Providing nutrition support to the mechanically ventilated patient is the standard of care. When delivered appropriately, nutrition support provides energy, protein, and nutrients needed to fuel the immune system; promotes wound healing; and prevents excess breakdown of lean body mass. However, if not properly managed, nutrition support can induce complications. Accumulated data suggest the route of nutrition support may influence the incidence of complications. Evidence exists for the preferred use of enteral support over total parenteral nutrition (TPN) whenever possible.

Q: When should nutrition support be initiated?

In order to maintain lean body mass (including diaphragmatic mass) and immune function, nutrition support should be started on day 3 for patients requiring mechanical ventilation. Malnourished patients should start nutrition support within 24 hours. An accumulating body of evidence suggests that early initiation of enteral nutrition may attenuate the acute...

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