March Summary

Posts from question 1 gave many complications that occur when an obese ICU patient is overfed. Some of the responses were increased production carbon dioxide, which impairs vent weaning, diabetes, hyperlipidemia, and increased aspiratory pneumonia. Other responses included: hyperglycemia, risk for infection, weight gain and hypertension. A few other complications included an increase in length of stay and heart complications. Yes all of these can play a role if an obese patient is overfed while in the hospital. One comment that was mentioned was the importance of finding that balance between over and underfeeding obese patient. This is important because there will be many obese patients in the hospital as we practice, due to the high obesity rate in the US. Hopefully, more research can be done to help us better understand how to feed the obese hospital patient and find a balance.

Posts from question 2 revealed maybe by providing less calories the patient had a lower risk for hyperglycemia, infection and vent weaning complications and overall less stress placed on the body. In addition, the lower calories would lead to less diabetes and heart or pulmonary complications and lead to less days in the hospital. Other explanations were that the calories calculated were too high from incorrect use of formula or error, which made the percentage used closer to an accurate calorie amount. By providing a calorie percentage it allowed the patient to be more accurately fed and lowered length of stay. Another common explanation was that by providing the body with fewer calories it gave the body more energy to heal and spent less energy digestion and breaking down food.

Posts from question 3 included first following the protocol established by the hospital. Many stated that they would need more evidence and felt that more studies need to be completed before they would present the information. One good point was the importance of building rapport with the doctors so that when you do feel comfortable and have enough information and research the doctors are willing to listen and trust your opinion. Another point that was made was if the research is there then be active. The only way the dietetics field will change for the better is if we as dietitians promote change and have research to back up our points. As a dietitian it is important to be up to date with the current research and use the research. Also keep in mind these complications and always be very accurate when calculating patient needs.