- In the 1980s, the concept of parenteral hyperalimentation or hypercaloric feeding was dominant.
- this was stopped due to the sequelae, which limit attempts to rapidly correct malnutrition
- some early studies suggesting harm from early feeding were actually showing the effects of overfeeding
RISK FACTORS FOR OVERFEEDING
- extremes of size (e.g. very small, or very large) are susceptible
- non-protein calories are not included (e.g. glucose in IV fluids, lipid in propofol)
- errors in height or weight measurements /estimates or calculations
- failure to account for clinical state (e.g. decreased energy needs from sedation and mechanical ventilation)
- use of parenteral nutrition
- hyperglycemia: osmotic diuresis, infection, hypertonic dehydration
- hyperlipidemia: hyperviscosity, immunosuppression, infections, pancreatitis, steatohepatitis, fat overload syndrome
- hypercapnia: respiratory acidosis, tachycardia, tachypnea, prolonged weaning from ventilator
- liver dysfunction, abnormal LFTs (cholestasis, transaminitis), steatohepatitis
- refeeding syndrome
References and Links
- Griffiths RD. Too much of a good thing: the curse of overfeeding. Crit Care. 2007;11(6):176. Review. PubMed PMID: 18036266; PubMed Central PMCID: PMC2246202.
- Klein CJ, Stanek GS, Wiles CE 3rd. Overfeeding macronutrients to critically ill adults: metabolic complications. J Am Diet Assoc. 1998 Jul;98(7):795-806. Review. PubMed PMID: 9664922.
- Schulman RC, Mechanick JI. Can nutrition support interfere with recovery from acute critical illness? World Rev Nutr Diet. 2013;105:69-81. doi: 10.1159/000341272. Epub 2012 Oct 12. PubMed PMID: 23075588.