Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Society for Parenteral and Enteral Nutrition and Society of Critical Care Medicine.

Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

American Society for Parenteral and Enteral Nutrition

Society of Critical Care Medicine

Publication Date: Jan 14, 2016

Page Last Updated: May 5, 2026

American Society for Gastrointestinal Endoscopy Grade System

Document Overview

Document Title: Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

Authoring Societies

American Society for Parenteral and Enteral Nutrition

Society of Critical Care Medicine

Document Publication Date: Jan 14, 2016

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: onlinelibrary.wiley.com/doi/full/10.1177/0148607115621863

Document Scope, Criteria, and Use Cases

Scope: Management

Diseases/Conditions (MeSH)

D018529 - Nutritional Support

Keywords: Nutrition Support , enteral nutrition, parenteral nutrition

Inclusion Criteria: Male, Female, Adult

Health Care Settings: Hospital, Long Term Care

Intended Users: Dietician/Nutritionist, Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Evidence Tables

Number of Source Documents: 480

Literature Search End Date: Tuesday, December 31, 2013

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No

Grade	Quality of Evidence	Definition
H	High	Further research is very unlikely to change our confidence in the estimate of effect.
M	Moderate	Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
L	Low	Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
VL	Very Low	Any estimate of effect is very uncertain.

Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

Recommendations

Nutrition Assessment

Initiate EN

Dosing of EN

Monitoring Tolerance and Adequacy of EN

Selection of Appropriate Enteral Formulation

Adjunctive Therapy

When to Use PN

When Indicated, Maximize Efficacy of PN

Pulmonary Failure

Renal Failure

Hepatic Failure

Acute Pancreatitis

Surgical Subsets

Trauma

Burns

Sepsis

Postoperative Major Surgery (SICU Admission Expected)

Chronically Critically Ill

Obesity in Critical Illness

Nutrition Therapy End-of-Life Situations

American Society for Gastrointestinal Endoscopy Grade System

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology