Abstract
Critically ill patients often require life support measures such as mechanical ventilation or haemodialysis. Despite the essential role of nutrition in patients’ recovery, the inappropriate use of medical nutrition therapy can have deleterious effects, as is the case with the use of respiratory, circulatory, or renal support. To increase awareness and to monitor the effects of inappropriate medical nutrition therapy, we propose to introduce the concept of nutritrauma in clinical practice, defined as metabolic adverse events related to the inappropriate administration of medical nutrition therapy or inadequate nutritional monitoring.
Highlights
During the twentieth century, many medical interventions were introduced to treat clinical conditions that would previously have been fatal
parenteral nutrition (PN) formulations are usually initiated at 2 g/kg/d of glucose to prevent the gluconeogenesis derived from amino acid precursors provided by skeletal muscle proteolysis
To increase awareness regarding inappropriate medical nutrition therapy (MNT) and to improve monitoring, we propose introducing the word “nutritrauma” as a new term in clinical nutrition [9], defined as metabolic adverse events related to an inadequate nutritional assessment and inappropriate prescription of MNT
Summary
Many medical interventions were introduced to treat clinical conditions that would previously have been fatal. In the case of mechanical ventilation, replacing the cycles of positive and negative pressure of spontaneous ventilation with positive pressure throughout the breath cycle produces a decrease in venous return, alterations in the immune response, and traumatic injuries due to hyperpressure (barotrauma), volutrauma, and atelectrauma (Table 1). Mechanical ventilation has provided life support for many patients who are in critical condition, but experience has taught us that it is insufficient to only program a suitable respiratory rate, tidal volume, and fraction of inspired oxygen (FiO2 ), but that it requires. Barotrauma: Lung injury due to positive pressure, overdistention and alveolar break. Volutrauma: Lung injury due to local overdistention as a result of using excessive tidal volumes Atelectrauma: Alveolar damage as a result of transient and repeated closure and reopening of alveoli during the respiratory cycle. Hepatobiliary disorders: Cholestasis, cholecystitis, cholelithiasis, hepatic steatosis, non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis
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