Personalized nutrition therapy in critical care: 10 expert recommendations
Recommendations
As issued by the authors
Low-dose enteral nutrition (EN) or parenteral nutrition (PN) can be started within 48 h of admission.
EN is preferred; when early EN is not feasible, isocaloric PN is effective and gives similar outcomes.
Indirect calorimetry (IC) measurement of energy expenditure (EE) after stabilization post-ICU admission.
Below-measured EE (≈70%) targets early, increased to match EE later in stay.
Low-dose protein early (~ D1-2) (< 0.8 g/kg/d), progressed to ≥ 1.2 g/kg/d as patients stabilize; consider avoiding higher protein in unstable patients and in AKI not on CRRT.
Clinicians must be aware of delivered energy/protein and the percentage of targets it represents.
In patients at risk of micronutrient/vitamin losses (e.g., CRRT), consider evaluating micronutrient levels post-ICU days 5-7, repleting deficiencies where indicated.
Post-ICU, consider continued IC measurement and other muscle measures to guide nutrition.
Original publication
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