Nutritional treatment in the critically-ill complicated patient

Abstract

This chapter reviews the nutritional treatment of the bariatric patients admitted to the intensive care unit. Prescription of calories and proteins based on direct measurements or on calculations with bodyweight is revised, as hypercaloric diets are associated with worse clinical outcomes. Adequate protein provision is emphasized to avoid protein catabolism in critical illness, and low-calorie high-protein diets are endorsed as the recommended nutritional therapy. Advice regarding the management of the metabolic complications of artificial nutrition is also given, as well as a brief comment on adding specific micronutrients. The last section of the chapter is dedicated to optimize the resuscitation of the obese critical patient and cautions the physician about the pharmacological modification that occurs in this setting.