Diet and Nutrition in Critical Care

Patients in need of critical care require expert holistic attention from physicians, surgeons, microbiologists, hematologists, clinical biochemists, pathologists, nurses, physiotherapists, and other medical specialties. Management of
the dietary and nutritional needs of these patients is crucial, and the evidencebased input of specialists in nutrition and dietetics is central to their care. It is
well recognized that malnourished patients spend longer in hospital and have
more interventions and higher rates of mortality and comorbid conditions than
their well-nourished counterparts. Some illnesses will cause frank malnutrition, which will exacerbate the illness and impede recovery. However, the
remedy is not just “feeding” or the use of standard (off-the-shelf) enteral or
parenteral solutions. There is a tremendous amount of scientific information
relating to the requirements of the critically ill. Depending on the medical
condition, some patients may be refractory to nutritional support for a number
of reasons. Specific diseases or trauma may require specific treatments or
nutrients that may not be applicable to other conditions. On the other hand,
some specific protocols may be equally applicable across a wide range of
conditions. Thus, the positive outcomes from one well-planned and scientifically sound study may be applicable to other medical conditions. In its purest
form, evidence-based clinical practice demands that these studies should be
repeated in each specific disease before widespread application. In some cases,
treatments may only be at the preclinical stage.