Nutrition

Nutritional Support in the ICU M.M. Brandt, MD, FACS, FCCM I.S. Rubinfeld, MD, FACS, FCCP Henry Ford Hospital Detroit, MI

Reasons for Support ,[object Object],[object Object],[object Object]

Baseline Patient Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Surgery: Scientific Principles and Practice

Stimuli for Stress Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Goals of Stress Response ,[object Object],[object Object],[object Object]

Response to Stress/Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Glucose Dependent Organs ,[object Object],[object Object],[object Object],[object Object]

Glucose Precursors ,[object Object],[object Object],[object Object],[object Object]

Energy Substrates: Carbohydrates ,[object Object],[object Object],[object Object]

Energy Substrates: Amino Acids ,[object Object],[object Object],[object Object],[object Object],[object Object]

Energy Substrates: Fat ,[object Object],[object Object],[object Object]

Metabolic Needs ,[object Object],[object Object],[object Object],[object Object],[object Object]

Goal Calculations: Ireton Jones ,[object Object],[object Object],[object Object]

Harris-Benedict Equation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Harris-Benedict Equation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nitrogen Balance ,[object Object],[object Object],[object Object],[object Object]

Problems with Nutritional Parameters ,[object Object],[object Object],[object Object]

Metabolic Cart Indirect Calorimetry: Theory ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Metabolic Cart - Indirect Calorimetry: Results ,[object Object],[object Object],[object Object],[object Object],[object Object]

Other Clinical Parameters ,[object Object],[object Object],[object Object],[object Object],[object Object]

Enteral vs. Parenteral? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Starting Estimates ,[object Object],[object Object],[object Object],[object Object],[object Object]

Nutrients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nutrients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rules of Thumb: TPN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TPN Example ,[object Object],[object Object],[object Object],[object Object]

TPN vs. Enteral: Advantages? ,[object Object],[object Object],[object Object]

Potential Reasons for TPN Failure ,[object Object],[object Object],[object Object]

Why Enteral? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Timing of Enteral Feeds ,[object Object],[object Object],[object Object],[object Object],[object Object]

Reflux ,[object Object],[object Object],[object Object]

Gastric vs. Post-pyloric Feeds ,[object Object],[object Object]

Anabolic Steroids (Oxandrolone) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Refeeding Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object]

Theoretical Advantages of Early Enteral Nutrition ,[object Object],[object Object],[object Object],[object Object]

Energy Requirement in Critical Illness: Different Conditions Greenfield 1997

Total Kcal Goals ,[object Object],[object Object],[object Object]

Total Protein Goals ,[object Object],[object Object],[object Object]

Lipid Goals ,[object Object],[object Object],[object Object],[object Object]

Nutritional Algorithm Greenfield 1997

Consequences of Overfeeding ,[object Object],[object Object],[object Object],[object Object],[object Object]

Consequences of Overfeeding ,[object Object],[object Object]

Nutritional Goals ,[object Object],[object Object],[object Object]

Clinical Scenario 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Scenario 1 (cont.) ,[object Object],[object Object],[object Object],[object Object]

Scenario 2 ,[object Object],[object Object],[object Object],[object Object]

References ,[object Object],[object Object],[object Object]

Nutrition

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