Nutrition In The Critically Ill Obese– Obesity is one of the leading causes of preventable death in the United States, second only to smoking. The historical view point toward obesity has deemed it to be a lifestyle choice or characterological flaw. However, given the emerging research into the development of obesity and its related complications, our perspective is changing. It is now clear that obesity is a heterogeneous disease with many different subtypes. The pathophysiology associated with weight gain is much more complex than originally thought. The heterogeneous nature of the disease makes the development of treatment strategies for obesity difficult.
Obesity should not be considered a single disorder but rather a mixture of numerous subtypes. In a large cohort study of primary care patients undergoing a general physical exam, physicians only correctly identified obese patients 19.9% (505/2543) of the time. Staff physicians were less likely to identify obese patients than resident physicians. A poorly understood interaction between genetic, environmental, and complex pathophysiology is involved. The need for an overview of the epidemiology of obesity, discussion of the nature of its heterogeneity, and an explanation of its underlying genetic variability is clearly visible.
The paucity of information for the nutrition management of the obese, critically ill patient in the literature and in specialty society guidelines is problematic. The absence of such recommendations implies that obese patients should be treated no differently than their lean counterparts. However, there is no evidence that such a concept is true, and clinical experience would suggest just the opposite. Clinicians are often on their own to design the appropriate nutrition regimen, determine the need for indirect calorimetry, select the most appropriate predictive equation, decide whether pharmaconutrition should be used, identify tolerance measures, and set appropriate monitors of feeding for the obese ICU patient.
Discuss the pathophysiology related to obesity.
Identify the comorbidities of obesity which complicate ICU care.
List the current suggested nutritional recommendations for the obese ICU population.
1.0 Free CPEUs for Registered Dieticians
This course also offers Free CEUs for Physicians, PAs, and Pharmacists