Overview
Introduction
Critical illness changes both fuel use and the consequences of feeding.
CNPLE
CNPLE
Critical illness changes both fuel use and the consequences of feeding. Stress hormones and inflammatory cytokines drive endogenous glucose production, insulin resistance, lipolysis and rapid muscle proteolysis. A patient can therefore lose lean mass while receiving calories, and full early feeding can add to energy already being produced internally. ICU nutrition is not a choice between feeding and withholding care: it is the controlled provision of enteral or parenteral substrate while perfusion, gastrointestinal function, electrolytes, glucose and respiratory tolerance are reassessed. Canadian ICUs commonly apply local protocols informed by ASPEN/SCCM and ESPEN guidance; the archived Canadian guideline is not a current national standard.
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