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)
Yébenes, Juan Carlos (Hospital de Santa Caterina (Salt, Girona))
Bordeje, Mª Luisa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
López-Delgado, Juan Carlos (Hospital Clínic i Provincial de Barcelona)
Lorencio-Cardenas, Carol (Hospital Universitari de Girona Doctor Josep Trueta)
Martinez de Lagrán, Itziar (Hospital de Mataró. Consorci Sanitari del Maresme)
Navas-Moya, Elisabeth (Hospital Universitari Vall d'Hebron)
Servia Goixart, Luis (Hospital Universitari Arnau de Vilanova)

Data:	2024
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Intensive care units ; Critical illness ; Nutritional therapy ; Functional recovery
Publicat a:	Nutrients, Vol. 16 Núm. 8 (April 2024) , ISSN 2072-6643

DOI: 10.3390/nu16081157
PMID: 38674847

18 p, 802.3 KB

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