Nutritional Support in the ICU

BMJ. 2025 Jan 2:388:e077979. doi: 10.1136/bmj-2023-077979.

Abstract

Critical illness is a complex condition that can have a devastating impact on health and quality of life. Nutritional support is a crucial component of critical care that aims to maintain or restore nutritional status and muscle function. A one-size-fits-all approach to the components of nutritional support has not proven beneficial. Recent randomized controlled trials challenge the conventional strategy and support the safety and potential benefits of below-usual calorie and protein intakes at the early, acute phase of critical illness. Further research is needed to define optimal nutritional support throughout the intensive care unit stay. Individualized nutritional strategies relying on risk assessment tools or biomarkers deserve further investigation in rigorously designed, large, multicenter, randomized, controlled trials. Importantly, although nutritional support is crucial, it might not be sufficient to enhance the recovery of critically ill patients. Thus, achieving the greatest efficacy may require individualized nutritional support combined with early, prolonged physical rehabilitation within a multimodal, holistic care program throughout the patient's recovery journey.

Publication types

  • Review

MeSH terms

  • Critical Care* / methods
  • Critical Illness* / rehabilitation
  • Critical Illness* / therapy
  • Dietary Proteins / administration & dosage
  • Energy Intake
  • Enteral Nutrition / methods
  • Humans
  • Intensive Care Units*
  • Nutritional Status
  • Nutritional Support* / methods
  • Randomized Controlled Trials as Topic

Substances

  • Dietary Proteins