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Curr Opin Crit Care · Apr 2014
ReviewFeeding the gut: how, when and with what - the metabolic issue.
- Jan Wernerman.
- Department of Anesthesiology and Intensive Care Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.
- Curr Opin Crit Care. 2014 Apr 1;20(2):196-201.
Purpose Of ReviewTo review the literature on feeding critically ill patients with special emphasis on the intestine.Recent FindingsMany dogmas have been questioned in the past few years. In particular, the absence of evidence for impact on outcomes in critically ill patients has been highlighted. So 'early enteral feeding', the trophic effect on intestinal mucosa in humans, 'pharmaco-nutrition', postpyloric feeding and prokinetic drugs have all been found to lack proper evidence to affect outcomes.SummaryThe use of gastric feeding in critical illness is recommended. Successful gastric feeding is indicative of a functional gastrointestinal tract. Pharmacological effects of nutrients are questionable, but supplementation of deficits (glutamine, selenium, etc.) may be in the patient's best interest. A more individualized prescription of nutrition in the critically ill is advocated.
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