ABSTRACT
Assessing for nutritional deficits; evaluating an ideal means for receiving nutrition; providing adequate nutrition; and monitoring response constitutes a collaborative effort between the advanced practice health professional, the bedside nurses, and the nutritionist. Early feeding in critical illness results in better outcomes in terms of survival and disability. The diagnosis of malnutrition requires two or more of the following: insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, localized or generalized fluid accumulation, and diminished functional status. History and physical examination are useful to evaluate malnutrition. The gold standard of nutritional assessment in the intensive care unit (ICU) is indirect calorimetry; it is the most accurate method for determining the energy expenditure of critically ill patients. There are over 200 predictive equations to estimate energy expenditure. Predictive equations can offer "stress" factors to account for the specific nutritional needs of special populations.
