Nutrition in the Surgical ICU Patient

TLDR: In malnourished or high nutrition risk patients, in whom EN is not feasible, PN should be started with 48 h of admission to the surgical ICU, and in patients with severe sepsis or septic shock, Pn and EN initiation should be delayed.

Abstract: Nutrition is an imperative component in the care of the surgical ICU patient. The benefit of either enteral nutrition (EN) or parenteral nutrition (PN) is greater in those patients determined to be malnourished or at high nutrition risk. Given the non-nutritional benefits, early EN (within 24–48 h of surgical ICU admission) is the preferred route of feeding. An immunonutrition EN formulation, used for the initial 7–10 days, may confer additional benefit in trauma and postoperative patients. In malnourished or high nutrition risk patients, in whom EN is not feasible, PN should be started with 48 h of admission to the surgical ICU. In patients with severe sepsis or septic shock, PN and EN initiation should be delayed.