Nutritional needs of critically ill patients

Nutrition for critically ill or injured animals should be addressed early in case management. These patients are typically anorectic as well as in a hypermetabolic state. The patient's need for water and energy should be addressed first. Requirements for vitamins and minerals are much less urgent. The veterinarian must assess the animal's nutritional requirements (which can be dramatically increased because of illness or injury) and its current intake. This article discusses the metabolic differences between simple starvation and critical illness. Also considered are laboratory findings that can profile nutritional status. The article also shows how to estimate the energy requirements of critically ill animals. These requirements are usually somewhere between resting and maintenance levels. A nutritional plan specifies not only the diet to be fed and the amount to be fed but also the route of administration. Enteral feeding is preferable whenever possible. Even a small amount of enteral feeding can facilitate protection of the gastrointestinal tract, thus helping to prevent sepsis. If the animal will not eat, the practitioner must decide whether the nutrients will be provided enterally or parenterally.