title: Nutrition in the ICU: an evidence-based approach.
abstract: Providing artificial nutrition is an important part of caring for critically ill patients. However, because of a paucity of robust data, the practice has been highly variable and often based more on dogma than evidence. A number of studies have been published investigating many different aspects of critical care nutrition. Although the influx of data has better informed the practice, the results have often been conflicting or counter to prevailing thought, resulting in discordant opinions and different interpretations by experts in the field. In this article, we review and summarize the data from a number of the published studies, including studies investigating enteral vs parenteral nutrition, supplementing enteral with parenteral nutrition, and use of immunonutrition. In addition, published studies informing the practice of how best to provide enteral nutrition will be reviewed, including the use of trophic feedings, gastric residual volumes, and gastric vs postpyloric tube placement.
authors.affiliation: Division of Gastroenterology, Duke University Medical Center, Durham, NC.
authors.forename: Svetang V
authors.initials: SV
authors.lastname: Desai
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: McClave
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN. Electronic address: todd.rice@vanderbilt.edu.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Rice
mesh_terms: D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods*; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D009752:Nutritional Status