Define Dietary Management of Sepsis with or without MODS?
Before we begin with the dietary management of patients suffering from sepsis with or without MODS let us read a case below. Mr. Sunder a 71 years old man was admitted to the ICU of a multi-speciality hospital suffering from moderate urinary tract infection and difficulty in breathing due to aspiration pneumonia. He was immediately put on ventilator to facilitate breathing. His medical history indicated that he was an old case of non-insulin dependent diabetes mellitus. Due to aspiration pneumonia and resultant intubations.
The patient had to be fed through external tube feeds. Presence of infection however exacerbated hyperglycemia and there was a marked reduction in WBC count. Gradually, the patient had to fed through the parenteral route. Due to persistent infection there was considerable wasting and under-nourishment. On one hand the infection entered the blood stream and affected other organs whereas on the other hand feeding through parenteral route resulted in atrophy of the small intestine. The patient ultimately expired after three months due to the septic shock, renal failure and diabetic coma. This is an example of the most common pathways which develop in critically ill patients. Keeping these complications in mind let us briefly discuss the nutrient requirements and the various forms of nutritional support which can be provided lo such patients.