Nutritional management of survivors of critical illness: The clinical pharmacists' role

Critically ill patients face many challenges such as dysphagia leading to muscle loss and malnutrition. To prevent and treat malnutrition, ICU protocols from the European Society of Clinical Nutrition and Metabolism (ESPEN) and American Society of Parenteral and Enteral Nutrition (ASPEN) are established, available and implemented in ICU's, However, in the post-ICU phase, little literature is available evaluating the nutritional needs of those patients as well as the challenges they are facing. Artificial nutrition can be used to provide adequate nutrition, but in combination with various drugs such as prokinetics or analgesics drug side effects, drug-drug and drug-nutrition interactions may occur resulting in suboptimal nutritional therapy. To prevent these problems, clinical pharmacists can provide meaningful support. Clinical pharmacists are specialists in medication review and medication reconciliation guaranteeing adequate dosing, preventing side effects and checking for drug appropriateness. Through multidisciplinary collaboration, they are also often involved in nutritional support. The aim of this article was to review current literature regarding the roles of clinical pharmacists as well as providing insights in their future role in post-ICU nutritional care.