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🌱 來自: Nutrition in the ICU
timing of nutrition🚧 施工中
Timing of nutritional support is an important factor in ICU patients. Although data are inconclusive, early enteral feeding (within 48 hours of ICU admission) is thought to decrease the risk of infection. However, no evidence of benefit exists for starting parenteral nutrition early.
In one study, 90-day mortality in patients started on early (within 48 hours) or late (after day 7) parenteral nutrition was similar. However, early IV nutrition was associated with increased risk of infection and a longer hospital stay. In practice, when enteral feeding is not an option, most patients are not started on IV nutrition until day 7−10 in the ICU .
In a 2018 study, no differences in mortality or secondary infections were found between early enteral versus early parenteral nutrition in ventilated patients with shock. However, early enteral feeding was associated with increased risk of bowel ischemia. (Note that in this study, nutrition was initiated at target rate, which is not done in practice).