In our daily practice, we aim to improve patients' outcome by providing all sorts of treatment modalities. However, are we really creating suvivors and not victims? Studies have shown that patients discharged from ICU may suffer from post ICU syndrome, in which patients will be manifested as impairment in physical, cognitive and mental health. Apart from ABCDEF bundle (A-assess, prevent and manage pain; B-both spontaneous awakening and breathing trials; C-choice of medication management; D-delirium; E-early mobility and exercise; F-family engagement and empowerment), appropriate nutrition therapy can improve patients' outcome.
There are a lot of convertrosies in the field of critical care nutrition, but the basic concept is to start early when the patient has adequately resuscitated, not to give too little or too much. We should bear in mind that every patient is different and one size does not fit all. Therefore, when we are considering nutrition therapy to our patients, we should provide assessment for individual patient.
We will encounter different obstacles during the journey of nutrition therapy. It is important for us to identify those obstacles and try to overcome them with the aim to reduce interruptions during nutrition therapy. It is also a time to review the role of gastric residual volume; which is a tradition to guide enteral feeding tolerance, and the establishment of nutrition therapy team (NTT) should be considered.
Our local position statement for critical care nutrition is currently under construction, with the support from Hong Kong Society of Critical Care Medicine (HKSCCM) and Hong Kong Society of Parenteral and Enteral Nutrition (HKSPEN). Hopefully this position statement can serve as a guide of nutrition therapy for critically ill patients in our locality.
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