Guidelines from Europe and the USA recommend that enteral nutrition (EN) should be commenced within 24-48 hours of admission to the intensive care unit (ICU) for patients who are not expected to be on a full oral diet within 3 days. This recommendation is supported by a recent meta-analysis, which showed that early EN (within 24 hours) compared with standard care was associated with a significant reduction in mortality and rate of pneumonia. However, caloric goals are often difficult to attain with EN in critically ill patients, resulting in underfeeding and a number of associated risks.
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