HARD DECISIONS IN INTENSIVE CARE UNIT

Intensivecareunitkapak

ENTERAL AND PARENTERAL NUTRITION IN INTENSIVE CARE UNIT

Gökhan Kılınç1

Volkan Yarar2

1 University of Health Sciences, Balikesir Atatürk City Hospital, Department of Anesthesiology and Reanimation, Balıkesir, Türkiye
2Balikesir Atatürk City Hospital, Department of Intensive Care, Balıkesir, Türkiye

Kılınç G, Yarar V. Enteral and Parenteral Nutrition in Intensive Care Unit. In: Turan S, editor. Hard Decisions in Intensive Care Unit. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.251-263.

ABSTRACT

Malnutrition is highly prevalent in critically ill patients, affecting up to 40-80% of those in intensive care units. Early nutritional support is crucial to mitigate the catabolic state and prevent complications. Current guidelines recommend initiating enteral nutrition (EN) within 24-48 hours of ICU admission when feasible. EN is preferred over parenteral nutrition (PN) due to its physiological benefits for gut health and immune function. However, PN remains an important alternative when EN is contraindicated or insufficient.

While EN and PN both carry potential risks, current evidence supports early initiation of nutritional support in most critically ill patients. An individualized approach considering the patient’s clinical status and nutritional needs is essential. Further research is needed to optimize nutrition protocols and improve outcomes in this high-risk population.

Current research supports the implementation of early EN for the majority of patients, with a gradual increase in daily dosage during the initial week. In instances where EN is contraindicated, PN can serve as a crucial alternative. Recent studies indicate that PN is comparable in efficacy to EN and can be initiated if adequate EN cannot be achieved within the first week of critical illness.

Keywords: Enteral nutrition; Parenteral nutrition; Intensive care unit; Micrnonutrients

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