Nutrition Therapy in Critical Illness - UCSF CME

Nutrition Therapy in Critical IllnessJami Baltz, RD, CNSDSan Francisco General Hospital and Trauma Discuss the hypermetabolism of the systemic inflammatory response and how it relates to Nutrition and metabolic response. Identify the uses of enteral Nutrition to address nutritional and inflammatory issues. Demonstrate the inadequacies of traditional approaches to Nutrition assessment, intervention, and SupportSupportSupportTherapy: Modulating the Stress Response and Systematic ImmunityAdjunctive Supportive CareProactive Primary TherapyRationale for Nutrition in the ICU Current Goals: " Therapy not support"Evidence-based risk reduction attenuate metabolic response limit and reverse loss of lean body tissue prevent oxidant stress favorably modulate immune responseMartindale R, Maerz L. Current Opin Crit Care 12:290-294,2006 Metabolic Comparisons: Stress vs. Starvation Urine Nitrogen Loss Proteolysis Protein Synthesis Plasma Lipids Ketogenesis Blood Glucose Gluconeogenesis Insulin GlucagonMixedFatPrimary Fuels RQ REES tressStarvationMetabolic Changes to Stress:Resting Energy Expenditure3 phases of metabolic response Ebb Phase = Stress (0-48 hours) Cardiac Output Tissue perfusion Oxygen Consumption REEN utritional Goal: Metabolic Support3 Phases of metabolic response Flow Phase = catabolic (24+hours) cytokines Counterregulatory

Objectives • Discuss the hypermetabolism of the systemic inflammatory response and how it relates to nutrition and metabolic response. • Identify the uses of enteral nutrition to address nutritional and inflammatory issues.

Tags:

  Critical, Therapy, Nutrition, Illness, Ucsf, Nutrition therapy in critical illness ucsf cme

Information