Significance of early enteral nutrition in critically ill patients

Abstract

Nutritional support has undergone many changes over time, and international guidelines now recommend that enteral nutrition replace parenteral nutrition in critically ill patients. Several studies have supported its effectiveness in maintaining bowel structure and function, and preventing infections involving processes like bacterial translocation. Guidelines recommend that enteral nutrition is started at least within 24-48 hours; however, in clinical studies, early enteral nutrition has not shown superiority compared to late (delayed) enteral nutrition and parenteral nutrition. Nutritional therapy remains controversial, not only in terms of initiation timing but also concerning its role in different diseases, the quantity of enteral nutrition, and evaluation methods. This review aimed to help clinicians develop an understanding of the effectiveness, limitations, and future directions of early enteral nutrition, and to reconsider the notion that “earlier is better”.