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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 Clinical Practice Guidelines are a set of 209 randomized controlled trials in the area of critical care nutrition.  The studies have undergone a formal review process to provide the latest and best evidence for clinical practice in the various areas of critical care nutrition. All the guideline topics have undergone a formal review process and were last updated in January 2009 and May 2009 (as indicated in red). The 2009 update added 40 new randomized controlled trials to the evidence-based guidelines. 

List of All included randomized controlled trials (n= 209)

Published version of the Clinical Practice Guidelines

Protocol: Development of Clinical Guidelines for Nutrition Support in Adult Critically Ill Patients

Summary of Recommendations

Table of Contents

Note: Please click on the Enabling Tools icon to be directed to enabling tools that relate to specific guideline topics. The date of the current version of these guidelines is January 2009, unless otherwise noted.

1. The use of EN vs PN Enabling Tools
2. Early vs Delayed Nutrient Intake Enabling Tools
3. Nutritional prescription (dose) of EN Enabling Tools
1. Use of indirect calorimetry vs. predictive equation Enabling Tools
2. Achieving target dose of enteral nutrition Enabling Tools
4. Composition of EN Enabling Tools
1. Immune enhancing Diets Enabling Tools
a. Arginine Containing Enabling Tools
b. Fish oils Enabling Tools
c. Glutamine Enabling Tools
d. Ornithine Ketoglutarate (OKG) Enabling Tools
2. Carbohydrate / Fat Enabling Tools
a. High fat / low carbohydrate Enabling Tools
b. Low fat / high carbohydrate Enabling Tools
c. High Protein vs. Low Protein Enabling Tools
3. Protein / peptides Enabling Tools
4. pH Enabling Tools
5. Fibre Enabling Tools
5. Strategies to optimize delivery and minimize risks of EN
1. Use of feeding protocols Enabling Tools
2. Motility agents Enabling Tools
3. Small bowel vs. gastric feedings Enabling Tools
4. Body position Enabling Tools
6. EN: Other Enabling Tools
1. Closed vs. Open system Enabling Tools
2. Prebiotics/Probiotics/Synbiotics - (May 2009) Enabling Tools
3. Continuous vs. other methods of administration Enabling Tools
4. Gastrostomy vs nasogastric feeding Enabling Tools
7. Enteral nutrition in combination with PN Enabling Tools
8. Use of PN vs. standard care alone in patients with an intact GI tract Enabling Tools
9. Composition of PN  
1. Branched chain amino acids Enabling Tools
2. Type of Lipids - (May 2009) Enabling Tools
3. Zinc - (May 2009) Enabling Tools
4. Glutamine Enabling Tools
10. Strategies to optimize benefits and minimize risks of PN  
1. Dose of PN Enabling Tools
2. Use of lipids Enabling Tools
3. Mode of lipid delivery Enabling Tools
4. Intensive insulin therapy - (May 2009) Enabling Tools
11. Supplemental Antioxidant Nutrients Enabling Tools
1. Combined vitamins and trace elements Enabling Tools
2. Parenteral Selenium Enabling Tools
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