Controversies Surrounding Critical Care Nutrition: An Appraisal of Permissive Underfeeding, Protein, and Outcomes

Jayshil J. Patel, Robert Martindale, Stephen A. McClave

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Over the past few years, numerous studies have called into question the optimal dose, timing, composition, and advancement rate of nutrition during the early acute phase of critical illness. These studies suggest permissive underfeeding with slow advancement may be more beneficial than aggressive full feeding. These counterintuitive results were possibly explained by enhanced autophagy, less hyperglycemia, or prevention of refeeding syndrome. This review underscores the controversies surrounding permissive underfeeding, aims to answer whether permissive underfeeding is appropriate for all critically ill patients, describes the impact of optimal protein delivery on critical care outcomes, discusses nutrition risk, and cogitates on the impact of nutrition on critical care outcomes.

Original languageEnglish (US)
Pages (from-to)508-515
Number of pages8
JournalJournal of Parenteral and Enteral Nutrition
Volume42
Issue number3
DOIs
StatePublished - Mar 1 2018

Keywords

  • hypocaloric feeding
  • nutrition risk
  • permissive underfeeding
  • trophic feeding

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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