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The CALORIES trial compared early enteral with early parenteral nutritional support in adults admitted unexpectedly to the ICU. Nutritional support began within 36 hours and was continued for up to five days, providing a pragmatic test of an everyday ICU decision. The trial did not demonstrate the expected survival advantage of early parenteral nutrition over enteral nutrition. Importantly, the study helped clarify that the route of feeding alone does not determine outcome; timing, dose, tolerance and the patient's underlying illness also matter. For HCPs, the paper supports a practical approach to nutrition: establish an individualised plan, favour the enteral route when feasible, monitor tolerance and avoid assuming that more aggressive feeding is automatically better. CritiCARE's nutrition sessions highlight protein delivery, feeding during shock, micronutrients and metabolic monitoring. CALORIES is a useful foundation for that discussion because it demonstrates why route, timing and energy delivery should be considered separately. The broader lesson is that ICU nutrition should be treated as active clinical management rather than a background supportive task. It needs regular reassessment as haemodynamics, gastrointestinal function, renal replacement and organ support evolve.
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The CALORIES trial compared early enteral with early parenteral nutritional support in adults admitted unexpectedly to the ICU. Nutritional support began within 36 hours and was continued for up to five days, providing a pragmatic test of an everyday ICU decision. The trial did not demonstrate the expected survival advantage of early parenteral nutrition over enteral nutrition. Importantly, the study helped clarify that the route of feeding alone does not determine outcome; timing, dose, tolerance and the patient's underlying illness also matter. For HCPs, the paper supports a practical approach to nutrition: establish an individualised plan, favour the enteral route when feasible, monitor tolerance and avoid assuming that more aggressive feeding is automatically better. CritiCARE's nutrition sessions highlight protein delivery, feeding during shock, micronutrients and metabolic monitoring. CALORIES is a useful foundation for that discussion because it demonstrates why route, timing and energy delivery should be considered separately. The broader lesson is that ICU nutrition should be treated as active clinical management rather than a background supportive task. It needs regular reassessment as haemodynamics, gastrointestinal function, renal replacement and organ support evolve.
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