How to feed patients with sepsis

Current Opinion in Critical Care
Felicity H. Hawker

Abstract

Sepsis is associated with profound catabolism and hypermetabolism that complicate provision of nutritional support. These metabolic changes are caused by inflammatory mediators involved in the septic process and cannot be reversed by nutritional means. High protein isocaloric nutritional regimens are recommended if possible, in association with aggressive measures to control the sepsis. However, nutritional therapy and its complications may also affect the incidence and course of sepsis. Hyperglycemia and conventional intravenous fat emulsions have been shown to increase susceptibility to infection. Enteral nutrition is associated with fewer infectious complications than parenteral nutrition, at least in severely injured patients. Recently nutritional formulations have been introduced that contain novel substrates that enhance various aspects of immunity. Several studies have suggested that this immunonutrition reduces infection risk in the critically ill, and preliminary findings suggest it may even have an effect on survival in sepsis.

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Citations

Jan 9, 2004·Clinics in Chest Medicine·Simon V Baudouin, Timothy W Evans
Mar 1, 2003·Clinics in Geriatric Medicine·Rami Y Haddad, David R Thomas
Apr 6, 2004·The Veterinary Clinics of North America. Equine Practice·Bettina M Dunkel, Pamela A Wilkins
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Feb 18, 2003·Current Opinion in Clinical Nutrition and Metabolic Care·Richard D Griffiths

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