Can body composition in multiple organ failure be favorably influenced by feeding?

Multiple organ failure is the final common path of numerous medical conditions whereby the various organ systems fail and are supported by pharmacologic or mechanical means. The patient appears septic but often no septic focus can be found. Whole body protein dynamics are similar to severe sepsis with an elevation of both synthesis and breakdown. Lean body mass is not maintained even in the presence of an apparently adequate energy intake. The more common methods of assessing body composition are all confounded by fluid retention, which also limits parenteral nutrient intake. There are also difficulties with the tolerance of enteral feeding. In the long term, pharmacologic methods are going to be required if it is deemed that the maintenance of body mass is desirable, but in the interim, a robust noninvasive method is required of monitoring body mass in the presence of severe edema.