ESPEN Guidelines on Enteral Nutrition: Intensive care
Enteral nutrition (EN) via tube feeding is, today, the preferred way of feeding the critically ill patient and an important means of counteracting for the
catabolic state induced by severe diseases. These guidelines are intended to give evidence-based recommendations for the use of EN in patients who have a complicated course during their ICU stay, focusing particularly on those who develop a severe inflammatory response, i.e. patients who have failure of at least one organ during their ICU stay. These guidelines were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publica-tions since 1985. They were discussed and accepted in a consensus conference. EN should be given to all ICU patients who are not expected to be taking a full oral diet within three days. It should have begun during the first 24 h using a standardÂ high-protein formula. During the acute and initial phases of critical illness an exogenous energy supply in excess of 20â€“25 kcal/kg BW/day should be avoided, whereas, during recovery, the aim should be to provide values of 25â€“30 total kcal/ kg BW/day. Supplementary parenteral nutrition remains a reserve tool and should be given only to those patients who do not reach their target nutrient intake on EN
alone. There is no general indication for immune-modulating formulae in patients with severe illness or sepsis and an APACHE II Score 415. Glutamine should be supplemented in patients suffering from burns or trauma.