000			01992nam a2200265 4500
001			ESSALUD
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040			_aBMG
041			_aeng
100			_aPatel, Jayshil J. _eAutor _953720
245			_aNutrition therapy in critically Ill adults
300			_apáginas: 162-174
520			_aIn the acute phase of critical illness, adults have severe catabolism, inflammation, muscle loss, and gut dysfunction, all of which shape nutritional requirements. Early enteral nutrition supports gut integrity and microbiome health, but trials have shown that early short-term parenteral nutrition is a safe alternative when enteral feeding is not possible. Large trials have shown that early full-dose energy delivery offers no benefit over restrictive dosing and may increase gastrointestinal and metabolic complications, findings that support a restrictive nutrition strategy, especially in patients who have circulatory shock or are at risk for refeeding syndrome. Similarly, large trials have shown no advantage of high-dose over standard-dose protein and suggest harm in patients with acute kidney injury. Because adverse events are common with enteral nutrition, safe nutrition delivery requires gradual advancement, strategies for prevention of refeeding syndrome, glycemic control, and avoidance of routine gastric residual volume monitoring. Patient heterogeneity underscores the need for precise, biomarker-guided, phase-specific nutrition to preserve lean muscle mass and improve recovery.
650			_aCUIDADOS INTENSIVOS _95208
650			_aNEUMOLOGÍA _925628
650			_aDIETA _97215
650			_aNUTRICIÓN
650			_aENDOCRINOLOGÍA _936891
650			_aENDOCRINOLOGÍA _936891
700			_aMcClave, Stephen A. _953721
773	0		_022717 _922635 _dMassachusetts NEJM Group _oNEJM002 _tThe New England Journal of Medicine _wESSALUD _x0028-4793
942			_cARTICULOS _e2026-07-30 _zsqb
999			_c22733 _d22733