ESPEN guidelines on enteral nutrition: intensive care
Open accessAbstract
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 publications 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 24h using a standard high-protein formula. During the acute and initial phases of critical illness an exogenous energy supply in excess of 20-25 kcal/kg BW/day should be avoided, whereas, during recovery, the aim should be to provide values of 25-30 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 >15. Glutamine should be supplemented in patients suffering from burns or trauma.
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Recent guidelines written by ESPEN, ASPEN/SCCM, the Canadian Critical Care Practice Guideline group and the ESICM working group were considered when formulating the updated ESPEN recommendations.
“Recent guidelines written by ESPEN [1,2], ASPEN/SCCM [32], the Canadian Critical Care Practice Guideline group [29] and the most recent clinical practice guidelines on early EN in critically ill patients by the ESICM working group on gastrointestinal function [13] were considered when formulating the updated ESPEN recommendations [4].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [1]
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“Nutritional therapy recommendations in the ICU are different in the American Society for Parenteral and Enteral Nutrition (ASPEN)[9] and the European Society for Parenteral and Enteral Nutrition (ESPEN)[10] guidelines, which increases uncertainty in clinical practice.”
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Monitoring in the Intensive Care
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Autophagy and Its Implications Against Early Full Nutrition Support in Critical Illness
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- Authors
- Kreymann, K. G., Berger, M. M., Deutz, N. E. P., Hiesmayr, M., Jolliet, P., Kazandjiev, G., Nitenberg, G., van den Berghe, G., Wernerman, J., Ebner, C., Hartl, W., Heymann, C., & Spies, C.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Centre Hospitalier Universitaire Vaudois (CH)
- Maastricht University (NL)
- Medical University of Vienna (AT)
- University Hospital of Geneva (CH)
- Military Medical Academy (BG)
- Institut Gustave Roussy (FR)
- Karolinska University Hospital (SE)
- Corresponding author
- Kreymann, K.G.
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2006-04
- Volume
- 25
- Issue
- 2
- Pages
- 210-223
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2527237442
- Cited by
- 1,366
- References
- 70
- Citations by year
- 2026: 19 · 2025: 22 · 2024: 31 · 2023: 40 · 2022: 33 · 2021: 65 · 2020: 43 · 2019: 66 · 2018: 91 · 2017: 88 · 2016: 97 · 2015: 138 · 2014: 133 · 2013: 107 · 2012: 85
- FWCI
- 40.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- enteral nutrition, intensive care, critically ill patients, tube feeding, catabolic state, organ failure, sepsis, energy requirements, protein intake, parenteral nutrition, glutamine supplementation, burns, trauma (physical injury), APACHE II score
- MeSH terms
- Critical Care, Enteral Nutrition, Europe, Gastroenterology, Humans, Nutritional Requirements, Patient Care Team, Practice Patterns, Physicians', Critical Illness, APACHE
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