Critically ill patients need appropriate nutritional supplementation for their energy requirements during their intensive care unit (ICU) stay and even after ICU stay.1 Any critical illness is a catabolic state and all critically ill patients have an ongoing low-grade inflammation and protein catabolism referred to as persistent inflammatory catabolism syndrome (PICS).2 Adequate supplementation of nutrition attenuates the stress response and modulates immune responses. The aim of nutritional supplementation is to supplement both macro- and micronutrient requirements. Careful supplementation of protein and caloric intake can avoid under- and overfeeding and will decrease the hospital stay and morbidity. Route of supplementation, that is, oral, enteral, or parenteral depends on the patient's hemodynamic status and gastrointestinal functioning. Initiation of feeding within 24–48 hours of critical illness has been recommended. Also, early start of physical exercise has favorable effect on muscle preservation and reduces protein catabolism. The patient's outcome in intensive care depends upon the timing of nutrition, amount, and type of nutrition.
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