title: Nutrition therapy of the severely obese, critically ill patient: summation of conclusions and recommendations.
abstract: This report compiles the conclusions and recommendations for nutrition therapy of the obese, critically ill patient derived by the group of experts participating in this workshop on obesity in critical care nutrition. The recommendations are based on consensus opinions of the group after review of the current literature. Obesity clearly adds to the complexity of nutrition therapy in the intensive care unit (ICU). Obesity alters the incidence and severity of comorbidities, tolerance of the prescribed regimen, and ultimately patient outcome through the course of hospitalization. Although the basic principles of critical care nutrition apply to the obese ICU patient, a high-protein, hypocaloric regimen should be provided to reduce the fat mass, improve insulin sensitivity, and preserve lean body mass. The ideal enteral formula should have a low nonprotein calorie to nitrogen ratio and have a variety of pharmaconutrient agents added to modulate immune responses and reduce inflammation.
authors: Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA. samcclave@louisville.edu
authors: Stephen A
authors: SA
authors: McClave
authors: Robert
authors: R
authors: Kushner
authors: Charles W
authors: CW
authors: Van Way
authors: Matt
authors: M
authors: Cave
authors: Mark
authors: M
authors: DeLegge
authors: John
authors: J
authors: Dibaise
authors: Roland
authors: R
authors: Dickerson
authors: John
authors: J
authors: Drover
authors: Thomas H
authors: TH
authors: Frazier
authors: Ken
authors: K
authors: Fujioka
authors: Dympna
authors: D
authors: Gallagher
authors: Ryan T
authors: RT
authors: Hurt
authors: Lee
authors: L
authors: Kaplan
authors: Lazlo
authors: L
authors: Kiraly
authors: Robert
authors: R
authors: Martindale
authors: Craig
authors: C
authors: McClain
authors: Juan
authors: J
authors: Ochoa
mesh_terms: D050110:Bariatric Surgery; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods*; D005526:Food, Formulated; D006801:Humans; D007362:Intensive Care Units; D015596:Nutrition Assessment; D009765:Obesity / Q000178:diet therapy*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D016896:Treatment Outcome