Nutrition therapy of the severely obese, critically ill patient: summation of conclusions and recommendations.

Abstract

This report compiles the conclusions and recommendations for nutrition therapy of the obese, critically ill patient derived by the group of experts participating in this workshop on obesity in critical care nutrition. The recommendations are based on consensus opinions of the group after review of the current literature. Obesity clearly adds to the complexity of nutrition therapy in the intensive care unit (ICU). Obesity alters the incidence and severity of comorbidities, tolerance of the prescribed regimen, and ultimately patient outcome through the course of hospitalization. Although the basic principles of critical care nutrition apply to the obese ICU patient, a high-protein, hypocaloric regimen should be provided to reduce the fat mass, improve insulin sensitivity, and preserve lean body mass. The ideal enteral formula should have a low nonprotein calorie to nitrogen ratio and have a variety of pharmaconutrient agents added to modulate immune responses and reduce inflammation.

• Authors: Stephen A McClave, Robert Kushner, Charles W Van Way 3rd, Matt Cave, Mark DeLegge, John Dibaise, Roland Dickerson, John Drover, Thomas H Frazier, Ken Fujioka, Dympna Gallagher, Ryan T Hurt, Lee Kaplan, Lazlo Kiraly, Robert Martindale, Craig McClain, Juan Ochoa
• Journal: JPEN. Journal of parenteral and enteral nutrition (JPEN J Parenter Enteral Nutr) Vol. 35 Issue 5 Suppl Pg. 88S-96S (Sep 2011) ISSN: 1941-2444 [Electronic] United States
• PMID: 21881019 (Publication Type: Journal Article)

Topics

• Bariatric Surgery
• Body Composition
• Body Mass Index
• Caloric Restriction
• Critical Care (methods)
• Critical Illness (therapy)
• Enteral Nutrition (methods)
• Food, Formulated
• Humans
• Intensive Care Units
• Nutrition Assessment
• Obesity (diet therapy)
• Practice Guidelines as Topic
• Risk Factors
• Treatment Outcome