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Metabolic and nutrition support in the chronic critical illness syndrome.

Abstract

Technological innovations in the ICU have led to artificially prolonged life, with an associated cost. Chronic critical illness (CCI) occurs in patients with prolonged mechanical ventilation and allostatic overload, and is associated with a discrete and consistent metabolic syndrome. Metabolic interventions are extrapolated from clinical critical care research, scientific theory, and years of CCI patient care experience. Intensive metabolic support (IMS) is a multi-targeted approach consisting of tight glycemic control with intensive insulin therapy, early and adequate nutrition therapy, nutritional pharmacology, management of metabolic bone disease, and meticulous attention to other endocrine/metabolic derangements. Ideally, IMS should be under the supervision of a metabolic support consultative team. Further research specifically focused on the CCI population is needed to validate this current approach.

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  • Authors

    Schulman RC, Mechanick JI

    Source

    Respiratory care 57:6 2012 Jun pg 958-77; discussion 977-8

    MeSH

    Bone Diseases, Metabolic
    Calcium, Dietary
    Calorimetry, Indirect
    Chronic Disease
    Critical Care
    Critical Illness
    Energy Metabolism
    Enteral Nutrition
    Humans
    Hyperglycemia
    Hypothalamo-Hypophyseal System
    Intensive Care
    Nutrition Assessment
    Nutritional Support
    Syndrome
    Vitamin D
    Wound Healing

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22663970