Standard Diet or Low-Protein, Low-Calorie Diet in the Intensive Care Unit?

Clinicians continue to debate when, how, and how much to feed patients who are critically ill. Guidelines recommend starting enteral feeding within 48 hours of admission to the intensive care unit (ICU) but how quickly caloric intake should be increased remains unclear. Some data suggest that anorexia and caloric restriction can heighten the immune response and minimize metabolic disturbances.

Investigators from France randomized more than 3000 ICU patients (from 61 ICUs) who were supported with mechanical ventilation and vasopressors to either standard or low-calorie, low-protein feeding. Feeding was initiated within 24 hours of intubation and continued by protocol for 7 days or until the patient was extubated and vasopressors had been disc…