Should enteral nutrition be started in the first week of critical illness?

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Martindale R, Warren M. Should enteral nutrition be started in the first week of critical illness? Curr Opin Clin Nutr Metab Care. 2015;18(2):202-206.

 

            This study looks at the early initiation of enteral nutrition for patients who are critically ill. Authors admit that there is a lack of trials that contain a large number of participants and are randomized. A majority of the supporting studies on this topic were done on animal models and not human patients.

            Results from this study show that the initiation of enteral nutrition within the first week of being in the intensive care unit promotes gut-mediated immunity, lowers metabolic response to stress, maintains microbial diversity, and improves clinical outcomes versus standard of care or parenteral nutrition.

            This is important because of the time frame and what’s going on. This is a very stressful time for the patient and family and feeding of any kind can often be associated with end of life circumstances. While there are a number of things that can go on during this time this study shows how important it is to start enteral feeding as soon as possible for patients in critical care.
Ellsworth

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