Provision of Nutrition Support Therapy in the Adult Critically Ill Patient
Publication Date: November 15, 2021
Last Updated: March 14, 2022
Summary of Recommendations
No significant difference in clinical outcomes was found between patients with higher vs lower levels of energy intake. We suggest feeding between 12 and 25 kcal/kg (ie, the range of mean energy intakes examined) in the first 7–10 days of ICU stay. (C, M)
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Other Questions
- In adult critically ill patients, do higher nutrition risk scores predict worse outcomes than BMI alone as the indicator of nutrition risk?
- Our searches yielded no RCTs comparing clinical outcomes based on groups of patients randomized according to either the Nutrition Risk in the Critically Ill (NUTRIC) score or the Nutrition Risk Screening 2002 (NRS2002) tool relative to BMI. The evidence supporting each of these approaches to nutrition assessment to date has been based largely on retrospective observational studies, a level of evidence excluded in this current guideline.
- In adult critically ill patients, do immune-enhancing nutrients provide better outcomes than standard care?
- This broad question encompasses differing numbers of nutrients (glutamine; ω-3 fatty acids; individual vitamins, minerals, and trace elements) that are compared at widely variable doses. Because this current guideline was focused on providing answers to foundational practice questions in the general critically ill population, the decision was made to construct a future author panel to deal with this question as its own guideline.
- In adult critically ill patients, do probiotics provide better outcomes than standard care?
- The RCTs that were identified by our search strategy reported on a variety of probiotic preparations and doses and did not report consistently on the outcomes included in this guideline.
Title
Provision of Nutrition Support Therapy in the Adult Critically Ill Patient
Authoring Organization
American Society for Parenteral and Enteral Nutrition