167x Filetype PPTX File size 1.07 MB Source: apa.memberclicks.net
Learning Objectives • Describe metabolic and nutritional changes during critical illness. • Discuss nutrition assessment in the ICU patients. • Review current guidelines for provision of nutrition support in adult critically ill patients. Definition of a Critically Ill Patient • American Association of Critical-Care Nurses –“Critically ill patients are defined as those patients who are at high risk for actual or potential life- threatening health problems. The more critically ill the patient is, the more likely he or she is to be highly vulnerable, unstable and complex, thereby requiring intense and vigilant nursing care”. Nutrition and Malnutrition in the Critically Ill Patient • Nutrition plays a key role for recovery from illness • Up to 50% of critically ill patients have preexisting nutritional disorders • Patients who are well nourished prior to ICU admission, develop nutritional disorders rapidly –Metabolic demands of illness and healing –Rapid fluid shifts –Loss of specific vitamins and trace elements • Extent of muscle wasting and weight loss is inversely correlated with long-term survival 5 Physiological Changes During Critical Illness Imbalanced hormone levels: catecholamines, Excess liver glucose Insulin resistance cortisol, glucagon, production growth hormone, insulin Increased production of Excess catabolism proinflammatory cytokines
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