How to Feed Critically Ill Patients: A Randomized Trial

Debate is ongoing over the appropriate way to deliver early nutritional support to critically ill patients. Although U.S. guidelines recommend enteral nutrition and delayed initiation of parenteral nutrition, European guidelines advocate earlier consideration and initiation of parenteral nutrition. Many studies of nutrition in intensive care units (ICUs) are small and dated, so we can reasonably ask which is the better route. Investigators in the U.K. randomized 2400 adults (mean age, 63) with unplanned ICU admissions to receive either enteral nutrition or parenteral nutrition starting within 36 hours of admission; patients were fed exclusively via their assigned routes for 5 days or until discharge from the ICU, transition to oral feeding,…