{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:32:24Z","timestamp":1791379944244,"version":"4.3.3"},"reference-count":137,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Landesprogramm f\u00fcr chancengerechte Hochschulmedizin, Ministry of Culture and Science of the State of North Rhine-Westphalia","award":["-"],"award-info":[{"award-number":["-"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: While consent exists, that nutritional status has prognostic impact in the critically ill, the optimal feeding strategy has been a matter of debate. Methods: Narrative review of the recent evidence and international guideline recommendations focusing on basic principles of nutrition in the ICU and the treatment of specific patient groups. Covered topics are: the importance and diagnosis of malnutrition in the ICU, the optimal timing and route of nutrition, energy and protein requirements, the supplementation of specific nutrients, as well as monitoring and complications of a Medical Nutrition Therapy (MNT). Furthermore, this review summarizes the available evidence to optimize the MNT of patients grouped by primarily affected organ system. Results: Due to the considerable heterogeneity of the critically ill, MNT should be carefully adapted to the individual patient with special focus on phase of critical illness, metabolic tolerance, leading symptoms, and comorbidities. Conclusion: MNT in the ICU is complex and requiring an interdisciplinary approach and frequent reevaluation. The impact of personalized and disease-specific MNT on patient-centered clinical outcomes remains to be elucidated.<\/jats:p>","DOI":"10.3390\/nu13082851","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T09:58:06Z","timestamp":1629367086000},"page":"2851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":107,"title":["Nutrition in the Intensive Care Unit\u2014A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7013-3357","authenticated-orcid":false,"given":"Aileen","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Intensive Care and Anesthesiology, University Hospital RWTH Aachen University, D-52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4948-1605","authenticated-orcid":false,"given":"Gunnar","family":"Elke","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arved","family":"Weimann","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Oncological Surgery, Surgical Intensive Care Unit, Klinikum St. Georg, D-04129 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.clnesp.2019.05.002","article-title":"Clinical Nutrition in Critical Care Medicine\u2014Guideline of the German Society for Nutritional Medicine (DGEM)","volume":"33","author":"Elke","year":"2019","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.clnu.2018.08.037","article-title":"ESPEN guideline on clinical nutrition in the intensive care unit","volume":"38","author":"Singer","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/0148607115621863","article-title":"Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)","volume":"40","author":"McClave","year":"2016","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s00134-016-4665-0","article-title":"Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines","volume":"43","author":"Starkopf","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1097\/CCM.0000000000002255","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016","volume":"45","author":"Rhodes","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.4102\/curationis.v42i1.1973","article-title":"Evidence on nutritional therapy practice guidelines and implementation in adult critically ill patients: A systematic scoping review","volume":"42","author":"Mooi","year":"2019","journal-title":"Curationis"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1177\/0148607115625638","article-title":"Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review","volume":"41","author":"Lew","year":"2017","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-2739-4","article-title":"Nutrition therapy in critical illness: A review of the literature for clinicians","volume":"24","author":"Lambell","year":"2020","journal-title":"Crit. Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/MCO.0000000000000041","article-title":"Nutritional-risk scoring systems in the intensive care unit","volume":"17","author":"Kondrup","year":"2014","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1378\/chest.125.4.1446","article-title":"Outcomes in critically ill patients before and after the implementation of an evidence-based nutritional management protocol","volume":"125","author":"Barr","year":"2004","journal-title":"Chest"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1177\/0148607110364843","article-title":"Impact of enteral feeding protocols on enteral nutrition delivery: Results of a multicenter observational study","volume":"34","author":"Heyland","year":"2010","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4745","DOI":"10.1016\/j.clnu.2021.03.031","article-title":"ESPEN practical guideline: Clinical nutrition in surgery","volume":"40","author":"Weimann","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1177\/0148607114531787","article-title":"Implementing the PEP uP Protocol in Critical Care Units in Canada: Results of a Multicenter, Quality Improvement Study","volume":"39","author":"Heyland","year":"2015","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/0884533615611845","article-title":"Process-Related Barriers to Optimizing Enteral Nutrition in a Tertiary Medical Intensive Care Unit","volume":"31","author":"Kozeniecki","year":"2016","journal-title":"Nutr. Clin. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/MCO.0000000000000260","article-title":"Nutritional needs for the critically ill in relation to inflammation","volume":"19","author":"Tjader","year":"2016","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jcsm.12383","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"10","author":"Cederholm","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_17","first-page":"466","article-title":"Role of Nutrition Support in Cardiac Surgery Patients\u2014An Overview","volume":"53","author":"Hill","year":"2018","journal-title":"Anasthesiol. Intensivmed. Notf. Schmerzther. AINS"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/MCC.0000000000000511","article-title":"Measuring and monitoring lean body mass in critical illness","volume":"24","author":"Looijaard","year":"2018","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1017\/S0954422420000165","article-title":"Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: Review and rationale for the EFFORTcombo trial","volume":"33","author":"Hill","year":"2020","journal-title":"Nutr. Res. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-015-0737-8","article-title":"Metabolic and nutritional support of critically ill patients: Consensus and controversies","volume":"19","author":"Preiser","year":"2015","journal-title":"Crit. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1056\/NEJMoa1409860","article-title":"Trial of the route of early nutritional support in critically ill adults","volume":"371","author":"Harvey","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0140-6736(17)32146-3","article-title":"Enteral versus parenteral early nutrition in ventilated adults with shock: A randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2)","volume":"391","author":"Reignier","year":"2018","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.clnu.2017.02.013","article-title":"ESPEN guideline: Clinical nutrition in surgery","volume":"36","author":"Weimann","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1177\/014860710302700174","article-title":"Nutrition support in the critical care setting: Current practice in canadian ICUs--opportunities for improvement?","volume":"27","author":"Heyland","year":"2003","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Hill, A., Heyland, D.K., Ortiz Reyes, L.A., Laaf, E., Wendt, S., Elke, G., and Stoppe, C. (2021). A combination of enteral and parenteral nutrition in the acute phase of critical illness: An updated systematic review and meta-analysis. J. Parenter. Enter. Nutr., 1\u201316.","DOI":"10.1002\/jpen.2125"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1097\/00003246-199506000-00010","article-title":"Enteral nutrition in the critically ill patient: A prospective survey","volume":"23","author":"Heyland","year":"1995","journal-title":"Crit. Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s001340050326","article-title":"A study of problems associated with the delivery of enteral feed in critically ill patients in five ICUs in the UK","volume":"23","author":"Adam","year":"1997","journal-title":"Intensive Care Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1097\/00003246-199907000-00003","article-title":"Enteral tube feeding in the intensive care unit: Factors impeding adequate delivery","volume":"27","author":"McClave","year":"1999","journal-title":"Crit. Care Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1177\/0148607109341769","article-title":"Enteral nutrition and cardiovascular failure: From myths to clinical practice","volume":"33","author":"Berger","year":"2009","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.clnu.2004.08.005","article-title":"Enteral nutrition in critically ill patients with severe hemodynamic failure after cardiopulmonary bypass","volume":"24","author":"Berger","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.clnu.2005.03.006","article-title":"Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients","volume":"24","author":"Villet","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1745-6215-12-21","article-title":"Impact of early parenteral nutrition completing enteral nutrition in adult critically ill patients (EPaNIC trial): A study protocol and statistical analysis plan for a randomized controlled trial","volume":"12","author":"Casaer","year":"2011","journal-title":"Trials"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-017-1736-8","article-title":"A randomized trial of supplemental parenteral nutrition in underweight and overweight critically ill patients: The TOP-UP pilot trial","volume":"21","author":"Wischmeyer","year":"2017","journal-title":"Crit. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0140-6736(12)61351-8","article-title":"Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: A randomised controlled clinical trial","volume":"381","author":"Heidegger","year":"2013","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-016-1298-1","article-title":"Enteral versus parenteral nutrition in critically ill patients: An updated systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Elke","year":"2016","journal-title":"Crit. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1164\/rccm.201605-1012OC","article-title":"Permissive Underfeeding or Standard Enteral Feeding in High- and Low-Nutritional-Risk Critically Ill Adults. Post Hoc Analysis of the PermiT Trial","volume":"195","author":"Arabi","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1177\/0148607114528980","article-title":"Hypocaloric vs Normocaloric Nutrition in Critically Ill Patients: A Prospective Randomized Pilot Trial","volume":"40","author":"Petros","year":"2016","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1097\/MCC.0000000000000844","article-title":"Indirect calorimetry in critical illness: A new standard of care?","volume":"27","author":"Jonckheer","year":"2021","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-021-03508-6","article-title":"Energy delivery guided by indirect calorimetry in critically ill patients: A systematic review and meta-analysis","volume":"25","author":"Duan","year":"2021","journal-title":"Crit. Care"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Pertzov, B., Bar-Yoseph, H., Menndel, Y., Bendavid, I., Kagan, I., Glass, Y.D., and Singer, P. (2021). The effect of indirect calorimetry guided isocaloric nutrition on mortality in critically ill patients-a systematic review and meta-analysis. Eur. J. Clin. Nutr., 1\u201311.","DOI":"10.1038\/s41430-021-00919-0"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1002\/jpen.1449","article-title":"The Effect of Higher Protein Dosing in Critically Ill Patients: A Multicenter Registry-Based Randomized Trial: The EFFORT Trial","volume":"43","author":"Heyland","year":"2018","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Heyland, D.K., Stapleton, R., and Compher, C. (2018). Should We Prescribe More Protein to Critically Ill Patients?. Nutrients, 10.","DOI":"10.3390\/nu10040462"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1007\/s00134-009-1567-4","article-title":"The relationship between nutritional intake and clinical outcomes in critically ill patients: Results of an international multicenter observational study","volume":"35","author":"Alberda","year":"2009","journal-title":"Intensive Care Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.clnu.2010.09.011","article-title":"The success of enteral nutrition and ICU-acquired infections: A multicenter observational study","volume":"30","author":"Heyland","year":"2011","journal-title":"Clin. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1097\/CCM.0b013e318226641d","article-title":"Optimal amount of calories for critically ill patients: Depends on how you slice the cake!","volume":"39","author":"Heyland","year":"2011","journal-title":"Crit. Care Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1177\/0148607115618449","article-title":"Protein Requirements in the Critically Ill: A Randomized Controlled Trial Using Parenteral Nutrition","volume":"40","author":"Ferrie","year":"2016","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1007\/s00134-015-3827-9","article-title":"Intravenous amino acid therapy for kidney function in critically ill patients: A randomized controlled trial","volume":"41","author":"Doig","year":"2015","journal-title":"Intensive Care Med."},{"key":"ref_48","first-page":"117","article-title":"Protein delivery and clinical outcomes in the critically ill: A systematic review and meta-analysis","volume":"19","author":"Davies","year":"2017","journal-title":"Crit. Care Resusc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.phrs.2017.12.007","article-title":"Amino acid supplements in critically ill patients","volume":"130","author":"Gunst","year":"2018","journal-title":"Pharmacol. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1002\/jpen.1166","article-title":"Targeted Full Energy and Protein Delivery in Critically Ill Patients: A Pilot Randomized Controlled Trial (FEED Trial)","volume":"42","author":"Fetterplace","year":"2018","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1016\/j.clnu.2021.02.021","article-title":"Medical high-protein nutrition therapy and loss of muscle mass in adult ICU patients: A randomized controlled trial","volume":"40","author":"Dresen","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1002\/jpen.2059","article-title":"Use of a High-Protein Enteral Nutrition Formula to Increase Protein Delivery to Critically Ill Patients: A Randomized, Blinded, Parallel-Group, Feasibility Trial","volume":"45","author":"Chapple","year":"2021","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_53","first-page":"1","article-title":"Very high intact-protein formula successfully provides protein intake according to nutritional recommendations in overweight critically ill patients: A double-blind randomized trial","volume":"22","author":"Petit","year":"2018","journal-title":"Crit. Care"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-021-03693-4","article-title":"The effect of higher versus lower protein delivery in critically ill patients: A systematic review and meta-analysis of randomized controlled trials","volume":"25","author":"Lee","year":"2021","journal-title":"Crit. Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.nut.2017.05.009","article-title":"Propofol sedation substantially increases the caloric and lipid intake in critically ill patients","volume":"42","author":"Charriere","year":"2017","journal-title":"Nutrition"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1038\/ejcn.2016.167","article-title":"Relevance of non-nutritional calories in mechanically ventilated critically ill patients","volume":"70","author":"Bousie","year":"2016","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/CCM.0000000000003152","article-title":"Early Enteral Nutrition Provided Within 24 Hours of ICU Admission: A Meta-Analysis of Randomized Controlled Trials","volume":"46","author":"Tian","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_58","first-page":"CD012276","article-title":"Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit","volume":"6","author":"Lewis","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jclinane.2018.08.008","article-title":"The effect of enteral versus parenteral nutrition for critically ill patients: A systematic review and meta-analysis","volume":"51","author":"Zhang","year":"2018","journal-title":"J. Clin. Anesth."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"616","DOI":"10.3945\/ajcn.114.086322","article-title":"Use of a concentrated enteral nutrition solution to increase calorie delivery to critically ill patients: A randomized, double-blind, clinical trial","volume":"100","author":"Peake","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1056\/NEJMoa1811687","article-title":"Energy-Dense versus Routine Enteral Nutrition in the Critically Ill","volume":"379","author":"Chapman","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1177\/0148607117700572","article-title":"Restoring the Microbiome in Critically Ill Patients: Are Probiotics Our True Friends When We Are Seriously Ill?","volume":"41","author":"Manzanares","year":"2017","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1517\/14740338.2014.872627","article-title":"A systematic review of the safety of probiotics","volume":"13","author":"Didari","year":"2014","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40560-020-00487-8","article-title":"Efficacy of probiotics in the prevention of VAP in critically ill ICU patients: An updated systematic review and meta-analysis of randomized control trials","volume":"8","author":"Batra","year":"2020","journal-title":"J. Intensive Care"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13643-021-01633-5","article-title":"Effect of gut microbiota modulation on feeding tolerance of enterally fed critically ill adult patients: A systematic review","volume":"10","author":"Seifi","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s00134-020-06322-w","article-title":"Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: The randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT)","volume":"47","author":"Litton","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1007\/s00134-003-1711-5","article-title":"Early enteral immunonutrition in patients with severe sepsis: Results of an interim analysis of a randomized multicentre clinical trial","volume":"29","author":"Bertolini","year":"2003","journal-title":"Intensive Care Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1042\/CS20140343","article-title":"Arginine infusion in patients with septic shock increases nitric oxide production without haemodynamic instability","volume":"128","author":"Luiking","year":"2015","journal-title":"Clin. Sci."},{"key":"ref_69","first-page":"1","article-title":"Plasma glutamine levels in patients after non-elective or elective ICU admission: An observational study","volume":"16","author":"Buter","year":"2016","journal-title":"BMC Anesthesiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1056\/NEJMoa1212722","article-title":"A randomized trial of glutamine and antioxidants in critically ill patients","volume":"368","author":"Heyland","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_71","first-page":"484","article-title":"Glutamine and antioxidants in critically ill patients","volume":"369","author":"Heyland","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"576","DOI":"10.3892\/br.2017.885","article-title":"Therapeutic benefits of glutamine: An umbrella review of meta-analyses","volume":"6","author":"McRae","year":"2017","journal-title":"Biomed. Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.clnesp.2016.09.007","article-title":"Glutamine dipeptide-supplemented parenteral nutrition improves the clinical outcomes of critically ill patients: A systematic evaluation of randomised controlled trials","volume":"17","author":"Stehle","year":"2017","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.21037\/apm-20-702","article-title":"Glutamine on critical-ill patients: A systematic review and meta-analysis","volume":"10","author":"Sun","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1186\/s13054-020-03356-w","article-title":"Omega-3 fatty acid-containing parenteral nutrition in ICU patients: Systematic review with meta-analysis and cost-effectiveness analysis","volume":"24","author":"Pradelli","year":"2020","journal-title":"Crit. Care"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.1016\/j.clnu.2021.03.034","article-title":"Enteral and supplemental parenteral nutrition enriched with omega-3 polyunsaturated fatty acids in intensive care patients\u2014A randomized, controlled, double-blind clinical trial","volume":"40","author":"Singer","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1001\/jamainternmed.2016.2514","article-title":"Effect of Sodium Selenite Administration and Procalcitonin-Guided Therapy on Mortality in Patients With Severe Sepsis or Septic Shock: A Randomized Clinical Trial","volume":"176","author":"Bloos","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.clnu.2020.06.033","article-title":"Antioxidant micronutrient supplementation in critically ill adults: A systematic review with meta-analysis and trial sequential analysis","volume":"40","author":"Gudivada","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1745-6215-15-339","article-title":"SodiUm SeleniTe Adminstration IN Cardiac Surgery (SUSTAIN CSX-trial): Study design of an international multicenter randomized double-blinded controlled trial of high dose sodium-selenite administration in high-risk cardiac surgical patients","volume":"15","author":"Stoppe","year":"2014","journal-title":"Trials"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jsbmb.2013.11.003","article-title":"Is vitamin D deficiency a major global public health problem?","volume":"144","author":"Palacios","year":"2014","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-017-1875-y","article-title":"Vitamin D deficiency in critically ill children: A systematic review and meta-analysis","volume":"21","author":"McNally","year":"2017","journal-title":"Crit. Care"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1002\/jmv.26360","article-title":"Vitamin D insufficiency as a potential culprit in critical COVID-19 patients","volume":"93","author":"Munshi","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Herrera-Quintana, L., Gamarra-Morales, Y., Vazquez-Lorente, H., Molina-Lopez, J., Castano-Perez, J., Machado-Casas, J.F., Coca-Zuniga, R., Perez-Villares, J.M., and Planells, E. (2021). Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels. Nutrients, 13.","DOI":"10.3390\/nu13061988"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"100106","DOI":"10.1016\/j.metop.2021.100106","article-title":"Vitamin D in infectious complications in critically ill patients with or without COVID-19","volume":"11","author":"Vassiliou","year":"2021","journal-title":"Metabol. Open"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.clnu.2017.05.006","article-title":"Vitamin D supplementation in the critically ill: A systematic review and meta-analysis","volume":"37","author":"Langlois","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1001\/jama.2014.13204","article-title":"Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: The VITdAL-ICU randomized clinical trial","volume":"312","author":"Amrein","year":"2014","journal-title":"JAMA"},{"key":"ref_87","first-page":"1070","article-title":"Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults","volume":"152","author":"Han","year":"2021","journal-title":"Chest"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e031083","DOI":"10.1136\/bmjopen-2019-031083","article-title":"Effect of high-dose vitamin D3 on 28-day mortality in adult critically ill patients with severe vitamin D deficiency: A study protocol of a multicentre, placebo-controlled double-blind phase III RCT (the VITDALIZE study)","volume":"9","author":"Amrein","year":"2019","journal-title":"BMJ Open"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1001\/jama.2019.11825","article-title":"Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial","volume":"322","author":"Truwit","year":"2019","journal-title":"JAMA"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.chest.2016.11.036","article-title":"Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study","volume":"151","author":"Marik","year":"2017","journal-title":"Chest"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Zayed, Y., Alzghoul, B.N., Banifadel, M., Venigandla, H., Hyde, R., Sutchu, S., Khasawneh, M., Borok, Z., Urbine, D., and Jantz, M. (2021). Vitamin C, Thiamine, and Hydrocortisone in the Treatment of Sepsis: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials. J. Intensive Care Med.","DOI":"10.1177\/0885066620987809"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"379","DOI":"10.5603\/AIT.a2015.0022","article-title":"Abdominal signs and symptoms in intensive care patients","volume":"47","author":"Starkopf","year":"2015","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/0884533614562841","article-title":"Gastric residual volume in critically ill patients: A dead marker or still alive?","volume":"30","author":"Elke","year":"2015","journal-title":"Nutr. Clin. Pract."},{"key":"ref_94","unstructured":"ERAS Society (2021, August 18). Enhanced Recovery after Surgery Society (ERAS). Available online: https:\/\/erassociety.org\/guidelines\/list-of-guidelines\/."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1177\/0148607114523451","article-title":"ERAS\u2014Enhanced recovery after surgery: Moving evidence-based perioperative care to practice","volume":"38","author":"Ljungqvist","year":"2014","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamasurg.2019.1153","article-title":"Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations","volume":"154","author":"Engelman","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1001\/jama.2012.196377","article-title":"Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: A randomized controlled trial","volume":"309","author":"Reignier","year":"2013","journal-title":"JAMA"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/0148607109344745","article-title":"Impact of not measuring residual gastric volume in mechanically ventilated patients receiving early enteral feeding: A prospective before-after study","volume":"34","author":"Poulard","year":"2010","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_99","first-page":"1","article-title":"Gastrointestinal dysfunction in the critically ill: A systematic scoping review and research agenda proposed by the Section of Metabolism, Endocrinology and Nutrition of the European Society of Intensive Care Medicine","volume":"24","author":"Preiser","year":"2020","journal-title":"Crit. Care"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1056\/NEJMoa011300","article-title":"Intensive insulin therapy in critically ill patients","volume":"345","author":"Wouters","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.nut.2013.07.019","article-title":"Metabolic self-destruction in critically ill patients: Origins, mechanisms and therapeutic principles","volume":"30","author":"Hartl","year":"2014","journal-title":"Nutrition"},{"key":"ref_102","unstructured":"(2021, August 18). CNSG East Cheshire NHS Trust: Guidelines for Prevention and Management of Refeeding Syndrome in Adults. Available online: https:\/\/docplayer.net\/45404167-Guidelines-for-prevention-and-management-of-refeeding-syndrome-in-adults.html."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-018-1939-7","article-title":"Supplemental parenteral nutrition versus usual care in critically ill adults: A pilot randomized controlled study","volume":"22","author":"Ridley","year":"2018","journal-title":"Crit. Care"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.jada.2009.11.020","article-title":"Adequacy of oral intake in critically ill patients 1 week after extubation","volume":"110","author":"Peterson","year":"2010","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1097\/TA.0b013e318256e000","article-title":"Persistent inflammation and immunosuppression: A common syndrome and new horizon for surgical intensive care","volume":"72","author":"Gentile","year":"2012","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1089\/sur.2015.184","article-title":"Persistent Inflammation, Immunosuppression, and Catabolism: Evolution of Multiple Organ Dysfunction","volume":"17","author":"Rosenthal","year":"2016","journal-title":"Surg. Infect."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1055\/s-0032-1332980","article-title":"Leitlinie der Deutschen Gesellschaft fur Ernahrungsmedizin (DGEM)","volume":"38","author":"Valentini","year":"2013","journal-title":"Aktuelle Ern\u00e4hrungsmedizin"},{"key":"ref_108","first-page":"91","article-title":"Nutrition in Critically Ill Patients\u2014Challenges in Special Patient Groups","volume":"55","author":"Hill","year":"2020","journal-title":"An\u00e4sthesiol Intensivmed. Notf. Schmerzther."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.3945\/ajcn.115.121178","article-title":"Universal equation for estimating ideal body weight and body weight at any BMI","volume":"103","author":"Peterson","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clnu.2018.05.024","article-title":"ESPEN guideline on clinical nutrition and hydration in geriatrics","volume":"38","author":"Volkert","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: Evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. Gerontology. Ser. A Biol. Sci. Med Sci."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12877-015-0022-3","article-title":"Prevalence and correlates of frailty among older adults: Findings from the German health interview and examination survey","volume":"15","author":"Buttery","year":"2015","journal-title":"BMC Geriatr."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"255","DOI":"10.2147\/CEG.S136429","article-title":"Refeeding syndrome in the frail elderly population: Prevention, diagnosis and management","volume":"11","author":"Aubry","year":"2018","journal-title":"Clin. Exp. Gastroenterol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1177\/0115426503018004285","article-title":"Feeding the hemodynamically unstable patient: A critical evaluation of the evidence","volume":"18","author":"Zaloga","year":"2003","journal-title":"Nutr. Clin. Pract."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/0884533615619932","article-title":"Feeding the Postoperative Patient on Vasopressor Support: Feeding and Pressor Support","volume":"31","author":"Bruns","year":"2016","journal-title":"Nutr. Clin. Pract."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"261","DOI":"10.4037\/ajcc2010197","article-title":"Early enteral nutrition and outcomes of critically ill patients treated with vasopressors and mechanical ventilation","volume":"19","author":"Khalid","year":"2010","journal-title":"Am. J. Crit. Care"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1097\/SHK.0000000000000327","article-title":"Catecholamine use is associated with enterocyte damage in critically ill patients","volume":"43","author":"Piton","year":"2015","journal-title":"Shock"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/MCO.0000000000000300","article-title":"Gastrointestinal dysmotility in the critically ill: A role for nutrition","volume":"19","author":"Weimann","year":"2016","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.clnu.2017.09.003","article-title":"ESPEN guideline clinical nutrition in neurology","volume":"37","author":"Burgos","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0033-1343169","article-title":"Leitlinie der Deutschen Gesellschaft f\u00fcr Ern\u00e4hrungsmedizin (DGEM) in Zusammenarbeit mit der GESKES, der AKE, der DGN und der DGG","volume":"38","author":"Volkert","year":"2013","journal-title":"Aktuelle Ern\u00e4hrungsmedizin"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-019-2400-2","article-title":"Dysphagia in the intensive care unit: Epidemiology, mechanisms, and clinical management","volume":"23","author":"Zuercher","year":"2019","journal-title":"Crit. Care"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.ccc.2020.06.002","article-title":"Preoperative Treatment of Malnutrition and Sarcopenia in Cardiac Surgery: New Frontiers","volume":"36","author":"Hill","year":"2020","journal-title":"Crit. Care Clin."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Hill, A., Nesterova, E., Lomivorotov, V., Efremov, S., Goetzenich, A., Benstoem, C., Zamyatin, M., Chourdakis, M., Heyland, D., and Stoppe, C. (2018). Current Evidence about Nutrition Support in Cardiac Surgery Patients-What Do We Know?. Nutrients, 10.","DOI":"10.20944\/preprints201804.0091.v1"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s13054-017-1690-5","article-title":"Role of nutrition support in adult cardiac surgery: A consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery","volume":"21","author":"Stoppe","year":"2017","journal-title":"Crit. Care"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-03159-z","article-title":"Nutrition of the COVID-19 patient in the intensive care unit (ICU): A practical guidance","volume":"24","author":"Thibault","year":"2020","journal-title":"Crit. Care"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1002\/jpen.2005","article-title":"Lessons Learned in Nutrition Therapy in Patients With Severe COVID-19","volume":"44","author":"Ochoa","year":"2020","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"154317","DOI":"10.1016\/j.metabol.2020.154317","article-title":"The role of visceral adiposity in the severity of COVID-19: Highlights from a unicenter cross-sectional pilot study in Germany","volume":"110","author":"Petersen","year":"2020","journal-title":"Metabolism"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.clnu.2020.03.022","article-title":"ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection","volume":"39","author":"Barazzoni","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1002\/jpen.1930","article-title":"Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019","volume":"44","author":"Martindale","year":"2020","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1186\/s13054-020-03286-7","article-title":"Persistent hypermetabolism and longitudinal energy expenditure in critically ill patients with COVID-19","volume":"24","author":"Whittle","year":"2020","journal-title":"Crit. Care"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.clnesp.2021.03.019","article-title":"Energy expenditure and feeding practices and tolerance during the acute and late phase of critically ill COVID-19 patients","volume":"43","author":"Lakenman","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1001\/jama.2020.26848","article-title":"Effect of a Single High Dose of Vitamin D3 on Hospital Length of Stay in Patients With Moderate to Severe COVID-19: A Randomized Clinical Trial","volume":"325","author":"Murai","year":"2021","journal-title":"JAMA"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1177\/0884533612446197","article-title":"The open abdomen: Definitions, management principles, and nutrition support considerations","volume":"27","author":"Friese","year":"2012","journal-title":"Nutr. Clin. Pract."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/0884533615620420","article-title":"Nutrition Support in the Open Abdomen","volume":"31","author":"Moore","year":"2016","journal-title":"Nutr. Clin. Pract."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.clnu.2018.12.022","article-title":"ESPEN guideline on clinical nutrition in liver disease","volume":"38","author":"Plauth","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1177\/0148607104028005324","article-title":"Feasibility and safety of needle catheter jejunostomy for enteral nutrition in surgically treated severe acute pancreatitis","volume":"28","author":"Weimann","year":"2004","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_137","first-page":"21","article-title":"S1-Guideline of the German Society for Nutritional Medicine (DGEM) in Cooperation with the GESKES, the AKE and the DGfN Enteral and Parenteral Nutrition in Patients with Kidney Disease","volume":"40","author":"Druml","year":"2015","journal-title":"Aktuelle Ern\u00e4hrungsmedizin"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/8\/2851\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:47:22Z","timestamp":1760165242000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/8\/2851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,19]]},"references-count":137,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["nu13082851"],"URL":"https:\/\/doi.org\/10.3390\/nu13082851","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,19]]}}}