Food for Thought: The Effects of Nutritional Support on Outcomes in Hospitalized Elderly Patients and the Critically Ill. (16th July 2014)

• Record Type: Journal Article
• Authors: Cohen, Jonathan; Tehilla, Miriam; Anbar, Ronit; Singer, Pierre
• Other Names: Elliott Rosalind Academic Editor.
• Is Part Of: Advances in critical care. Volume 2014(2014)
• Publication Date: 2014-07-16
• Subjects: Critical care medicine -- Periodicals; 616.028
• DOI: 10.1155/2014/871328
• Languages: English
• ISSNs: 2356-6639

Abstract

Abstract : The provision of adequate nutritional support appears to be essential for critically ill patients and other groups of patients at high risk for having malnutrition. In this review paper we describe our recent research regarding the amount of energy to be provided, how this should be assessed, and the beneficial effects of specialized nutritional support. We have shown that repeated measurements of energy expenditure using indirect calorimetry capture the dynamic energy changes characteristic of hospitalized patients. The provision of energy according to these measurements was associated with lower hospital mortality in critically ill patients when compared to patients receiving a fixed energy intake. A similar study performed in geriatric patients revealed a significant reduction in the number of infections when energy was provided according to repeated measurements. We have also shown that a diet enriched with eicosapentaenoic acid and gamma-linolenic acid improved oxygenation and lung dynamics and decreased ventilation duration in ICU patients with acute lung injury and ARDS. A similarly enriched diet together with micronutrients resulted in significantly less progression of existing pressure ulcers in ICU patients compared to an isonitrogenous, nutrient-sufficient formula. This may be related to an increase in the percentage of positive lymphocyte and granulocyte adhesion molecules.