Nutrition Delivery in Critically Ill Patients

This chapter discusses the importance of medical nutrition therapy in critically ill patients in the ICU. The goals of nutrition in the ICU include preserving lean body mass, maintaining immune function, and avoiding metabolic complications. The chapter also covers topics such as nutrition assessment, assessment of energy expenditure, starting enteral nutrition, dosing and monitoring of tolerance and adequacy of EN, selection of appropriate EN, indications of parenteral nutrition, diet formulation in special medical conditions, impact of nutrition on fluid therapy and accumulation, and introduction of nutrition stewardship. The take-home messages emphasize the importance of early enteral nutrition, tailoring feeding to the patient’s requirements and tolerance, and avoiding calorie deficits. The chapter concludes by encouraging the implementation of nutrition stewardship to optimize patient outcomes, taking into account the 4 D’s of nutrition therapy: drug, dose, duration, and de-escalation.