Nutrizione clinica in medicina intensiva

To analyse pros and cons of different artificial nutrition approaches to the critically ill patients. Parenteral nutrition: In parenteral nutrition the best results are achieved with a prevalent glucose system. Higher levels of blood insulin can stimulate the anabolic drive. Reduced lipid intake is recommended for acute respiratory failure. Enteral Nutrition: It is widely accepted that enteral nutrition is better than parenteral. Early enteral nutrition seems to further improve results; however, in the presence of severe sepsis, immunoenhancing enteral support should be administered with caution. Comparison between enteral and parenteral nutrition Better results achieved with parenteral nutrition can be ascribed to higher caloric intake; however, enteral nutrition was found to be better for some classes of patients. Conclusion: Nutritional support is deemed to be useful in critically ill patients. Enteral and parenteral formulas should induce endogenous insulin production without producing hyperglycaemia. Normoglycaemic status is mandatory for reducing mortality and complications in critically ill patients.