Nutrition Support in Critically Ill Adults in Intensive Care Units: An Evidence Analysis Center Scoping Review of Current Systematic Reviews and Guidelines

Critically ill adults in intensive care units (ICUs) are at high risk of malnutrition, which can make recovery slower and increase the risk of complications. Providing the right nutrition to these patients is challenging because their needs are complex, and recommendations from different sources are inconsistent.

"Nutrition Support in Critically Ill Adults in Intensive Care Units: An Evidence Analysis Center Scoping Review of Current Systematic Reviews and Guidelines" highlights variability in quality and scope, as well as important gaps, showing the need for clear, high-quality guidance for clinicians and researchers.

The Academy of Nutrition and Dietetics (Academy), Academy of Nutrition and Dietetics Foundation, and the Dietitians in Nutrition Support Dietetic Practice Group funded this project and the Academy's Evidence Analysis Center reviewed all available guidelines and systematic reviews on nutrition support for adults with critically illness to give clinicians and researchers a clear picture of the evidence.

Recently published in the Journal of the Academy of Nutrition and Dietetics, the review included 11 guidelines and 58 systematic reviews published since 2015 and 2020, respectively. These resources provide an overview of key topics such as how and when to provide nutrition support, the amount of energy and protein patients need, the choice between feeding through the gut (enteral) or through the bloodstream (parenteral), and the use of fiber or prebiotics.

The project found that while many guidelines and systematic reviews exist, their quality and focus vary widely. For example, some guidelines lack patient input or clear strategies for implementation, and some systematic reviews have methodological weaknesses.

The findings highlight important gaps in knowledge and show that clinicians need clear, high-quality guidance to provide the best nutrition care for critically ill adults. Developing a comprehensive, evidence-based nutrition support guideline using a structured approach could help improve patient outcomes and support consistent, effective care.

This work also points to areas where future research is needed, including studies on specific patient subgroups, such as those with obesity or other complex medical conditions.