The Critical Care Section presents their Member Spotlight on Dr. Jayshil Patel. As the current Chair-Elect for the Critical Care Section, Dr. Patel reflects on his work in clinical nutrition.
What is your current position and what specifically do you do?
I am an assistant professor in the Department of Medical, Division of Pulmonary and Critical Care Medicine at the Medical College of Wisconsin. I see patients, educate, and conduct research alongside a wonderful group of talented individuals.
How did you become involved in the field of clinical nutrition?
In 2009, I was unable to find an answer to my question “Should we introduce enteral nutrition in a mechanically ventilated patient with septic shock (i.e. on vasoactive support)?” At the time, the Surviving Sepsis Campaign guideline did not have a single recommendation for nutrition support/therapy. I started a journey to seek out the answer myself, and along the way had many more unanswered questions, which I now consider ripe opportunities.
How has critical care changed since you’ve been in the field?
I admit it is difficult to answer this question as I have only been an academic intensive care provider since 2011. However, I can say we are placing more emphasis on multi-disciplinary bedside care and team science. With nutrition therapy/support, my colleagues provide perspective and a better understanding on various topics related to bedside care and our research.
Tell us more about your research.
Currently, I am (1) studying the impact of early enteral nutrition in critically ill patients with septic shock and (2) identifying sarcopenic obesity in critical care survivors and determining whether protein optimization coupled with physical therapy can reverse sarcopenia.
Are providers becoming more apt to embrace clinical nutrition as a key component for optimal patient outcomes?
Yes, I believe they are becoming more apt to embrace clinical nutrition as a key component for optimal patient care. I believe we are shifting (for the better) towards individualized care. For example, the 2016 nutrition support therapy guidelines emphasize identifying which patients will be “at nutritional risk” and to tailor therapy based on whether the patient is likely to suffer consequences of inadequate nutrition provision. This helps us shape and modify the language we use in direct patient care. For example, if a patient is deemed to be at nutritional risk, we consider nutrition to be a form of therapy, as opposed to nutrition “support.” Therapy is pro-active and intended to shape patient outcomes.
Why is an organization like ASPEN vital to the field of clinical nutrition?
ASPEN’s strength lies in its multi-disciplinary members and their contributions. The members are the pulse of organization that disseminate vital information to their communities, directly impacting patient care and outcomes.
Are there any recommendations you would give to a clinician just starting out?
As a new clinician, you are impetus for fresh ideas – so keep asking questions and realize there are organizations such as ASPEN that can help in various facets of your career development, such as (1) continuing education, (2) mentorship, (3) fostering research, and importantly, (4) allowing you to get involved to be the change you want to see.
