This issue is of particular interest in mechanically ventilated patients so much of the data is derived from this population. Published human feeding protocols have tried to define the threshold volume above which feeding should be withheld as well as recommend the frequency of GRV assessment. Human critically ill patients often have gastrointestinal intolerance that is manifested by an increased gastric residual volume (GRV). These include the use of prokinetic agents (Table 1) and adjusted feeding strategies. Cardiovascular instability is regarded as a relative contraindication to enteral feeding and, therefore, many of these patients are not assessed as ready to receive nutritional support.ĭuring critical illness, patients often develop gastrointestinal dysmotility problems that require a host of medical and nutritional strategies to manage these complications. The biggest obstacles for provision of nutrition support in critically ill patients includes intolerance to enteral feeding, difficulties with airway management and the reality that many of these patients may be cardiovascularly unstable, and therefore, priority is given to interventions with immediate patient benefits. Aspects of nutritional support that require special consideration include the timing that nutrition should be initiated, the route of feeding, the composition of the diet and other aspects of management that may impact nutritional management. However, provision of nutrition in this patient population (i.e., critically ill) is particularly challenging and measures must be taken to decrease risk of complications. Patients receiving early enteral nutritional support (i.e., within 2 days of admission) have lower risks of developing nosocomial infections, require fewer days of mechanical ventilation and have overall better patient outcomes. Preservation of nutritional status has important implications for immune function, and wound healing required for recovery. Books & VINcyclopedia of Diseases (Formerly Associate)Ĭritically ill small animal patients require a host of supportive measures including nutritional support to ensure successful management and resolution of the underlying disease.VINcyclopedia of Diseases (Formerly Associate).
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