Nutrition for the critically ill.

Standard IV therapy for a critically ill patient is a form of semi-starvation. The rate of complications and mortality can be as much as 50% higher in malnourished patients. Assessing patients' nutritional state as it was before the surgery or illness by asking about eating patterns indicates how severely a patient may react to further malnourishment. Even more important is assessment of the patient's immune defense system. Rate of hypermetabolism in the critically ill will indicate the amounts of nutrients needed and when. Enteral feeding is best, where possible. The physician must know the exact contents of whatever liquid diet is being used. If parenteral nutrition is used, stringent aseptic technique must be employed.