TdC 296: Nutrição no paciente em terapia intensiva (UTI)

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨Kaue Malpighi convida Amyr Chacar e Álvaro Delgado, gastroenterologista e especialista em terapia nutricional e reabilitação intestinal, para discutir sobre manejo de nutrição no paciente crítico em 3 tópicos:1. Abordagem inicial e fases da terapia nutricional2. Vias de nutrição3. Monitoramento e ajustesReferências:1. Gramlich L, Guenter P. Enteral Nutrition in Hospitalized Adults. N Engl J Med. 2025;392(15):1518-1530. doi:10.1056/NEJMra24069542. Singer P, Blaser AR, Berger MM, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clin Nutr. 2023;42(9):1671-1689. doi:10.1016/j.clnu.2023.07.0113. Compher C, Bingham AL, McCall M, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2022;46(1):12-41. doi:10.1002/jpen.22674. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P; Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003;27(5):355-373. doi:10.1177/01486071030270053555. Ramaswamy T, DeWane MP, Dashti HS, et al. Nine Myths about Enteral Feeding in Critically Ill Adults: An Expert Perspective. Adv Nutr. 2025;16(1):100345. doi:10.1016/j.advnut.2024.1003456. Reignier J, Boisramé-Helms J, Brisard L, et al. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet. 2018;391(10116):133-143. doi:10.1016/S0140-6736(17)32146-37. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta-analysis. J Gastrointest Surg. 2009;13(3):569-575. doi:10.1007/s11605-008-0592-x8. Reignier J, Mercier E, Le Gouge A, et al. Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial. JAMA. 2013;309(3):249-256. doi:10.1001/jama.2012.1963779. Ho KM, Dobb GJ, Webb SA. A comparison of early gastric and post-pyloric feeding in critically ill patients: a meta-analysis. Intensive Care Med. 2006;32(5):639-649. doi:10.1007/s00134-006-0128-310. Montejo JC. Enteral nutrition-related gastrointestinal complications in critically ill patients: a multicenter study. The Nutritional and Metabolic Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units. Crit Care Med. 1999;27(8):1447-1453. doi:10.1097/00003246-199908000-0000611. Dionne JC, Johnstone J, Heels-Ansdell D, et al. Diarrhea in Mechanically Ventilated Patients: A Nested Multicenter Substudy. Crit Care Med. 2025;53(6):e1247-e1256. doi:10.1097/CCM.000000000000666712. Qu J, Xu X, Xu C, Ding X, Zhang K, Hu L. The effect of intermittent versus continuous enteral feeding for critically ill patients: a meta-analysis of randomized controlled trials. Front Nutr. 2023;10:1214774. Published 2023 Aug 21. doi:10.3389/fnut.2023.1214774