Position statement for critical care nutrition in Hong Kong

Abstract

Nutrition therapy is an important yet controversial issue in critical care field. There are numerous international guidelines or publications showing different views; therefore it is difficult to practice critical care nutrition in clinical setting. We believed that by providing appropriate and individualized nutrition therapy, patient’s outcome can be improved.

A local position statement was written by the opinion of critical care physicians, intensivists, and dietitians in Hong Kong after reviewing available evidence; with the aim to provide recommendations in nutrition therapy in local critical care setting and to stress the importance of appropriate nutrition therapy. The position statement includes recommendations on the general aspects, enteral nutrition, parenteral nutrition, and nutrition for specific diseases. A flow chart (Figure 1) is constructed to provide a pathway for implementing nutritional therapy in clinical practice. The position statement was endorsed by the Hong Kong Society of Critical Care Medicine (HKSCCM) and the Hong Kong Society of Parenteral and Enteral Nutrition (HKSPEN).


Authors: Li Li Chang, Yue Ho Vincent Lau, Ting Ting Sinn, Siu Pik Peggy Lee, Ka Ming Kwok, Tin Yan Li, Anfernee Yim

Restrictive versus liberal fluid bolus therapy in septic shock children: An evidence-based case report

Abstract

Fluid bolus therapy (FBT) is one of prime management in early goal-directed therapy (EGDT) to achieve adequate cardiac output. The Fluid Expansion as Supportive Therapy (FEAST) trial, a randomized-clinical trial that was used as an evidence to support fluid resuscitation recommendation in Surviving Sepsis Campaign (SSC) 2020, must be discontinued because of increasing mortality in the group that received higher volume of FBT. We present a case of a 9-year-old girl, 15 kg, came to emergency ward with refractory septic shock and became fluid overload after the second FBT. This proceeding aimed to deliver evidence-based case practice if the comparison between liberal versus restrictive FBT in children with septic shock.


Authors: Irene Yuniar