2024 Volume 31 Issue 4 Pages 253-260
The importance of nutrition monitoring for critically ill patients has been recognized as a method to ensure adequate provision of nutrition for critically ill patients, while accounting for the complex metabolic dynamics in the early phase of the critical illness. During the acute phase of a critical illness, metabolism can be significantly enhanced or suppressed due to the high degree of stress and can change dramatically depending on the type and severity of the illness, therapeutic intervention, progression of the disease state, and development of complications. Feeding according to the measured energy expenditure by indirect calorimetry is recommended to avoid over- and underfeeding by adapting to the metabolic characteristics of the individual patient. The relationship between consumption and requirement is not as clear for protein as it is for energy, and the requirement can be only be evaluated in relative terms based on the assessment of protein loss by nitrogen balance and changes in the muscle mass by body composition analyses. Monitoring should be implemented with a thorough understanding of its mechanisms and limitations. Further optimization of nutrition therapy for critically ill patients can be achieved by developing methods to recognize the optimal timing to start feeding and to determine the complete profile of the required nutrients.
