Premium
High‐Protein Hypocaloric Nutrition for Non‐Obese Critically Ill Patients
Author(s) -
Hoffer L. John
Publication year - 2018
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10091
Subject(s) - medicine , parenteral nutrition , catabolism , critically ill , protein catabolism , intensive care medicine , endocrinology , weight loss , enteral administration , obesity , physiology , amino acid , metabolism , biochemistry , biology
Abstract High‐protein hypocaloric nutrition, tailored to each patient's muscle mass, protein‐catabolic severity, and exogenous energy tolerance, is the most plausible nutrition therapy in protein‐catabolic critical illness. Sufficient protein provision could mitigate the rapid muscle atrophy characteristic of this disease while providing urgently needed amino acids to the central protein compartment and sites of tissue injury. The protein dose may range from 1.5 to 2.5 g protein (1.8–3.0 g free amino acids)/kg dry body weight per day. Nutrition should be low in energy (≈70% of energy expenditure or ≈15 kcal/kg dry body weight per day) because efforts to match energy provision to energy expenditure are physiologically irrational, risk toxic energy overfeeding, and have repeatedly failed in large clinical trials to demonstrate clinical benefit. The American Society for Parenteral and Enteral Nutrition currently suggests high‐protein hypocaloric nutrition for obese critically ill patients. Short‐term high‐protein hypocaloric nutrition is physiologically and clinically sensible for most protein‐catabolic critically ill patients, whether obese or not.