CRC NUTR SUPP CRIT ILL PATI PDF

Preface

The practice of nutrition support has gone through many changes since its inception in 1968. Because it closely interfaces with medicine, the science of nutrition is very dynamic as it evolves with advances in medical care. This contributes to making nutrition support a very exciting and challenging field in which to practice. In the current medical environment, nutritionists face the many challenges of providing optimal patient care while working within the constraints of managed care. In order to accomplish this, they must not only possess a keen comprehension of nutrition, but also of physiology, pharmacology, research, and health care administration.

No single therapeutic plan is applicable to all patient populations. The critically ill patient is unique from the general hospitalized or long-term care patient receiving nutrition support. Medical intervention, including nutritional therapy, varies significantly among patient acuity levels. There are significant alterations in the physiologic and metabolic pathways in critical illness. These variances, with the potential systemic and organ dysfunctions that may result, affect provision of optimal medical nutritional therapy. The goal of this book is to provide a comprehensive reference on the principles and practice of nutrition support for the critically ill population through evidencebased medicine. The primary target audience for this book is any critical care practitioner, to include physicians, dietitians, pharmacists, nurses, respiratory therapists, and those studying and researching the science of critical care nutrition. This book will also be helpful to those practicing in rehabilitation or long-term care settings, because it will provide insight into the metabolic conditions their patients have undergone while in the acute care setting.

The book has a progressive structure, beginning with an in-depth review of the metabolic alterations that occur during critical illness. Next follows discussion of energy, macronutrient, micronutrient, and fluid and electrolyte requirements, as well as specialized nutrients that can be applied to a general critical care population. This is followed by discussion of the delivery of nutrition support to the critically ill and all the issues and challenges that accompany it. Separate chapters outline the unique nutritional needs and issues that occur throughout the lifecycle. Included are chapters on physiologic and systemic conditions encountered in the intensive care unit, to include trauma, burns, systemic inflammatory response, and sepsis. Next come special considerations for the various disease states and complications that can occur in critically ill patients, including renal, hepatic, and pulmonary disease and pancreatitis. Several professional issues are presented, including ethical considerations, quality improvement, and the economic considerations of nutrition support. Unique features of this book include the extensive list of current references and the inclusion of protocols, tables, figures, and case studies, allowing the reader to apply the science-based information directly to clinical practice.

The chapters have been written by a prominent group of authors, who not only have committed their careers to nutrition support but who also currently practice in the subject area about which they wrote. This allows for insight into the nuances of the practice of nutrition support for the critically ill. It is my goal that this volume be the reference book of choice as a practice guide for nutrition support in the critically ill. With the commitment and enthusiasm of the authors and publisher, this vision is a reality.