Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
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We published the first article that addressed hypocaloric, high-protein enteral nutrition therapy for critically ill patients with obesity more than 10 years ago. This study demonstrated that it was possible to successfully achieve this mode of therapy with a commercially available high-protein enteral formula and concurrent use of protein supplements. ⋯ The results of this study, its unique findings, and shortcomings are discussed. Subsequent studies have added clarity to the effective use of this therapy, including its use in home parenteral nutrition patients, patients with class III obesity, and older patients with obesity.
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The prevalence of obesity in adolescents has dramatically increased over the past 3 decades in the United States. Weight loss surgery is becoming a viable treatment option for obese adolescents. The number of surgeries being performed yearly is rising, and this trend is likely to continue. ⋯ Before surgery is offered as an option, unique factors to adolescents must be addressed. The multidisciplinary clinical team must consider the adolescents' cognitive, social, and emotional development when considering their candidacy for surgery. As the number of adolescent bariatric surgery programs increases, continued research and long-term outcome data need to be collected and shared to base future treatment decisions.
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Obesity remains a challenging public health problem. The anatomic and physiologic complexities of obese patients make their healthcare challenging under routine circumstances, but in the setting of critical illness, these challenges are magnified. This review explores some of the unique difficulties that critical care providers face when caring for the obese patient and highlights areas in which future research is needed to provide optimal care.