Using nutritional support (NS) to achieve best outcomes for our critically ill patients is important in all countries. The Australian and New Zealand healthcare systems place strong emphasis on the education and clinical practice of high quality critical care nutrition. A recent international survey has demonstrated that Australasians administer a high proportion of enteral nutrition (EN), which is commenced early after admission. There is very common use of evidence-based feeding protocols which place emphasis on the use of promotility drugs and small bowel feeding when gastric intolerance occurs. Parenteral nutrition (PN) is uncommonly administered unless there is major gastrointestinal pathology and the combination of EN and PN is rare. Arginine-containing EN is used very rarely and glutamine is only infrequently supplemented. Unfortunately, despite the recent supportive evidence, EN with fish oil, borage oil and antioxidants is not commercially available in our countries. Nevertheless when PN is used, newer style lipids (such as olive oil) appear to be taking over from soybean oils. The Australian and New Zealand Intensive Care Society Clinical Trials Group has a strong focus on critical care nutrition with 3 important multi-centre research trials underway. These are testing the interventions of early nasojejunal feeding, early parenteral nutrition and intensive insulin therapy with results eagerly awaited.

From
The 12th PENSA Congress
October 18-20 2007
Century Park Hotel, Manila, Philippines
Page: 46