Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition

Front

1 of 3 · Front

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care

Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition

In one breath

ASPEN's 2022 nutrition support guideline for the adult critically ill patient: because no consistent outcome differences were found, prescribe energy cautiously at 12–25 kcal/kg/day, favour enteral nutrition when feasible, and assume no advantage for exclusive or supplemental parenteral nutrition or higher doses.

Edition2022

Issued byAmerican Society for Parenteral and Enteral Nutrition (ASPEN)

Place of issueUnited States

PublishedJournal of Parenteral and Enteral Nutrition · 2022;46(1):12–41

⏳ Pending verification

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 1

2 of 3 · Back 1

Back colours mark the reading sections — the chapter colour is the band and chip.

§1 · What it covers

This guideline covers adult critical-care energy/protein dose, EN versus PN, supplemental PN, and injectable lipid emulsions.

Applies to: Adult critically ill patients, including surgical ICU patients.

§2 · Key recommendations

Use GRADE.
because no consistent outcome differences were found, prescribe energy cautiously in the 12-25 kcal/kg/day range.
use clinical judgment and close monitoring for protein and energy.
no routine assumption that exclusive isocaloric PN, supplemental PN plus EN, higher protein/energy, or one lipid emulsion improves mortality or length of stay.
favor EN when clinically feasible but use PN when indicated.
account for contraindications, GI function, hemodynamics, and safety.

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 2

3 of 3 · Back 2

Back colours mark the reading sections — the chapter colour is the band and chip.

§3 · Evidence & grading

GRADE. The review identified 2,320 citations and 36 trials involving 20,578 participants; most comparisons showed no outcome differences and evidence certainty was insufficient to support aggressive universal targets. The paper explicitly says that as evidence becomes more consistent, more precise recommendations may be possible.

§4 · What changed in this edition

Not yet established — pending verification.

§5 · Source & working link

Compher C, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2022;46(1):12–41. doi:10.1002/jpen.2267 · PMID 34784064.

Publisher — the record's original_url, carried verbatim ↗DOI — 10.1002/jpen.2267 ↗PubMed — PMID 34784064 ↗

Link check 2026-11-11: the publisher (ASPEN) URL, DOI and PubMed record (PMID 34784064) all fetched live — title, journal, volume and pages match the record. (The record's identifier field also carries a second DOI string, 10.1002/jpen.2419, which is not the guideline's own DOI and is not carried.)

Source: Tamer-supplied guideline index, intake 2026-11-10 (record #153, Domain 14) · Card built 2026-11-11 (Wave D) from the record itself; the §5.2 verification pass (UpToDate + Medscape → Perplexity → Tamer decision) has not yet run on this card. ⚑ Conflict flag on the source record — documented cross-society disagreement (intake DOCX Table 2): Critical-care nutrition — ESPEN 2023 vs ASPEN 2022. This record's own evidence note states the point: ASPEN is more conservative about target-dose claims than ESPEN; this is not a simple EN-versus-PN conflict — both allow individualised EN/PN decisions. Unresolved — pending the verification pass (UpToDate + Medscape → Perplexity → Tamer decision).

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

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