Knowledge deficit among doctors, dieticians keeps role of nutrition neglected in intensive care

May 10, 2022 0 By Team FM

The concept of optimal nutrition, a key element in critical care, is still grossly neglected in the intensive care units in most Indian hospitals mainly due to lack of awareness among the hospital staff including doctors and dieticians. While the requirement of nutrition support at the optimum level is important for early and timely recovery of critically ill patients who are under treatment, this is often not considered as a priority in the country as the medical curriculum does not include this area as a  serious study or training material, reveals experts who participated in the latest Nutrition Boot Camp organised in Mumbai.

The 6th Edition of Nutrition Boot Camp-2022 organised as part of a clinical education programme supported by the Indian Society for Parenteral and Enteral Nutrition, S.L.Raheja Hospital and DocMode Health Technologies was attended by 300-plus delegates including physicians, intensivists, surgeons, registered dieticians and physicians from other medical specialists.

“Physicians and registered dieticians in our country do not get adequate exposure to nutritional aspects of critical care during their training period. Understandingly, nutritional needs of critically ill patients continue to be neglected,” says Dr. Sanjith Saseedharan, chief organiser and scientific lead of the Nutrition Boot Camp, and Head of Critical Care Department at S.L. Raheja Hospital, Mumbai.

“However, the practice of nutrition has seen a big change in the last two to three years as Covid-19, in particular, brought home how nutrition could make a crucial difference in survival and good functional outcome,” added Dr Saseedharan. 

Studies have revealed that up to 50 percent of patients after critical illness do not survive for more than 1 year, and only 70 percent reach optimal functional recovery after 5 years in India. Recent pre-clinical and clinical studies provide more insights into the role of nutrition and what it does to one’s body and how the body reacts. Numerous biomarkers, the doctor said, are being developed to study subgroups of patients and how they could benefit from targeted nutrition in an ICU setup.

“Nutrition practice, though, has been subjected to a paradigm shift in the last couple of years from “feed as much as we can” to “feed what is required.  The emphasis now is to personalise nutrition and use it as a therapeutic modality to ensure good, long-term outcomes,” say experts.

Arriving at the nutrition needs of critically ill patients in the absence of correct assessment of pathophysiology and disease progression is a challenge. However, according to participants, the Boot Camp has helped them get hands-on experience in best nutrition practices. Besides, they also got a feel of the best equipment that helps in the conduct of critical care nutrition more objectively. Although these validated devices are commonly available and installed in most healthcare setups abroad, they are rare in India. 

The Boot Camp also witnessed the release of a book titled “MCQs in Critical Care Nutrition”,  authored by Dr Saseedharan. The book, which comprehensively addresses the critical role of nutrition for the early recovery of critically ill patients, is an honest attempt to answer the most frequently asked questions on this topic, according to the author. 

“The Camp equipped the delegates with up-to-date knowledge on the nutritional needs of critically ill patients and how they can be administered safely, which is emphasised in the book authored by Dr. Saseedharan,” said Hans Lewis, founder, DocMode Healthcare Technologies, the official knowledge partner of the event.