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Orally fed patients are at high risk of calorie and protein deficit in the ICU

Peterson, Sarah J; Sheean, Patricia M; Braunschweig, Carol L

Current Opinion in Clinical Nutrition & Metabolic Care: March 2011 - Volume 14 - Issue 2 - p 182–185
doi: 10.1097/MCO.0b013e3283428e65
Nutrition and the intensive care unit: Edited by Mette Berger and Jeffrey I. Mechanick

Purpose of review Malnutrition can lead to serious complications in the ICU. Less than half of patients admitted to ICU require ventilation and for many, their optimal route of feeding is oral medical nutrition therapy, rather than enteral or parenteral nutrition. Inadequate oral intake is a prevalent and often difficult problem within this population, as increased calorie deficits are common in the ICU and associated with worse outcomes.

Recent findings Consuming less than 75% of daily calorie requirements in the hospital setting is associated with worse outcomes. Unfortunately, oral intake is often inadequate. Little is known about the consequences of inadequate oral intake in the ICU; however, data have described worse outcomes with large calorie deficits from enteral and parenteral nutrition. Whether or not these data can be extrapolated to patients in the ICU with poor oral intake remains uncertain.

Summary Despite evidence-based guidelines directing the delivery of nutrition support in the ICU, there is limited research focused on oral intake during this time of hospitalization. Future research is needed to determine the long-term associations of inadequate versus adequate oral intake in the ICU.

Rush University Medical Center, Chicago, Illinois, USA

Correspondence to Sarah J. Peterson, MS, RD, CNSC, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.