Prof. Andrea Marshall: Nutrition in ICU - more important than you realise

Does feeding make a difference to critically ill patients….or not? There remains considerable variability in nutrition support practice for the critically ill despite the availability of numerous guidelines to support our practice. The complexity of the metabolic response to critical illness, coupled with patient heterogeneity, means that a one-size-fits-all approach to nutrition support is unlikely to work and that not all patients will benefit equally from nutrition interventions. We also lack clarity on the best way to determine nutritional requirements and there are insufficient data to specify the amount of protein and/or calories that patients should receive. All of these factors contribute to uncertainty regarding the benefits and best practices in relation to nutrition. Nevertheless, we know that if we don’t feed patients they do poorly. We also know that the practices of critical care nurses who manage the delivery of nutrition can have a significant impact on nutrition adequacy both in ICU and during recovery in the ward. Think about what you can do to make a difference to nutrition intake for patients recovering from critical illness.