• Crit Care · Feb 2020

    Review

    Nutritional support in sepsis: when less may be more.

    • Gustav van Niekerk, Charné Meaker, and Anna-Mart Engelbrecht.
    • Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa. gustav.v.niekerk@gmail.com.
    • Crit Care. 2020 Feb 14; 24 (1): 53.

    AbstractDespite sound basis to suspect that aggressive and early administration of nutritional support may hold therapeutic benefits during sepsis, recommendations for nutritional support have been somewhat underwhelming. Current guidelines (ESPEN and ASPEN) recognise a lack of clear evidence demonstrating the beneficial effect of nutritional support during sepsis, raising the question: why, given the perceived low efficacy of nutritionals support, are there no high-quality clinical trials on the efficacy of permissive underfeeding in sepsis? Here, we review clinically relevant beneficial effects of permissive underfeeding, motivating the urgent need to investigate the clinical benefits of delaying nutritional support during sepsis.

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