This text provides a review of the current knowledge in both the mechanics of nourishing the critically ill and the metabolic and immunological roles nutrients play. In-depth chapters discuss disease-related malnutrition as distinct from under-or-over nourishment and the impact of nourishment in either form of malnutrition. The appropriate timing and indications for nutrition support are provided as well as advanced techniques for improving practice. A broad range of issues related to interdisciplinary practice are addressed. Useful for a wide variety of practitioners, including ICU doctors, hospitalists, and nutrition support physicians, Nutrition Support of the Critically Ill provides practical bedside advice and simplified recommendations for practice.

Reviews the current literature to define the bases for current practices Identifies areas of current controversy and uncertainty Provides practical bedside advice for the practitioner Recommendations for practice are provided in each chapter Written by experts in the field

Autorentext

Dr. Seres is the Director of Medical Nutrition at Columbia University Medical Center. He is one of the few physicians in the country with a primary focus on hospital based nutrition. He supervises the hospital programs in total parenteral nutrition, manages much of the hospital supplementary enteral nutrition, and provides consultation on feeding issues and malnutrition. Dr. Van Way s activities have centered around hemorrhagic shock, and to exploring the basic mechanisms of cell injury during hemorrhagic shock and resuscitation, and to identify changes which produce long-term damage. In the past several years, his research team has carried out basic and clinical studies of the genomic response to shock and injury, and has developed several potential therapeutic agents for the treatment of hemorrhagic shock. Currently, his team is exploring the mechanisms by which cells adjust to the low-oxygen environments which characterize low perfusion states such as septic and hemorrhagic shock."

Inhalt

1 An Introduction to Malnutrition in the Intensive Care Unit.- 2 The Immunological Role of Nutrition in the Gut.- 3 Assessment of the Patient.- 4 Timing and Indications for Enteral Nutrition in the Critically Ill.- 5 Access and Complications of Enteral Nutrition Support for Critically Ill Patients.- 6 Timing and Indication for Parenteral Nutrition in the Critically Ill.- 7 Access and Complications of Parenteral Nutrition.- 8 Surgical Intensive Care Considerations.- 9 Major Infections and Sepsis.- 10 Organ Failure and Specialized Enteral Formulas.- 11 Management of the Obese Patient.- 12 Ethical Considerations in Nutrition Support in Critical Care.- 13 Safe Practices for Enteral and Parenteral Nutrition.- 14 The Economic Impact of Nutrition Support, and the Multidisciplinary Approach.- 15 Microbiome in the Critically Ill.- Future Research.