RESUMO
Historically, several studies showed an association between malnutrition in critically ill patients and poor outcomes. As a result, the standard practice had been to provide patients with full nutrition as soon as possible to eliminate malnutrition, improve outcomes, and reduce mortality. However, several studies recently suggested that providing more calories and protein is not better in critical illness and may be harmful in certain disease states. This literature review and editorial describe the harms of maximal feeding early in critical illness.
Assuntos
Estado Terminal , Humanos , Estado Terminal/terapia , Cuidados Críticos/métodos , Hipernutrição/complicações , Ingestão de Energia/fisiologia , Desnutrição/complicações , Apoio Nutricional/métodos , Apoio Nutricional/efeitos adversosRESUMO
Neurocognitive changes are the most common complication after cardiac surgery, ranging from acute postoperative delirium to prolonged postoperative neurocognitive disorder. Changes in cognition are distressing to patients and families and associated with worse outcomes overall. This review outlines definitions and diagnostic criteria, risk factors for, and mechanisms of Perioperative Neurocognitive Disorders and offers strategies for preoperative screening and perioperative prevention and management of neurocognitive complications.