Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect

Nutritional support is crucial for critically ill patients. Recent clinical studies suggest that both overfeeding during the acute phase of critical illness and overly conservative or delayed nutritional therapy can pose significant risks. Given substantial individual variability among critically il...

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Main Authors: Youquan Wang, Yanhua Li, Nan Li, Yuting Li, Hongxiang Li, Dong Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1555311/full
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author Youquan Wang
Yanhua Li
Nan Li
Yuting Li
Hongxiang Li
Dong Zhang
author_facet Youquan Wang
Yanhua Li
Nan Li
Yuting Li
Hongxiang Li
Dong Zhang
author_sort Youquan Wang
collection DOAJ
description Nutritional support is crucial for critically ill patients. Recent clinical studies suggest that both overfeeding during the acute phase of critical illness and overly conservative or delayed nutritional therapy can pose significant risks. Given substantial individual variability among critically ill patients, it is challenging to prescribe universally applicable and objective feeding strategies; Instead, we pointed out which nutritional interventions were harmful. We also summarized the reasons for protective nutrition, and elaborated the advantages of protective nutrition from three perspectives: gastrointestinal protection, nutritional protection and metabolic protection. In particular, it is emphasized that overfeeding will lead to metabolic disorders, such as mitochondrial dysfunction, autophagy inhibition, ketogenic inhibition, hyperglycemia, insulin resistance, etc. These detrimental processes can exacerbate one another, contributing to multiple organ dysfunction syndrome and poorer clinical outcomes. We also propose protective nutrition strategies comparable to lung protective ventilation strategies, which may benefit patients. Vigilant monitoring during nutritional implementation is also paramount, enhancing awareness of adverse events for early diagnosis and intervention to mitigate their harm.
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spelling doaj-art-866710aeceb7469eb62897071e1a6c432025-08-20T02:15:16ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-05-011210.3389/fnut.2025.15553111555311Protective nutrition strategy in the acute phase of critical illness: why, what and how to protectYouquan WangYanhua LiNan LiYuting LiHongxiang LiDong ZhangNutritional support is crucial for critically ill patients. Recent clinical studies suggest that both overfeeding during the acute phase of critical illness and overly conservative or delayed nutritional therapy can pose significant risks. Given substantial individual variability among critically ill patients, it is challenging to prescribe universally applicable and objective feeding strategies; Instead, we pointed out which nutritional interventions were harmful. We also summarized the reasons for protective nutrition, and elaborated the advantages of protective nutrition from three perspectives: gastrointestinal protection, nutritional protection and metabolic protection. In particular, it is emphasized that overfeeding will lead to metabolic disorders, such as mitochondrial dysfunction, autophagy inhibition, ketogenic inhibition, hyperglycemia, insulin resistance, etc. These detrimental processes can exacerbate one another, contributing to multiple organ dysfunction syndrome and poorer clinical outcomes. We also propose protective nutrition strategies comparable to lung protective ventilation strategies, which may benefit patients. Vigilant monitoring during nutritional implementation is also paramount, enhancing awareness of adverse events for early diagnosis and intervention to mitigate their harm.https://www.frontiersin.org/articles/10.3389/fnut.2025.1555311/fullcritical illnessintensive careenteral nutritionfeeding intolerancefeeding strategyrefeeding syndrome
spellingShingle Youquan Wang
Yanhua Li
Nan Li
Yuting Li
Hongxiang Li
Dong Zhang
Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
Frontiers in Nutrition
critical illness
intensive care
enteral nutrition
feeding intolerance
feeding strategy
refeeding syndrome
title Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
title_full Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
title_fullStr Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
title_full_unstemmed Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
title_short Protective nutrition strategy in the acute phase of critical illness: why, what and how to protect
title_sort protective nutrition strategy in the acute phase of critical illness why what and how to protect
topic critical illness
intensive care
enteral nutrition
feeding intolerance
feeding strategy
refeeding syndrome
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1555311/full
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