Nutrition in the critically ill in resource-limited settings/low- and middle-income countries

PURPOSE OF REVIEW: To share current concepts and provide an overview of the contextual issues and nutrition practices in critically ill patients in resource-limited settings (RLSs)/low- and middle-income countries (LMICs). Most of the world's population reside in these settings which also carries the greatest burden of critical illness.

RECENT FINDINGS: There is a paucity of evidence on nutrition practice in critically ill patients in RLSs and international guidelines are largely based on evidence derived from high-income countries (HICs). While some recommendations are adaptable to RLSs, many are not feasible or directly transferable. Despite the challenges that may prevail, pragmatic solutions can address many of the difficulties to enhance nutrition practice and improve patient outcomes.

SUMMARY: This review provides a contemporary synopsis of nutrition practice in critically ill patients in RLSs covering the relevance of optimal nutrition, gives insights into relevant contextual issues and challenges in RLSs, evaluates recent scientific evidence and available literature pertinent to critically ill patients in RLSs, addresses nutrition guidelines, discusses some pragmatic options and solutions, deals with relevant and important complications that may arise, and offers suggestions and future considerations to enhance nutrition practice in critically ill patients in these settings.