ESPEN guideline on clinical nutrition in the intensive care unit
Pierre Singer a, *, Annika Reintam Blaser b, c, Mette M. Berger d, Waleed Alhazzani e,
Philip C. Calder f, Michael P. Casaer g, Michael Hiesmayr h, Konstantin Mayer i,
Juan Carlos Montejo j, Claude Pichard k, Jean-Charles Preiser l, Arthur R.H. van Zanten m,
Simon Oczkowski e, Wojciech Szczeklik n, Stephan C. Bischoff o
Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best
medical nutritional therapy to critically ill patients have been updated. These guidelines define who are
the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of
energy to provide, the route to choose and how to adapt according to various clinical conditions. When to
start and how to progress in the administration of adequate provision of nutrients is also described. The
best determination of amount and nature of carbohydrates, fat and protein are suggested. Special
attention is given to glutamine and omega-3 fatty acids. Particular conditions frequently observed in
intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery,
sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy.
Monitoring of this nutritional therapy is discussed in a separate document.
© 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights