title: Disease-specific nutrition therapy: one size does not fit all.
abstract: BACKGROUND
  The delivery of adequate nutrition is an integral part of the care of the critically ill surgical patient, and the provision of nutrition may have a greater impact on outcome than many other therapies commonly employed in the treatment of certain disease states.
  
  
  METHODS
  A review of the existing literature was performed to summarize the evidence for utilizing disease-specific nutrition in critically ill surgical patients.
  
  
  RESULTS
  Enteral nutrition, unless specifically contraindicated, is always preferable to parenteral nutrition. Methodological heterogeneity and conflicting results plague research in immunonutrition, and routine use is not currently recommended in critically ill patients.
  
  
  CONCLUSIONS
  There is currently insufficient evidence to recommend the routine initial use of most disease-specific formulas, as most patients with the disease in question will tolerate standard enteral formulas. However, the clinician should closely monitor for signs of intolerance and utilize disease-specific formulas when appropriate.
authors.affiliation: Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, 165 Cambridge St. #810, MA, 02114, USA. Dyeh2@partners.org.
authors.forename: D D
authors.initials: DD
authors.lastname: Yeh
authors.affiliation: Division Chief of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St. #810, Boston, MA, USA.
authors.forename: G C
authors.initials: GC
authors.lastname: Velmahos
keywords: Hepatic failure; Immunonutrition; Nutrition; Obesity; Pulmonary failure; Renal failure
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