Clin Nutr. 2012 Apr;31(2):153-5. doi: 10.1016/j.clnu.2011.10.014. Epub 2011 Dec 19.
Large surveys auditing feeding regimen in the ICU consistently reported hypocaloric 23 enteral feedings patterns and many studies described the association between 24 energy deficit and increased complication rate. ESPEN and ASPEN experts 25 recommend early (after 48 h) or late (after 7-10 days) catch up of the 26 energy deficit with parenteral nutrition (PN) respectively, but the level of evidence 27 was poor and larger PRCT were missing. In the recent months, several ICU studies 28 have tried to answer to three critical questions: 1) how much energy to administer, 2) 29 when to start (early or late), and 3) which route should be used. However, weaknesses 30 in the study design and some mixing of the 3 questions have created confusion in the 31 message delivered. In addition, the severity of the acute illness was not always similar 32 in these studies, mixing short-term acutely ill patients (less than 4 days in the ICU) 33 with long term patients (more than 10 days in the ICU).
大型调查研究对 ICU 中的喂养方案进行审核后，一致报告了低热量肠内喂养方案，许多研究描述了能量不足与并发症发生率增加之间的关系。ESPEN 和 ASPEN 专家分别推荐早期（48 小时后）或晚期（7-10 天后）通过肠外营养（PN）补充能量不足，但证据水平较差，且缺少更大规模的 RCT。近几个月来，几项 ICU 研究试图回答三个关键问题：1）给予多少能量，2）何时开始（早期或晚期），3）应使用哪种途径。然而，研究设计的缺陷以及对这三个问题的一些混淆，使得传递的信息产生了混乱。此外，这些研究中急性疾病的严重程度并不总是相似的，将短期急性疾病（ICU 中不到 4 天）的患者与长期患者（ICU 中超过 10 天）混合在一起。
