c9942808514418ea212c0aa458ad8e97 nutrients-16-01157.pdf 0db18606596e94cab7245492f3c07f0b3c70354c nutrients-16-01157.pdf a0438bccc5a6f2991ccc6787a4b71483067eb8331c6e4fc5eda7319018c50ba7 nutrients-16-01157.pdf Title: Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients—Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC) Subject: Adequate medical nutrition therapy for critically ill patients has an impact on their prognoses. However, it requires an individualized approach that takes into account the activity (phases of metabolic stress) and particularity of these patients. We propose a comprehensive strategy considering the patients’ nutritional status and the set of modifiable circumstances in these patients, in order to optimize/support nutritional efficiency: (1) A detailed anamnesis and an adequate initial nutritional assessment must be performed in order to implement medical nutrition therapy that is in line with the needs and characteristics of each patient. Furthermore, risks associated with refeeding syndrome, nutritrauma or gastrointestinal dysfunction must be considered and prevented. (2) A safe transition between nutrition therapy routes and between health care units will greatly contribute to recovery. The main objective is to preserve lean mass in critically ill patients, considering metabolic factors, adequate protein intake and muscle stimulation. (3) Continuous monitoring is required for the successful implementation of any health strategy. We lack precise tools for calculating nutritional efficiency in critically ill patients, therefore thorough monitoring of the process is essential. (4) The medical nutrition approach in critically ill patients is multidisciplinary and requires the participation of the entire team involved. A comprehensive strategy such as this can make a significant difference in the functional recovery of critically ill patients, but leaders must be identified to promote training, evaluation, analysis and feedback as essential components of its implementation, and to coordinate this process with the recognition of hospital management. Keywords: intensive care units; critical illness; nutritional therapy; functional recovery Author: Juan Carlos Yébenes, Maria Luisa Bordeje-Laguna, Juan Carlos Lopez-Delgado, Carol Lorencio-Cardenas, Itziar Martinez De Lagran Zurbano, Elisabeth Navas-Moya and Lluis Servia-Goixart Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Sat Apr 13 10:42:53 2024 CEST ModDate: Sat Apr 13 10:46:11 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 821578 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- BTFGED+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 VMMCCF+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 DOYFQB+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 YLWYSI+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 IYDCBB+VnURWPalladioL Type 1 Custom yes yes yes 32 0 HGMNRX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 UIEKTG+CMSY10 Type 1 Builtin yes yes yes 65 0 MLIBBG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 98 0 MLIBBH+PalatinoLinotype CID TrueType Identity-H yes yes yes 101 0 MLIBBI+PalatinoLinotype TrueType WinAnsi yes yes no 107 0 MLIBBK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 110 0 MLIBGJ+PalatinoLinotype TrueType MacRoman yes yes no 113 0 QDCWHF+EURM10 Type 1 Builtin yes yes yes 138 0 MLIBBG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 172 0 MLIBBH+PalatinoLinotype CID TrueType Identity-H yes yes yes 175 0 MLIBBI+PalatinoLinotype TrueType WinAnsi yes yes no 181 0 MLIBBK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 184 0 MLIBGJ+PalatinoLinotype TrueType MacRoman yes yes no 187 0 RYVCUX+VnURWPalladioL-Italic Type 1 Custom yes yes yes 204 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-06-21 02:43:38 CEST RepresentationInformation: nutrients-16-01157.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-06-20 18:16:59 CEST Size: 821578 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 424 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methodology Destination: section.2 Item: Title: Conference Sections Destination: section.3 Children: Item: Title: Exit Phase of the Critical Situation Destination: subsection.3.1 Item: Title: Suitable Quantity and Quality of Protein-Energy Intake Destination: subsection.3.2 Item: Title: Muscle Stimulation Destination: subsection.3.3 Item: Title: Concluding Remarks Destination: section.4 Item: Title: References Destination: section.5 Info: Title: Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC) Author: Juan Carlos Yébenes, Maria Luisa Bordeje-Laguna, Juan Carlos Lopez-Delgado, Carol Lorencio-Cardenas, Itziar Martinez De Lagran Zurbano, Elisabeth Navas-Moya and Lluis Servia-Goixart Subject: Adequate medical nutrition therapy for critically ill patients has an impact on their prognoses. However, it requires an individualized approach that takes into account the activity (phases of metabolic stress) and particularity of these patients. We propose a comprehensive strategy considering the patients’ nutritional status and the set of modifiable circumstances in these patients, in order to optimize/support nutritional efficiency: (1) A detailed anamnesis and an adequate initial nutritional assessment must be performed in order to implement medical nutrition therapy that is in line with the needs and characteristics of each patient. Furthermore, risks associated with refeeding syndrome, nutritrauma or gastrointestinal dysfunction must be considered and prevented. (2) A safe transition between nutrition therapy routes and between health care units will greatly contribute to recovery. The main objective is to preserve lean mass in critically ill patients, considering metabolic factors, adequate protein intake and muscle stimulation. (3) Continuous monitoring is required for the successful implementation of any health strategy. We lack precise tools for calculating nutritional efficiency in critically ill patients, therefore thorough monitoring of the process is essential. (4) The medical nutrition approach in critically ill patients is multidisciplinary and requires the participation of the entire team involved. A comprehensive strategy such as this can make a significant difference in the functional recovery of critically ill patients, but leaders must be identified to promote training, evaluation, analysis and feedback as essential components of its implementation, and to coordinate this process with the recognition of hospital management. 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