ABSTRACT

Planning for nutritional support of the critically ill patient begins during the initial interaction between physician and patient. Although many ICU patients present in a hypermetabolic state due to critical illness where prolonged recovery is expected, there is a definite group of patients whose critical illness results from complications of surgical therapy. In this group, early identification of the high-risk patient may lead to preemptive preoperative nutritional support, where specific intraoperative procedures (such as GI tract cannulation) can reduce postoperative complications and preclude long ICU stays. Thus, treatment of critical illness and prevention of critical illness are appropriate parts of an aggressive nutrition approach.