Critical Care Nutrition

 

Critical Patient:
If an unwell or critical patient has only eaten a small amount of food or hasn’t eaten anything over the course of 48h – 72h, a nutritional assessment is necessary to determine which support approach is preferable. Prolonged anorexia or hyporexia can cause digestive tract dysfunctions, organ dysfunction and compromised general immunity.  At this stage enterocytes, cells that lining the small intestine, die quickly without nutrition. This causes a breakdown of the intestinal barrier and it can lead to bacterial infection in other sites of the body.


 


The Diet:
Critical care diets, with their high-fat, high-protein, easy digestibility, antioxidant-enriched nutrient profile, can help target undesired metabolic changes, providing fat to supply energy and protein to support the body’s recovery.

Anorectic, critically ill, recovering, or malnourished patients require a concentrated energy source and a nutrient profile that supports recovery.

It is very important that a nutritional care approach to the critical patient starts as early as possible, this action would help to bring an early recovery and a best response to any other treatment.

 

Clinical Situations:
On few clinical situations as Pancreatitis and some virus infections like Parvovirus, prolonged fasting are correlated to high mortality, when compared with early start of parenteral nutrition.

Enteritis caused by Parvovirus can bring the animal to a debilitate and critical stage very quickly and an early auction is important to increase the chances of response to the treatment. In 2003, Mohr at al, showed that a rapid return of appetite, a quickly weight gain and a better intestinal wall integrity in puppies who was supported with an early enteral nutrition by naso-oesophageal tube when compared with those who were fed low-fat tinned food.