3/22/2023 0 Comments Normal gastric residual volumePatients with reduced nutrient intake from the gastrointestinal tract have an increased risk of infection because of reduced gut integrity and the physiologic stress response ( McClave 2009b). Under these circumstances, enteral nutrition (EN) (enteral tube feeding) or parenteral nutrition (PN) (the delivery of calories and nutrients into a vein) can compensate for nutritional intake until oral intake becomes satisfactory ( Bounoure 2016). Inflammatory conditions result in increased glycogenolysis, protein catabolism, and fatty acid degradation, and insufficient nutrient intake causes depletion of organ proteins, ultimately leading to malnutrition, and increased risk of infection and death ( Reintam 2017). Critically ill patients also show highly variable metabolic and immune responses to injury or illness ( Shaw 1993 Wanzer 1989). Patients under such conditions have higher mortality rates ( Esteban 2013 Rubenfeld 2005), and it is imperative for medical care providers to explore the best interventions to maintain proper nutritional status, especially since nutritional management has recently been emphasized as an important determinant of patient survival ( Reintam 2017). This issue is especially relevant in critically ill patients, since oral intake is severely affected in such cases for reasons including the need for mechanical ventilation, gastrointestinal surgery, or unconsciousness. The reasons may include appetite loss due to acute illness, nausea, vomiting, early satiety, and difficulty in swallowing. However, in some people with acute illness, oral intake of food may not provide the necessary nutritional value due to various reasons ( Gomes 2017 Weimann 2017). To achieve target energy for hospitalized patients who are at risk of malnutrition, it is important to take pre‐emptive measures. Up to 40% of in‐hospital patients are affected by "disease‐related malnutrition," which is a specific type of malnutrition caused by concomitant disease ( Cederholm 2017 Nutrition Day). Malnutrition leads to an increase in medical expenses, increased length of hospital stays, and poor patient prognosis.
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