Current Opinion in Critical Care · 1 author, 1 centre
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This editorial introduces a special edition advocating for personalized nutrition therapy in critical care, using phenotyping and endotyping to tailor energy, protein, and micronutrient delivery to individual patients. It argues that moving beyond standard, population-based guidelines can improve outcomes.
This editorial reviews the rationale for personalized nutrition therapy in critical illness, advocating for a shift from traditional, weight-based feeding guidelines. It describes phenotyping as the use of patient-specific data like BMI and metabolic state, and endotyping as identifying disease mechanisms via biomarkers to guide therapy. The central argument is that individualized strategies for energy, protein, and micronutrient provision are essential to prevent overfeeding or underfeeding and improve outcomes. The text cites recommendations for using indirect calorimetry for energy assessment and suggests biomarkers like the urea nitrogen appearance for protein dosing. Limitations include the acknowledged complexity of implementing such a personalized approach in practice. The implications are that personalized methods could be more effective than current standard care, though high-dose micronutrient supplementation is not recommended.
