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Critical Care Nutrition at the Clinical Evaluation Research Unit (CERU)

is dedicated to improving nutrition therapies in the critically ill through knowledge generation, synthesis, and translation. We engage in a broad range of research activities and promote a culture of best practices in critical care nutrition. Ultimately, this will result in improved clinical outcomes for critically ill patients and increased efficiencies to our health care systems.

The 2015 Canadian Critical Care Nutrition CPGs are released!

The 2015 Clinical Practice Guidelines summarize the evidence from approximately 354 randomized controlled trials in the area of critical care nutrition since 1980.

The included studies have undergone a formal review process by the Canadian Clinical Practice Guidelines Committee and provide the latest and best evidence for clinical practice in the various areas of critical care nutrition. These guidelines were developed in collaboration with the Canadian Critical Care Society (CCCS) and the Canadian Critical Care Trials Group (CCCTG).

List of new randomized controlled trials included under each topic (n=41)

     > Also available in Spanish!

Highlights of the 2015 Canadian Clinical Practice Guidelines
Summarizes the evidence from 41 new randomized controlled trials since the 2013 Guidelines

There are a total of 46 recommendations under 12 main topics and several sub topics

New! There are 2 new sections in this year's update. Enteral Glutamine vs Parenteral Dipeptide Supplementation is under the topic PN Glutamine (topic 9) and Vitamin C is under the topic Antioxidant Strategies (topic 11).

The full Summary of Evidence is not yet available for topics 11.1 and 11.2. We are waiting upon further information from a recent trial. 

We want to hear from you!

Check out the "Comments" feature that allows you to write a comment about the 2015 updated Summaries of Evidence from the Guidelines. Use this feature to inform us of missing articles, incorrect data or interpretation of the evidence

Updated May 29th, 2015

1. The use of Enteral Nutrition vs. Parenteral Nutrition (EN vs. PN)

May 2015

(Access the 2009 and 2013 versions)

2. Early Vs Delayed Nutrient Intake

May 2015

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3. Nutritional Prescription (dose) of Enteral Nutrition

3.1 Indirect Calorimetry vs. Predictive


May 2015

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3.2 Achieving Target Dose of Enteral Nutrition


May 2015

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3.3 Intentional Underfeeding

3.3a Trophic Feeds vs Full Feeds


May 2015

(Access the 2013 version)


3.3b Hypocaloric Enteral Nutrition


May 2015

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4. Composition of Enteral Nutrition

4.1 Immune Enhancing Diets

4.1a Diets Supplemented with Arginine and Select Other Nutrients


May 2015

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4.1b i) Fish Oils, Borage Oils and Antioxidants


May 2015

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4.1b ii) Fish oils supplementation


May 2015

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4.1c Glutamine


May 2015

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4.1d Ornithine KetoGlutarate (OKG)


May 2015

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4.2 Carbohydrate/Fat

4.2a High fat/Low Carbohydrate


May 2015

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4.2b Low fat/High Carbohydrate


May 2015

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4.2c High Protein vs. Low Protein


May 2013

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4.3 Protein vs. Peptides


May 2015

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4.4 pH


May 2015

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4.5 Fibre


May 2015

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5. Strategies to Optimize Delivery and Minimize risk of Enteral Nutrition

5.1 Feeding Protocols


May 2013

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5.2 Motility Agents


May 2015

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5.3 Small Bowel vs. Gastric


May 2015

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5.4 Body position


May 2015

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5.5 Threshold of Gastric Residual Volumes


May 2015

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5.6 Discarding Gastric Residual Volumes


May 2015

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6. Enteral Nutrition: Other

6.1 Closed vs. Open system


May 2015

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6.2 Probiotics


May 2015

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6.3 Continuous vs. other methods of administration


May 2015

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6.4 Gastrostomy vs. Nasogastric feeding


May 2015

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6.5 Other Formulas


May 2015

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7. Enteral Nutrition plus Parenteral Nutrition

7.1 Combination Enteral and Parenteral Nutrition


May 2015

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7.2 Early vs Delayed Supplemental PN


May 2015

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8. Parenteral Nutrition vs. Standard care

May 2015

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9. Composition of Parenteral Nutrition

9.1 Branched Chain Amino Acids


May 2015

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9.2 Type of lipids


May 2015

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9.3 Zinc (alone or in combination)


May 2015

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9.4 Parenteral Glutamine


9.4a Parenteral Glutamine Supplementation


May 2015

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9.4b Combined Parenteral and Enteral Glutamine Supplementation


May 2015

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New!
9.4c Enteral Glutamine vs Parenteral Dipeptide Supplementation


May 2015
10. Strategies to Optimize Parenteral Nutrition

10.1 Dose of Parenteral Nutrition


May 2015

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10.2 Use of lipids


May 2015

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10.3 Mode of lipid delivery


May 2015

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10.4 Insulin and Glucose Control


10.4a Optimal glucose control: Insulin therapy


May 2015

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10.4b Optimal glucose control: Carbohydrate restricted formula and insulin therapy


May 2015

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11. Supplemental Antioxidants

11.1 Combined Vitamins and Trace Elements


August 2015

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11.2 Parenteral Selenium (alone or in combination)


August 2015

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New!
11.3 Vitamin C Supplementation


May 2015
12. Vitamin D

May 2015

(Access the 2009 and 2013 versions)

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