Feeding the critically ill obese patient: a systematic review protocol.

Abstract

REVIEW QUESTION/OBJECTIVE The objective of this review is to identify effective enteral nutritional regimens targeting protein and calorie delivery for the critically ill obese patient on morbidity and mortality. More specifically, the review question is: In the critically ill obese patient, what is the optimal enteral protein and calorie target that improves mortality and morbidity? INCLUSION CRITERIA Types of participants This review will consider studies that include critically ill obese adult patients receiving enteral nutritional support at any stage during their Intensive Care Unit admission for a time period of greater than 72 hours. Studies eligible for retrieval will include intensive care patients in intensive care units or alternatively using a population of patients in which greater than or equal to 50% of trial participants required mechanical ventilation. In attempting to limit the search to studies involving critically ill patients in this way, it is acknowledged that there are differing criteria that determine Intensive Care Unit admission between countries determined in part by resources, in part by cultural differences and in part by the model of intensive care that predominates (closed versus open Intensive Care Units). This is, however, a universal conundrum of critical care research in which there is often heterogeneity in admission diagnosis, severity of disease, metabolic derangement and therapeutic interventions, and which has been recognized in other publications. Critically ill populations comprising both elective and emergency Intensive Care Unit admissions will be included, as will critically ill populations with a medical or surgical TRUNCATED AT 250 WORDS