Nutrition Part III
Part 3: Enteral Nutritional
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 first 3-4 days may have detrimental effects due to metabolic overload and intestinal fragility. Guidelines have been recently worked out to translate the recent data into recommendations for clinical practice.
General Information
Enrolled trainees 1678
Open 28.05.2019
Available for ESICM members
Student effort 2
Last Updated May 13, 2024
Intended Learning Outcomes
After studying this module on Enteral Nutritional you should be able to:
- Describe the indications for enteral nutrition
- Outline essentials of enteral nutrition prescription
- Describe the advantages and disadvantages of enteral nutrition
- Describe indications and contra-indications for the percutaneous route
- Discuss the evidence for early enteral feeding
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
- 2.2 Undertakes timely and appropriate investigations
- 2.8 Liaises with radiologists to organise and interpret clinical imaging
- 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
- 4.1 Prescribes drugs and therapies safely
- 4.8 Recognises and manages electrolyte, glucose and acid-base disturbances
- 4.9 Co-ordinates and provides nutritional assessment and support
- 7.1 Identifies and attempts to minimise the physical and psychosocial consequences of critical illness for patients and families
- 11.4 Identifies and minimises risk of critical incidents and adverse events, including complications of critical illness
- 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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