Critical Illness

Pathway Contributor: Felicity Grove

Contributions:

• Does continuous administration of enteral nutrition compared with intermittent or bolus feeding result in better outcomes in critically ill adults?  

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• Does enteral feeding into the small intestine (post-pyloric) compared to gastric feeding result in improved outcomes in critically ill adults?  

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• What strategies are effective to optimize delivery of enteral nutrition and minimize risks in critically ill adults (e.g. feeding protocols, motility agents, positioning)?  

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• Is the practice of measuring gastric residual volume (GRV) in mechanically ventilated critically ill adults who are tube fed into the stomach reliable for predicting tolerance, regurgitation and aspiration? What is considered an acceptable GRV?  

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• What are the energy and protein requirements of critically ill adults?  

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• What are the energy and protein requirements of critically ill adults with higher weights (BMI ≥30 kg/m2)?  

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• Does early enteral nutrition (initiating feeding within 48 hours of admission to ICU) versus delayed enteral nutrition (initiated within 48 to 96 hours of admission) result in improved outcomes in critically ill adults?  

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• Does immunonutrient supplementation improve patient outcomes in critically ill adults?  

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• What nutrition monitoring (e.g. overfeeding, underfeeding, refeeding syndrome) is recommended for critically ill adults receiving nutrition support?  

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• What nutrition screening and assessment tools can be used to identify nutritional risk and to assess malnutrition in critically ill adults?  

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• Does the use of enteral versus parenteral nutrition or enteral nutrition combined with parenteral nutrition result in improved outcomes in critically ill adults?  

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