Addressing nutrition issues in critically ill patients is a crucial task since the choice of a meal may define the patient’ chances for successful recovery or aggravate the condition to a significant extent. In their article, McClave et al. (2016) provide guidance for the dieting choices to be made for patients that are in a critical condition. Introducing strong evidence, profound research, and a well-constructed nutrition framework for patients in a critical condition, McClave et al. (2016) contribute to the improvement of the quality of critical care.
The study overviews the key instances in which the approach to patient nutrition must be configured in order to alleviate the difficulties and pain experienced by the patient. The researchers point out the fact that critical conditions are typically associated with the state that requires a careful choice of meals due to the increase in inflammation (McClave et al., 2016, p. 161). The authors recommend starting with the assessment of the nutrition risk so that an EN therapy could be introduced in time if needed. Furthermore, the tests required for the identification of comorbid health issues are suggested as a crucial measure in addressing critical patients’ nutritional needs. McClave et al. (2016) point out the significance of using calorimetry as the tool for gauging the necessary amount of nutritional value in each meal. Finally, the assessment of the protein intake must be performed to locate the amount needed for the patient.
Setting the standards for enteral nutrition (EN) in the next stage of their research, McClave et al. (2016) specify that it is vital to assess the GI contractility factors at the start of the EN process. In turn, the dosing of EN is set at zero for the patients with the NUTRIC score below 5. In turn, medium nutrition risk calls for the application of trophic or full nutrition, whereas the patients with the NUTRIC score of 5 and over are deemed as malnourished and require e the full nutrition process along with the ventilation and the monitoring for the emergence of the refeeding syndrome (McClave et al., 2016). The authors also emphasize the role of monitoring the patient’s health status for the possibility of intolerance toward some of the aspects of the suggested EN. As for the formula, McClave et al. (2016) suggest that the MICU patients should receive the same formula, whereas the SICU patients should be provided with a unique formula modified according to their needs. Emphasizing the importance of adjunctive therapy and the enhancement of perentreal nutrition (PN) whenever needed, the researchers examine the dieting options for patients who have experienced the failure of internal organs (specifically, kidneys, heart, etc.). Outlining that obesity can be a problem for critically ill patients, McClave et al. (2016) promote strict compliance with the established guide.
By incorporating strong evidence, a clear set of standards, and reasonable arguments, McClave et al. provide clear and accurate guidelines for nutrition choices for critically ill patients. The research integrates a review of multiple articles and points to the necessity to focus specifically on the issue of patient hydration when rethinking the approach toward nutrition for critically ill patients. The study discusses key scenarios of catering to the needs of critically ill patients, including the provision of end-of-life services, therefore, creating a comprehensive overview of key requirements.
Reference
McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C.,… Compher, C. (2016). Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN. Journal of Parenteral and Enteral Nutrition, 40(2), 159-211.