Nutrition in ICU patients

The article is professionally consulted by Doctor Nguyen Ngoc Phuong Nam - Emergency Resuscitation Doctor - Emergency Resuscitation Department - Vinmec Central Park International General Hospital

Appropriate nutrition therapy in the ICU is a “drug” that improves mortality in ICU patients. The doctor of the intensive care unit, together with the doctor of the nutrition department, is the one who decides on the nutritional supplement method, the type of supplement product, the quantity appropriate to the stage of the disease and the effectiveness of the intervention.

1. How are ICU patients nutritionally assessed?

First, screen and assess nutritional risk at the time of patient's ICU admission. Due to the nature of the serious condition when admitted to the ICU, doctors have their own Rating Scales (such as NUTRIC score, NRS score), which are different from some scales of other non-ICU departments.
Based on nutritional risk assessed through transcripts and medical condition, doctors will decide the timing of nutritional intervention is: early when < 24 - 48 hours after admission or late when > 24 hours - 48 hours after admission and the mode of feeding (intranasal or intravenous), the amount of food as well as the type of food. The above factors will be developed by the intensive care unit into a feeding process, in order to bring optimal benefits to the patient in terms of nutrition and treatment of accompanying diseases.

2. Nutritional modalities in ICU patients

2.1 Enteral nutrition is an aid in maintaining the function and integrity of the gastrointestinal tract in critically ill patients. Currently, this is considered the optimal feeding method if there are no contraindications.
There are many modes of nutrition through the gastrointestinal tract such as:
Eating by mouth: for fully awake patients Feeding through a nasogastric tube: The patient has to be intubated for mechanical reasons for medical reasons. or not awake, the doctor will put a soft plastic tube from the nose to the stomach to pump food into the stomach to nourish like eating by mouth.

Dinh dưỡng qua ống tiêu hóa — Sonde mũi dạ dày là phương pháp cung cấp dinh dưỡng qua ống tiêu hóa cho người bệnh

Feeding through gastro-jejunostomy tube: Indicated for patients who cannot place a nasogastric tube such as: esophagitis, patients needing long-term nutrition... Patients will be surgically placed The tube that passes through the skin into the stomach is called: Open the stomach to the skin to pump food into the stomach. 2.2 Intravenous nutrition Depending on the type of nutrient and nutritional product, the doctor will decide whether to give a peripheral or central intravenous infusion. Intravenous feeding is indicated only when there is a contraindication to enteral feeding, or when parenteral nutrition does not meet the energy target due to poor absorption by the gastrointestinal tract in some enterectomy pathologies. , abdominal surgery in the postoperative period.

3. Types of energy that need to be supplemented in patients in the intensive care unit

Two important goals currently recommended by reputable practice guidelines are energy (kCal) and protein (protein) levels. Typically, patients in the ICU need a protein intake of 1.2-2g/kg/day, and 25-30 kCal/kg/day. The Recommendations recommend protein-rich formulations to meet the body's protein needs in critically ill patients.
Nutrition in patients in the ICU is one of the treatment methods in the ICU. Nutrition contributes to faster healing and is also an important goal during care in the critical care unit. Providing nutritional support to critically ill patients is complex and requires constant updating of knowledge.

Để đặt lịch khám tại viện, Quý khách vui lòng bấm số HOTLINE hoặc đặt lịch trực tiếp TẠI ĐÂY. Tải và đặt lịch khám tự động trên ứng dụng MyVinmec để quản lý, theo dõi lịch và đặt hẹn mọi lúc mọi nơi ngay trên ứng dụng.

XEM THÊM:

Dịch vụ từ Vinmec