Key messages

• After admission to the intensive care unit, feeding may be delayed for three common reasons: feed not prescribed, poor understanding of the urgency of nutritional support, and late prescription of total parenteral nutrition when enteral nutrition is poorly tolerated.

• Gastrointestinal motility is often impaired in critically ill patients receiving mechanical ventilation, and this is most marked in the stomach.

• True ileus is uncommon in the critically ill and is often stated to be present when there is simply gastric stasis.

• In addition to its effects on body composition, malnutrition is associated with impaired respiratory function, cardiac function, immune responsiveness, wound healing, and mobilization.

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