Many survivors of critical illness face significant physical and psychological disability following discharge from the intensive care unit (ICU). They are often malnourished, a condition associated with poor outcomes, and nutrition remains problematic particularly in the early phases of ICU recovery. Yet nutrition rehabilitation, the process of restoring or optimizing nutritional status following illness, is seldom prioritized, possibly because it is an underrecognized and underappreciated area in critical care rehabilitation and research. To date, 16 original studies have been published where one of the objectives includes measurement of indices relating to nutritional status (e.g., nutrition intake or factors impacting nutrition intake) in ICU survivors. The primary aim of this narrative review is to provide a comprehensive summary of key themes arising from these studies which form the basis of our current understanding of nutritional recovery and rehabilitation in ICU survivors. ICU survivors face a multitude of barriers in achieving optimal nutrition that are of physiological (e.g., poor appetite and early satiety), functional (e.g., dysphagia, reduced ability to feed independently), and psychological (e.g., low mood, body dysmorphia) origins. Organizational-related barriers such as inappropriate feeding times and meal interruptions frequently impact an ICU survivor’s ability to eat. Healthcare providers working on wards frequently lack knowledge of the specific needs of recovering critically ill patients which can negatively impact post-ICU nutrition care. Unsurprisingly, nutrition intake is largely inadequate following ICU discharge, with the largest deficits occurring in those who have had enteral nutrition prematurely discontinued and rely on an oral diet as their only source of nutrition. With consideration to themes arising from this review, pragmatic strategies to improve nutrition rehabilitation are explored and directions for future research in the field of post-ICU nutrition recovery and rehabilitation are discussed. Given the interplay between nutrition and physical and psychological health, it is imperative that enhancing the nutritional status of an ICU survivor is considered when developing multidisciplinary rehabilitation strategies. It must also be recognized that dietitians are experts in the field of nutrition and should be included in stakeholder meetings that aim to enhance ICU rehabilitation strategies and improve outcomes for survivors of critical illness.

中文翻译：

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营养康复在危重病幸存者康复中的作用：被低估和被低估

许多危重病幸存者在从重症监护室 (ICU) 出院后面临严重的身体和心理残疾。他们通常营养不良，这种情况与不良预后相关，而且营养仍然存在问题，特别是在 ICU 恢复的早期阶段。然而，营养康复，即疾病后恢复或优化营养状况的过程，很少被优先考虑，可能是因为它是重症监护康复和研究中一个未被充分认识和低估的领域。迄今为止，已经发表了 16 项原始研究，其中一个目标包括测量与 ICU 幸存者的营养状况相关的指标（例如，营养摄入或影响营养摄入的因素）。这篇叙述性综述的主要目的是对这些研究产生的关键主题进行全面总结，这些主题构成了我们目前对 ICU 幸存者营养恢复和康复的理解的基础。ICU 幸存者在获得最佳营养方面面临许多障碍，这些障碍来自生理（例如食欲不振和早饱）、功能障碍（例如吞咽困难、独立进食能力下降）和心理障碍（例如情绪低落、身体畸形） . 与组织相关的障碍，例如不适当的进食时间和进餐中断，经常会影响 ICU 幸存者的进食能力。在病房工作的医疗保健提供者经常缺乏对重症患者康复特定需求的了解，这可能会对 ICU 后的营养护理产生负面影响。不出所料，ICU 出院后营养摄入基本不足，其中最大的不足发生在那些过早停止肠内营养并依赖口服饮食作为唯一营养来源的人中。结合本综述提出的主题，探讨改善营养康复的务实策略，并讨论ICU后营养恢复和康复领域的未来研究方向。鉴于营养与身心健康之间的相互作用，在制定多学科康复策略时，必须考虑提高 ICU 幸存者的营养状况。