Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders>>>>>Nutrition in Critical Illness
Question 3#

Which of the following patients should have enteral nutrition advanced to goal within the first 24 to 48 hours of hospitalization instead of waiting up to 1 week before instituting enteral nutrition?

A. 24-year-old with history of type I diabetes mellitus now post multitrauma motorcycle crash
B. 39-year-old G1P1 with ROSC after arrest due to postpartum hemorrhage
C. 76-year-old with a history of COPD and hypertension with urosepsis and renal failure
D. 85-year-old with a history of a lung nodule now post right lower lobe lobectomy

Correct Answer is C

Comment:

Correct Answer: C

The American Society of Enteral and Parenteral Nutrition recommends that patients with a NUTRIC score ≥5 should be rapidly advanced to goal enteral nutrition within the first 24 to 48 hours. NUTRIC scores are based on age, comorbidities, APACHE score, SOFA score, and days from hospital to ICU admission (IL-6 level can also be included if available).

References:

  1. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient. JPEN J Parenter Enteral Nutr. 2016;40:159-211.
  2. Heyland DK, Stephens KE, Day AG, McClave SA. The success of enteral nutrition and ICU-acquired infections: a multicenter observational study. Clin Nutr. 2011;30(2):148-155.