title: Metabolic and nutritional support of critically ill patients: consensus and controversies.
abstract: The results of recent large-scale clinical trials have led us to review our understanding of the metabolic response to stress and the most appropriate means of managing nutrition in critically ill patients. This review presents an update in this field, identifying and discussing a number of areas for which consensus has been reached and others where controversy remains and presenting areas for future research. We discuss optimal calorie and protein intake, the incidence and management of re-feeding syndrome, the role of gastric residual volume monitoring, the place of supplemental parenteral nutrition when enteral feeding is deemed insufficient, the role of indirect calorimetry, and potential indications for several pharmaconutrients.
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, 808 route de Lennik, Brussels, 1070, Belgium. Jean-Charles.Preiser@erasme.ulb.ac.be.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Preiser
authors.affiliation: Department of Intensive Care, Gelderse Vallei Hospital, Willy Brandtlaan 10, Ede, Gld 6716RP, The Netherlands. ZantenA@zgv.nl.
authors.forename: Arthur R H
authors.initials: AR
authors.lastname: van Zanten
authors.affiliation: Service de Médecine Intensive Adulte et Brûlés, CHUV BH 08.612, Lausanne, CH 1011, Switzerland. mette.berger@chuv.ch.
authors.forename: Mette M
authors.initials: MM
authors.lastname: Berger
authors.affiliation: Department of Medical, Surgical and Health Sciences, Clinica Medica AOUTS, University of Trieste, via Farneto 3, Trieste, 34142, Italy. Biolo@units.it.
authors.forename: Gianni
authors.initials: G
authors.lastname: Biolo
authors.affiliation: Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven (UZ Leuven), Herestraat 49, Leuven, B-3000, Belgium. michael.casaer@uz.kuleuven.ac.be.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Casaer
authors.affiliation: Northern Clinical School Intensive Care Research Unit, University of Sydney, Reserve Road, St Leonards, NSW, 2065, Australia. gdoig@med.usyd.edu.au.
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Doig
authors.affiliation: Department of Medicine, University of Liverpool, Liverpool, Merseyside, L69 3BX, UK. rdg@liverpool.ac.uk.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Griffiths
authors.affiliation: Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, K7L 2 V7, Canada. dkh2@queensu.ca.
authors.forename: Daren K
authors.initials: DK
authors.lastname: Heyland
authors.affiliation: Division of Cardiac-Thoracic-Vascular Anesthesia and Intensive Care, Medical University Vienna, Spitalgasse 23, Wien, 1090, Austria. michael.hiesmayr@meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Hiesmayr
authors.affiliation: Department of Anesthesiology and Intensive Care, Universita' degli Studi di Milano, via Di Rudini' 8, Milano, 20142, Italy. g.iapichino@unimi.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Iapichino
authors.affiliation: Department of Clinical Medicine, Sapienza University, Piazzale Aldo Moro 5, Roma, 00185, Italy. alessandro.laviano@uniroma1.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Laviano
authors.affiliation: Department of Nutrition, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland. claude.pichard@unige.ch.
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
authors.affiliation: Department of Intensive Care, Beilison Hospital, Petah Tikva, 49100, Israel. psinger@clalit.org.il.
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
authors.affiliation: Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven (UZ Leuven), Herestraat 49, Leuven, B-3000, Belgium. greet.vandenberghe@med.kuleuven.be.
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
authors.affiliation: Department of Anesthesiology & Intensive Care Medicine, Karolinska University Hospital, Huddinge, Stockholm, 141 86, Sweden. jan.wernerman@karolinska.se.
authors.forename: Jan
authors.initials: J
authors.lastname: Wernerman
authors.affiliation: Department of Anesthesiology, University of Colorado School of Medicine, 12700 E. 19th Ave, Box 8602, Aurora, CO, RC2 P15-7120, USA. Paul.Wischmeyer@ucdenver.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Wischmeyer
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, 808 route de Lennik, Brussels, 1070, Belgium. jlvincen@ulb.ac.be.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D032921:Consensus; D016638:Critical Illness / Q000628:therapy*; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods*; D006801:Humans; D010288:Parenteral Nutrition / Q000379:methods*
chemical_list: D004044:Dietary Proteins