Nutrition therapy of the severely obese, critically ill patient: Summation of conclusions and recommendations

Stephen A. McClave*, Robert F Kushner, Charles W. Van Way, Matt Cave, Mark DeLegge, John Dibaise, Roland Dickerson, John Drover, Thomas H. Frazier, Ken Fujioka, Dympna Gallagher, Ryan T. Hurt, Lee Kaplan, Lazlo Kiraly, Robert Martindale, McClain Craig McClain, Juan Ochoa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

This report compiles the conclusions and recommendations for nutrition therapy of the obese, critically ill patient derived by the group of experts participating in this workshop on obesity in critical care nutrition. The recommendations are based on consensus opinions of the group after review of the current literature. Obesity clearly adds to the complexity of nutrition therapy in the intensive care unit (ICU). Obesity alters the incidence and severity of comorbidities, tolerance of the prescribed regimen, and ultimately patient outcome through the course of hospitalization. Although the basic principles of critical care nutrition apply to the obese ICU patient, a high-protein, hypocaloric regimen should be provided to reduce the fat mass, improve insulin sensitivity, and preserve lean body mass. The ideal enteral formula should have a low nonprotein calorie to nitrogen ratio and have a variety of pharmaconutrient agents added to modulate immune responses and reduce inflammation.

Original languageEnglish (US)
JournalJournal of Parenteral and Enteral Nutrition
Volume35
Issue number5 SUPPL.
DOIs
StatePublished - Sep 1 2011

Keywords

  • Critical illness
  • Enteral nutrition
  • Hypocaloric feeding
  • Obesity
  • Pharmaconutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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