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VOL. 12, ISSUE 11 (2025)
Nutritional support in sepsis and septic shock: current evidence and future directions
Authors
Prama Bose
Abstract
Nutritional support plays a critical role in the management of sepsis
and septic shock, significantly influencing patient outcomes through modulation
of immune function, organ recovery, and metabolic balance. Sepsis induces a
hypermetabolic and catabolic state, increasing energy and protein requirements,
which necessitates timely and appropriate nutritional intervention to preserve
lean body mass and optimize immune response. Early enteral nutrition (EEN),
ideally initiated within 24–48 hours of diagnosis, is recommended when
feasible, as it maintains gut integrity, reduces bacterial translocation, and
may lower infection rates and ICU length of stay. In patients with hemodynamic
instability or on high-dose vasopressors, cautious initiation of EEN—such as trophic
feeding or delayed feeding—is advised due to the risk of intestinal ischemia.
Parenteral nutrition (PN) is indicated when EN is contraindicated or
insufficient, although early PN may increase infection risk and metabolic
complications, requiring strict aseptic technique and close monitoring.
Permissive underfeeding is recommended during the acute phase to prevent
overfeeding-related complications, with gradual escalation to full caloric
requirements as patients stabilize. Protein intake should be individualized,
targeting 1.2–2.0 g/kg/day for patients with significant catabolism, while
micronutrient supplementation, such as magnesium and vitamin C, may offer
adjunctive benefits. Advances in personalized nutrition, including predictive
modeling and artificial intelligence, hold promise for tailoring energy and
nutrient delivery to dynamic patient-specific needs, optimizing outcomes while
minimizing complications. Overall, enteral nutrition remains the preferred
route in sepsis and septic shock, with parenteral nutrition reserved for select
scenarios, and individualized, evidence-based nutritional strategies are
essential to improve clinical outcomes in this critically ill population.
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Pages:29-30
How to cite this article:
Prama Bose "Nutritional support in sepsis and septic shock: current evidence and future directions". International Journal of Multidisciplinary Research and Development, Vol 12, Issue 11, 2025, Pages 29-30
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