Links:
ESPEN guideline on clinical nutrition in the intensive care unit (PDF)
ACG Clinical Guideline: Nutrition Therapy in the Adult Hospitalized Patient
Enteral nutrition preferred
Early is better: within 48 hours
Parenteral nutrition- early does not improve outcomes, may increase rate of infections
Typically not started until 1-2 weeks without nutrition
Resting Energy Expenditure
Basal Energy Expenditure (BEE): heat production of basal metabolism in resting/fasting state
BEE (kcal/day) = 25 x wt (kg)
Resting Energy Expenditure (REE): energy expenditure of basal metabolism in resting but not fasting state
REE = BEE x 1.2
Fever: BEE x 1.1/° C above normal
Mild stress (q3 call): BEE x 1.2
Moderate stress (ED on your pager) BEE x 1.4
Severe stress (call as an intern) BEE x 1.6