Controversies and Misconceptions in Intensive Care Unit Nutrition

Clin Chest Med. 2015 Sep;36(3):409-18. doi: 10.1016/j.ccm.2015.05.013. Epub 2015 Jul 9.


The early initiation of enteral nutrition remains a fundamental component of the management of critically ill and injured patients in the intensive care unit. Trophic feeding is equivalent, if not superior, to full-dose feeding. Parenteral nutrition has no proved benefit over enteral nutrition, which is the preferred route of nutritional support in intensive care unit patients with a functional gastrointestinal tract. Continuous enteral and parental nutrition inhibits the release of important enterohormones. These changes are reversed with intermittent bolus feeding. Whey protein, which is high in leucine, has a greater effect on insulin release and protein synthesis than does a soy- or casein-based enteral formula.

Keywords: Critical care nutrition; Enteral nutrition; ICU nutrition; Nutrition; Parenteral nutrition; Trophic feeding.

Publication types

  • Review

MeSH terms

  • Humans
  • Intensive Care Units / organization & administration*
  • Parenteral Nutrition / methods*