Enteral Nutrition in the Critically Ill Patient
Clinical factors, such as premorbid nutritional status and severity of illness, determine the overall efficacy of nutritional support. Malnutrition may be defined as â€œa disorder of body composition in which macronutrient and/or micronutrient deficiencies occur when nutrient intake is less than required.â€1 Malnutrition leads to reduced organ function, abnormal laboratory chemistry values, and poorer clinical outcome. For all hospitalized patients, the reported prevalence of malnutrition is as high as 50%. Although difficult to quantify, the incidence in intensive care unit (ICU) patients is closer to 5%. A malnourished patient is more likely to have infectious morbidity, a prolonged hospital stay, and increased mortality.2 However, not all patients in the ICU need nutritional support, and disease and nutrition exhibit complex interactions. In critical illness, malnutrition results from abnormal nutrient processing and not starvation. Each individual patient should receive a nutritional formula specific to their disease process. Keeping this in mind, it is important to provide early nutritional support during critical illness.