Management of parenteral nutrition in critically ill patients: literature review

 

Orinta Klimaitė1

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania

Abstract

Appropriately selected artificial nutrition, administration, management and knowledge of complications allow to avoid poorer prognosis in critically ill patients. This article reviews the management of parenteral nutrition in critically ill patients. Management and monitoring should be adjusted to the individual patient’s acuity, stability, and risks for deficiencies. Routine monitoring of parenteral nutrition includes measurement of fluid intake and output, as well as selected laboratory studies. Protocols and guidelines allow early diagnosis and prevention of severe conditions, which brings better outcomes and lesser complications in critically ill patients. To reduce the rate of parenteral nutrition ­related complications one more recommendation is to know well them. Knowledge of complications allows for quick response. The most common complications can be classified as: metabolic; infectious; and mechanical. Infectious complications, as mechanical complications, are more properly catheter-related and not parenteral nutrition-related complications. Parenteral nutrition requires a lot of care and attention so it is recommended that parenteral nutrition be prescribed by a multidisciplinary team of physicians, nutritionists, pharmacists, and nurses.

Keywords: Parenteral nutrition; Enteral nutrition; Artificial nutrition; Critically ill patients; Intensive care; COVID-19