The Unresolved Questions of Nutritional Support in the ICU: Now or Later, More or Less, Enteral or Parenteral?

Two divergent recommendations recently published by ESPEN and ASPEN [1] [2] have stressed the need for more research regarding the indication for supplemental parenteral nutrition (PN) in critically ill patients who are not achieving their calorie target in the first 48 hours after admission. In a recent paper, Casaer et al. [3] suggest that early PN may be detrimental for these patients, a view which is contrary to the ESPEN guidelines. However, the topic has to be analyzed cautiously since the consequences of such an assertion could significantly affect patient outcome if misunderstood. In fact, the idea of as…