Nutrition for Obese Critically Ill Intensive Care Patients with Special Regard for the Dosing of Protein

Nutrition for obese critically ill patients is still a controversial discussion. Latest guidelines give contradictory and partially unphysiological recommendations. Even if they agree on a hypocaloric, high protein feeding regimens, there is no agreement on the exact amount of energy and protein that should be provided for the obese patients. We describe a new concept of hypoalimentation which is based on the definition of lean body weight as well as protein dosing which is based on an estimation of the lean body mass. A comparison with traditional recommendation reveals the physiologic advantages of this new approach.