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NUTRITION IN ICU
Hippocrates 400 B.C.
Blood
Weight
biochemistry
Anthropometric measurements
Indirect calorimetry
Physical examination
Examine regularly
Nutritional status
Weight should be measured daily
Hydration status
Reasonable predictor of body fat and caloric
balance
Functional assessment
Repletion of protein and energy reserves is
associated with:
IMPROVEMENT IN FUNCTIONAL
ABILITIES
• Grip strength
• Activity level
• Physical endurance
Laboratory test
Useful for monitoring individual patient responses
to parenteral and enteral nutrition support
• Metabolic state
• Protein – energy balance
• Micronutrition status
• Fluid and electrolyte
• Acid – base balance
• Organ function
PN and Tube feeding Test
Na+,K+,Cl-,CO2,Glu,BUN,Cre Daily until stable
at
Albumin Weekly
Transthyretin Weekly
C- Reactive Protein As needed
PO4 Every other day
Mg Every other day
Vitamin C As needed
Zinc As needed
24-hour Urinary Nitrogen As needed
Parenteral only
Chemsticks 6 hourly
iCa Every alternate day ( until
stable)
Alkaline Phosphatase Weekly
AST Weekly
Total Bilirubin Weekly
Triglyceride As needed
PT As needed
Nitrogen balance
Useful in determining individual protein
requirement
fall.
Transthyretin
previously known as prealbumin
Transferrin