Nutrition du patient obèse agressé

Over the past three decades, the incidence of obesity showed a steady rise in developed countries. So, it is not surprising that obese patients constitute an increasing portion of patients admitted to the intensive care units. Critically ill obese patients are characterized by wide variations in their carbohydrate, lipid and amino acid/protein metabolism. Nutrition support in the critically ill patient is challenging but is even more difficult in a morbidly obese patient. Providing nutritional support for the critically ill obese patients represents a unique challenge to the medical team. Measurement of energy expenditure by indirect calorimetry has become the preferred method, however, it is not always available and different equations could be used. Hypocaloric, high-protein nutritional support may be beneficial for net protein anabolism and better glycemic control.