Nutritional support in the critically ill surgical patient.

Aggressive nutritional support in the critically ill surgical patient is essential if improved outcome is to be realized. An understanding of the metabolic alterations of trauma and sepsis provides the foundation for a nutritional prescription for the individual patient. Careful nutritional assessment; titration of fluid, electrolytes, and micronutrients; provision of adequate calories and nitrogen to meet metabolic needs; and the selective use of specialized formulations are important components of nutritional management in the ICU.