Chapter 33. Nutritional Support

There is a consensus that nutritional support should be routinely provided to intensive care unit (ICU) patients. Hospitalized patients with malnutrition (macronutrient and/or micronutrient deficiency) suffer from increased infectious morbidity, prolonged hospital stays, and increased mortality. Moreover, even those hospitalized medical and surgical patients without antecedent malnutrition are typically subjected to stress, infection and impaired organ function, resulting in a hypercatabolic state. Often these patients are unable to meet their caloric needs, as they are either too sick or physically unable to ingest food. Although strong evidence demonstrates that providing nutritional support for such patients results in improved clinical outcomes, the optimal method of delivery, timing of administration, and specific formulation requires further research.