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Improving Nutritional Management in Surgical Intensive Care

Sebastian Harald

Nutritional supplementation is crucial in the treatment of surgical critical care patients. Malnutrition and prolonged catabolism during surgery can have a number of negative consequences, including delayed or aberrant wound healing, secondary infections, muscular atrophy, and a longer hospital stay. Early Enteral Nutrition (EN) assists in meeting metabolic needs during the acute phase of surgery-related critical illness, rebuilds nutritional stores during recovery, and lowers hospital mortality. When oral feeding isn't an option, it's more physiologic to supply nutrients through the gut, which helps to maintain the gut's barrier function. EN is preferable to Parenteral Nutrition (PN) since it has been found to maintain GI integrity and function while also improving blood flow and peristalsis. It also reduces the risk of systemic infections by preventing bacterial translocation. In comparison to medical patients, surgical patients are less likely to receive EN and more likely to receive PN, according to the research. Following both elective and urgent surgery, tube feeding is frequently delayed, and patients are less likely to achieve nutritional adequacy. Without explanation, patients undergoing gastrointestinal and cardiovascular surgery receive the least quantity of EN. Despite the benefits, providing appropriate nourishment early in the Surgical Intensive Care Unit (SICU) can be difficult due to frequent pauses from surgery and test scheduling, reported discomfort of tube feeding, ventilator weaning trials, and normal nursing care.