Nutrition in critically ill adult patients: An update

Critical illness is a catabolic state leading to a loss of lean body mass and malnutrition. Even though there have been insights regarding the role of nutrition in adult patients admitted to the intensive care unit (ICU), there has been no consensus regarding the proper assessment of the nutritional status of the patient or the nutritional risk assessment. The pathophysiology of critical illness and the pivotal role of nutrition in such patients, with its reflection on the duration of MICU stay and overall mortality, suggest that the treating clinician should have an in-depth knowledge and understanding about nutrition in critically ill patients for ensuring better treatment outcomes. Nutrition has to be given with care after calculating the resting energy expenditure of the patient, as both over- and undernutrition result in poorer outcome. In this review, the recent guidelines, recommendations and complications of enteral and parenteral nutrition in patients with critical illness are presented. The challenges that a clinician faces in specific disease conditions pertaining to nutrition, along with the prevailing opinion regarding micronutrient supplementation and the debated mortality benefit of antioxidants, have also been reviewed.