Understanding of the physiologic and metabolic changes
during acute illness. Energy requirements and macronutrient utilization.
Protein metabolism and its importance. Screening and assessment of
malnutrition. Specific situations related to previous nutrition status (severe
undernutrition, obesity, sarcopenia), comorbidity (cancer, age, renal or liver
failure, …), and previous stay in the hospital. Determination of nutritional
prescription (calories, protein), choice of the route, decision regarding
timing (early enteral or parenteral nutrition), requirement of supplemental
parenteral nutrition. Choice of special nutrients and in which conditions:
glutamine, omega 3 fatty acids, various lipid emulsions, high protein feeding,
probiotics, vitamins and trace elements in special conditions (CRRT, liver
failure, ARDS, ECMO). Adaption of the nutritional regimen according to the
progress of the patient in the course of his therapy. Prevention of frailty
during stabilization and preparing for best rehabilitation.