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VOL. 12, ISSUE 11 (2025)
Parenteral vs. enteral nutrition: Evidence-based guidelines for critical care
Authors
Enakshi Raychowdhury
Abstract
Nutritional support is a cornerstone of care
for critically ill patients. Enteral nutrition (EN) and parenteral nutrition
(PN) differ in physiologic effects, risks, logistics and cost. Over the last
two decades practice has moved toward earlier use of the gut when safe, driven
by guideline recommendations and meta-analytic data suggesting reduced
infectious complications and intensive care unit length of stay with EN, while
mortality effects are inconsistent. However, PN remains essential when EN is
contraindicated or insufficient, and supplemental PN can be used to meet
energy/protein targets when EN alone cannot. This review synthesizes
contemporary guideline recommendations (ESPEN, ASPEN/SCCM), randomized trials,
systematic reviews and meta-analyses to present practical, evidence-based
guidance for selecting and managing artificial nutrition in critically ill
adults. Key recommendations: prioritize EN where feasible and safe; initiate EN
early (within 24-48 h) for most patients; use PN when EN is contraindicated or
if caloric/protein goals cannot be met after an appropriate trial of EN;
monitor for and prevent complications (aspiration, refeeding, catheter
infections, hyperglycemia); individualize timing/route in high-risk subgroups.
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Pages:3-7
How to cite this article:
Enakshi Raychowdhury "Parenteral vs. enteral nutrition: Evidence-based guidelines for critical care". International Journal of Multidisciplinary Research and Development, Vol 12, Issue 11, 2025, Pages 3-7
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