Nutritional support in the acute phase of critical illness—how to break the dilemma
1Medical School of Nanjing University, 210011 Nanjing, Jiangsu, China
2Department of Critical Care Medicine, the Affiliated Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, Jiangsu, China
DOI: 10.22514/sv.2022.026 Vol.19,Issue 1,January 2023 pp.9-14
Submitted: 24 July 2021 Accepted: 08 September 2021
Published: 08 January 2023
Overfeeding caused by the inaccurate estimation of energy might be one of the most important reasons leading to unsatisfactory outcomes of nutritional support, especially for Parental Nutrition (PN). The current method of determining calorie needs by energy expenditure (EE), either measured by indirect calorimetry (IC) or equations, might not accurately represent the actual energy requirements of critically ill patients, especially in the acute phase. Nutrition protocols based on the measurement of time might not be effective. Research on the real-time metabolic status and the actual energy requirements of the patients, as well as more individualized nutrition therapy, is required. Central regulation, especially those involving hypothalamic pathways, is an effective solution for the current dilemma.
Nutrition; Critical illness; Energy requirement; Hypothalamic, Central regulation
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