Critical care nutrition

• October 26, 2023
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Patients in the intensive care unit (ICU) are at increased risk of malnutrition, and few can feed themselves. Route, timing, rate, and formulation of nutritional support are important to consider. Enteral nutrition, via a tube directly into the gastrointestinal tract, is the mainstay of nutritional support. Parenteral nutrition, delivered intravenously via peripheral or central vein, is an option for patients unable to be fed enterally. Patients in the ICU are at increased risk for stress ulcers. Risk factors include shock, sepsis, and mechanical ventilation. To prevent stress-related gastrointestinal bleeding, patients are frequently started on prophylactic acid suppressive medications. In a 2018 study, regular pantoprazole use was not associated with a benefit in 30-day mortality. However, pantoprazole did reduce GI bleeding and therefore, should be used in high-risk patients.

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