Thread by @LifeWithoutDiet

@NileshMehtaMD up next to discuss what’s new in #ICUNutrition guidelines and how he has interpreted them. #SCCM2023

Mehta: Reminder of the hierarchy of evidence. #SCCM2023 #ICUNutrition

Mehta: guidelines must have clinical context. #SCCM2023 #ICUNutrition

Mehta: Utilizing GRADE means the clinical context & study design could increase or decrease the level of evidence despite where study type falls in the hierarchy. #SCCM2023 #ICUNutrition

#SCCM2023 #ICUNutrition

Mehta: we all agree that in both adults and #PedsICU we must screen all patients and identify those at risk early & complete full assessment. There are many scores for adult but not much for peds. #SCCM2023 #ICUNutrition

Mehta: timing of nutrition provision important to consider. Too much too early could be detrimental #SCCM2023 #ICUNutrition

Mehta reminds us that weight based equations are NOT accurate, simply estimates. Indirect calorimetry is “coming back” with advancements in technology. #SCCM2023 #ICUNutrition

Mehta: aim for 2/3 of goal in first ~week of acute phase. Important to avoid over feeding. #ICUNutrition #SCCM2023

Mehta: Protein also unclear w/ its impact on outcomes, especially in early acute phase. #SCCM2023 #ICUNutrition

Mehta: still agree that early EN is safe and preferred, but be cautious of overzealous caloric provision. #SCCM2023 #ICUNutrition

Mehta: PN IS SAFE! We may still need more data on timing. #SCCM2023 #ICUNutrition

More to come on mixed oil lipids. #SCCM2023 #ICUNutrition

Standard formulas are fine for critically ill. No evidence for specialized formulas. #SCCM2023 #ICUNutrition

Missed the slide, but Mehta says no evidence for various micronutrient treatments (ex Vit C) #SCCM2023 #ICUNutrition

@NileshMehtaMD Summary slides #SCCM2023 #ICUNutrition