Key messages

• Parenteral feeding of a well-nourished patient able to take enteral nutrition within 4 to 5 days or with a relatively minor injury is unnecessary.

• Parenteral feeding should be performed when enteral nutritional support is strictly contraindicated or enteral nutrition is unable to cope with energy and nutrient requirements.

• The nutrient intake must be within an appropriate range (20-35 kcal/kg and 0.1-0.3 g/kg/day nitrogen) to avoid over- or underfeeding (the first is considerably more dangerous).

• The absence of foodstuff in the gut lumen is a disadvantage of the parenteral feeding approach.

• Parenteral nutrition in the critically ill is usually via a multiple-lumen central venous catheter with one lumen dedicated exclusively to nutritional fluids. Introduction

The administration of nutrients to critically ill patients is a supportive measure. Its importance relative to the specific therapy of the underlying disease is often underestimated. The maintenance of physiological balance is one of the foundations of intensive care, without which the outcome is often death ( Nit§D„b.®r9...„1993).

Thus nutritional support, by supporting protein synthesis and controlling catabolism, should maintain the energy equilibrium and restore, or at least limit, the reduction of body energy stores and the wasting of lean tissue.

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