrition Part I
Part 1: Nutritional assessments
Summary
In addition to the high prevalence of malnutrition in patients admitted to intensive care units, critical illness further increases the risk and severity of malnutrition., The breakdown of muscle proteins and lipolysis are undesired components of the stress response and cannot be inhibited during the acute phase of critical illness. If left uncontrolled, the long-term consequences include a high rate of disability, functional impairment, and healthcare-related costs. Appropriate provision of energy substrates, proteins and micronutrients (vitamins and trace elements) is required during the rehabilitation process, together with physical activity. In addition, during the acute phase (3-7 days after injury), enteral nutrition support has an important trophic role for the gastrointestinal tract. Recent findings suggest that a high intake of macronutrients during the acute phase may have detrimental effects. Guidelines are currently being worked out to translate the recent data into recommendations for clinical practice.
General Information
Enrolled trainees 2292
Open 28.05.2019
Available for ESICM members
Student effort 3
Last Updated May 13, 2024
Intended Learning Outcomes
- Describe the metabolic response to critical illness
- Outline essentials of feeding during the different phase of critical illness
- Describe how to assess malnutrition in critically ill patients
- Outline the clinical markers for nutritional status and their limitations in clinical use.
- Outline the biochemical markers for nutritional status and their limitations in clinical use.
Relevant competencies in CoBaTrICE
- 1.1 Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology
- 1.4 Triages and prioritises patients appropriately, including timely admission to ICU
- 2.1 Obtains a history and performs an accurate clinical examination
- 2.2 Undertakes timely and appropriate investigations
- 2.9 Monitors and responds to trends in physiological variables
- 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis
- 3.7 Recognises and manages the patient with acute gastrointestinal failure
- 4.8 Recognises and manages electrolyte, glucose and acid-base disturbances
- 4.9 Co-ordinates and provides nutritional assessment and support
- 11.6 Critically appraises and applies guidelines, protocols and care bundles
- 11.7 Describes commonly used scoring systems for assessment of severity of illness, case mix and workload
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