Wednesday July 16, 2008
Is enteral feeding is all we need in ICU???

It has been advocated for several years that one should start enteral feeding in intensive care unit as soon as possible. There are instances when patient is severely nutritionally depleted and enteral feeding may take a while, and is there any role for combination of enteral and parenteral feeding. Recent paper by Heidegger shed some light on it.

According to them, the evidence had shown that enteral nutrition can result in under-feeding and that nutritional goals are frequently reached only after one week. Contrary to former beliefs, recent meta-analyses of ICU studies showed that parenteral nutrition is not related to a surplus mortality and may even be associated with improved survival.

Conclusion: Early enteral nutrition is recommended in critically ill patients. Supplemental parenteral nutrition combined with enteral nutrition can be considered to cover the energy and protein targets when enteral nutrition alone fails to achieve the caloric goals. Whether this combined nutritional support provides any additional overall outcome benefit is yet to be determined. Further studies are suggested.


Reference: click to get abstract

Heidegger CP, Darmon B, Pichard CB. Enteral vs. parenteral nutrition for the critically ill patient: a combined support should be preferred. Current Opinion in Critical Care 2008; 14 (4): 408-414