ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit

Front

1 of 3 · Front

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

ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit

In one breath

ESPEN's practical ICU nutrition guideline: assess nutritional risk, prefer early oral or enteral feeding when feasible, individualise parenteral nutrition, use indirect calorimetry where available, and approach energy and protein targets progressively rather than forcing full targets early.

Edition2023 (practical, partially revised)

Issued byEuropean Society for Clinical Nutrition and Metabolism (ESPEN)

Place of issueEurope

PublishedClinical Nutrition · 2023;42(9):1671–1689

⏳ 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 ICU nutrition: nutritional-risk assessment, energy/protein prescription, enteral and parenteral nutrition, feeding route/timing, special conditions, monitoring, and implementation.

Applies to: Critically ill adults in ICU, including surgical ICU patients and patients with special clinical conditions.

§2 · Key recommendations

Assess nutrition risk and clinical condition.
prefer early oral/enteral feeding when feasible.
use parenteral nutrition when enteral feeding is contraindicated or inadequate and individualize supplemental PN.
progress cautiously in hemodynamic instability and monitor tolerance, refeeding risk, glucose, electrolytes, and overfeeding.
use indirect calorimetry where available to determine energy expenditure, with pragmatic alternatives where it is not.
progressively approach energy/protein targets rather than force full targets early.
tailor route and formula to GI function and special conditions.

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

The practical guideline presents 56 recommendations and is based on the ESPEN scientific guideline/SOP process. Recommendation grades and evidence levels are carried over from the ESPEN evidence framework where stated; certainty is not uniformly expressed in the same GRADE language as ASPEN. This should be described as a practical clinical guideline, not as a high-certainty trial mandate for every feeding target.

§4 · What changed in this edition

Not yet established — pending verification.

§5 · Source & working link

Singer P, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clin Nutr. 2023;42(9):1671–1689. doi:10.1016/j.clnu.2023.07.011 · PMID 37517372.

Publisher — the record's original_url, carried verbatim ↗DOI — 10.1016/j.clnu.2023.07.011 ↗PubMed — PMID 37517372 ↗

Link check 2026-11-11: the publisher (ESPEN) PDF URL fetched live — HTTP 202 (accepted, content not machine-readable in the check); the PubMed record (PMID 37517372) fetched live — title, journal, volume and pages match, and the DOI row was completed from that PubMed record (marked in completions).

Source: Tamer-supplied guideline index, intake 2026-11-10 (record #152, 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. Completed in verification: doi — PubMed record PMID 37517372 (article IDs), fetched live 2026-11-11. ⚑ 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: ESPEN emphasises early enteral nutrition and calorimetry-informed dosing, while ASPEN 2022 found no outcome advantage for higher versus lower energy/protein prescriptions and uses a cautious 12–25 kcal/kg/day range; both support individualisation and avoiding early overfeeding. 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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