The critically ill surgical patient: nutritional considerations.

The nutritional care of the patient in the surgical intensive care unit is one of the most challenging in the field of nutritional support. Each patient must be assessed individually and specific goals of nutritional support established. Specialized nutritional solutions may be needed for the patient with significant renal, hepatic, or pulmonary disease, as well as patients in a chronic septic state. Knowledge of the infectious and metabolic complications that frequently occur in this population is essential in order to keep nutritionally related morbidity at a minimum. Finally, the realization that, in the surgical intensive care unit, nutritional therapy is often a supportive measure used in an attempt to gain time to eradicate the primary process will enable the clinician to establish the proper approach to the nutritional care of these patients.