Alfred Intensive Care Unit

Nutrition

The provision of optimal nutrition to critically ill patients is regarded as a key component of intensive care management. The Department of Intensive Care has had a substantial interest in nutrition over many years and has therefore had a long track record of collaboration with the Department of Nutrition to optimise nutrition therapy.

Nutrition is one of the items of the ICU daily checklist. This means that nutrition is discussed on the multi-disciplinary intensivist-led morning ward round. There are 3 dietitians allocated to each of the 3 sections of the ICU (trauma, cardio-thoracic and general) and they provide a 7 day service. When a new patient is admitted, nutrition can be commenced rapidly after discussion between the ICU and nutrition teams.

Since 2007, the Alfred ICU has participated in the International Critical Care Nutrition Survey. This has been run annually. Based on results of the 2009 survey, the Alfred ICU was judged the Best of the Best from over 100 ICUs who were compared for aspects of optimal nutrition therapy and adherence to clinical practice guidelines. The next survey will be held in 2011.

www.criticalcarenutrition.com.au

In 2010, the Department of Intensive Care held the Inaugural Nutrition in the Critically Ill Symposium in conjunction with the Department of Nutrition. This was a 2 day meeting held at the Park Hyatt, Melbourne and attracted substantial interest from around Australia and New Zealand. Key invited speakers were Prof Daren Heyland (Kingston, Canada), A/Prof Marianne Chapman (Adelaide), A/Prof Peter Devitt (Adelaide) and Ms Lyn Gillanders (Auckland). Baxter were the main sponsors. A 2nd Symposium will be held in conjunction with AuSPEN in November 2011.

www.alfredicunutrition.org.au

The Alfred ICU has recently purchased 3 indirect calorimetry machines. The aim is for these to be used on the most severely unwell ICU patients to optimise nutritional targets.

www.cosmed.it

One of the key programs of research in the Department of Intensive Care is nutrition in the critically ill. Amongst other studies, the department has been a major contributor to both the multi-centre ENTERIC (early nasojejunal enteral nutrition) and ASAP (nutrition in acute pancreatitis) studies, and has participated in the Early Feeding Guidelines (cluster RCT on evidence-based guidelines). A significant area of research focus has been on the dose of protein required in patients receiving haemofiltration.

ICU Research

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