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Nutrition in the ICU: new trends versus old-fashioned standard enteral feeding?

Koekkoek, Kristine, W.A.C.; van Zanten, Arthur, R.H.

Current Opinion in Anaesthesiology: April 2018 - Volume 31 - Issue 2 - p 136–143
doi: 10.1097/ACO.0000000000000571

Purpose of review The narrative review aims to summarize the relevant studies from the last 2 years and provide contextual information to understand findings.

Recent findings Recent ICU studies have provided insight in the pathophysiology and time course of catabolism, anabolic resistance, and metabolic and endocrine derangements interacting with the provision of calories and proteins.

Early provision of high protein intake and caloric overfeeding may confer harm. Refeeding syndrome warrants caloric restriction and to identify patients at risk phosphate monitoring is mandatory.

Infectious complications of parenteral nutrition are associated with overfeeding. In recent studies enteral nutrition is no longer superior over parenteral nutrition.

Previously reported benefits of glutamine, selenium, and fish oil seem to have vanished in recent studies; however, studies on vitamin C, thiamine, and corticosteroid combinations show promising results.

Summary Studies from the last 2 years will have marked impact on future nutritional support strategies and practice guidelines for critical care nutrition as they challenge several old-fashioned concepts.

Department of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, The Netherlands

Correspondence to Arthur R.H. van Zanten, MD, PhD, Department of Intensive Care, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands. Tel: +31 318 43 41 15; e-mail:

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