New guidelines providing updated recommendations on nutrition therapy methods, procedures, and tools for healthcare providers involved in nutrition therapy of the critically ill were published by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and the Society of Critical Care Medicine (SCCM). The guidelines provide healthcare providers - physicians, nurses, dietitians, and pharmacists - with the most up-to-date recommendations on providing the best nutrition therapy for critically ill adult patients (those 18 years or older).

"Nutrition plays a significant role in a hospital setting, particularly in the intensive care unit where patients are in a critical state and malnutrition can have fatal consequences," said Beth E. Taylor, RD, DCN. "These guidelines assist the care team in providing proper nutrition therapy, which can diminish complications, reduce length of stay and disease severity and improve patient outcomes."

Health professionals developed the Guidelines through analysis of literature, international and national guidelines, expert options and clinical practicality.

Recommendations include:

  • Early assessment of patients admitted to the Intensive Care Unit (ICU) for nutrition risk, and calculation of energy and protein requirements to determine goals of nutrition therapy;
  • Initiation of enteral nutrition (EN) within 24-'48 hours following the onset of critical illness and admission to the ICU;
  • Take steps as needed to reduce risk of aspiration and improve tolerance to gastric feeding;
  • Implementation of enteral feeding protocols with institution-specific strategies to promote delivery of EN;
  • Elimination of the use of gastric residual volumes as part of routine care to monitor ICU patients receiving EN; and
  • Initiation of parenteral nutrition early, when EN is not feasible or sufficient in high-risk or poorly nourished patients.

The recommendations were published in the OnlineFirst version of the Journal of Parenteral and Enteral Nutrition (JPEN).