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Nutritional support in the critically ill

Wise, Matthew and Frost, Paul 2018. Nutritional support in the critically ill. In: Davey, Patrick and Sprigings, David eds. Diagnosis and Treatment in Internal Medicine, Oxford: Oxford University Press, (10.1093/med/9780199568741.003.0334)

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Major injury evokes a constellation of reproducible hormonal, metabolic, and haemodynamic responses which are collectively termed ‘the adaptive stress response’. The purpose of the adaptive stress response is to facilitate tissue repair and restore normal homeostasis. If critical illness is prolonged, the adaptive stress response may become maladaptive, in essence exerting a parasitic effect leaching away structural proteins and impairing host immunity. Primarily therapy should be directed towards the underlying illness, as nutritional support per se will not reverse the stress response and its sequelae. Nonetheless, adequate nutritional support in the early stages of critical illness may attenuate protein catabolism and its adverse effects. This chapter covers nutritional assessment; detection of malnutrition; energy and protein requirements; monitoring the effectiveness of nutritional replacements; nutritional delivery; complications; and refeeding syndrome.

Item Type: Book Section
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Oxford University Press
ISBN: 9780199568741
Last Modified: 25 Jan 2022 11:29

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