The role of nutrition in critical care

Critically ill patients will require suitable nutritional support to protect against severe catabolism and to prevent significant deterioration of their condition. Early detection of patients that are malnourished and/or at high nutritional risk is important for timely and optimal nutrition intervention; these typically will be patients suffering from lack of appetite or the ability to eat, which leads to proteolysis and related muscle loss. Insufficient nutrient intake can cause impaired immunity; decreased resistance to infection; decreased wound strength; impaired drug metabolism and increases the risk of complications following surgery (Chan, 2015). Nutritional support should be considered for animals that show recent unintentional weight loss that exceeds 10% of their bodyweight or for those whose oral intake has been or will be interrupted for more than 5 days (less with young patients or smaller species), and those with increased nutrient losses from chronic diarrhoea or vomiting, wounds, renal disease, or burns (Marks, 2010). The goals of nutritional support are to meet the patient's nutritional needs and prevent further deterioration. This can be achieved by offering a high quality food providing adequate energy substrates, essential fatty acids, protein and micronutrients, initiated as early as possible. As with any medical intervention, there are always risk factors to consider which can be minimised by formulating a nutritional strategy including a systematic evaluation of the patient, referred to as a nutritional assessment to develop a specific nutritional plan that meets the individual's needs. Making an accurate estimate of calorie consumption is of great importance in the successful nursing of these critically ill patients.