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Support Line







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Dietitians in Nutrition Support


Nutrition support is recognized as an important component of care for patients with critical illness. Providing energy and protein at estimated requirements is thought to prevent or decrease the likelihood of disease-related malnutrition. However, short-term calorie restriction may be advantageous in this setting. Using PubMed, we conducted a search for studies of “permissive underfeeding” or “hypocaloric feeding” for patients with critical illness to evaluate relevant outcomes. Of the initial 137 studies, 32 papers were evaluated, and 16 papers met all eligibility criteria. The results support a benefit or neutral impact on nutrition support-related complications, yet conflicting findings on mortality and infection incidence when compared to patients provided higher energy and protein targets. Across studies, energy and protein needs were calculated using different methods, and the amount of protein administered, and the percentage of estimated calorie needs that constitutes underfeeding remains broad. To become common practice, a consensus on the percentage of calories and amount of protein to define underfeeding must be clarified.


Author Posting © Dietitians in Nutrition Support, 2020. This article is posted here by permission of Dietitians in Nutrition Support for personal use, not for redistribution. The article was published in Support Line, Volume 42, Issue 5, October 2020,

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Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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