Nutritional support for critically ill patients by the Korean Society for Parenteral and Enteral Nutrition—part II: a clinical practice guideline

Abstract

Purpose: Nutritional therapy is an essential component of intensive care management. Appropriate nutritional support may reduce infectious and metabolic complications and promote recovery in critically ill patients. However, nutritional practices vary across institutions, and international guidelines may not be directly applicable to clinical practice in Korea. Evidence-based clinical practice guidelines that reflect Korean intensive care unit practice are therefore needed.Methods: The Korean Society for Parenteral and Enteral Nutrition developed these clinical practice guidelines for nutritional therapy in critically ill adults through a systematic literature review and multidisciplinary expert consensus.Results: In total, 24 key clinical questions and 59 recommendations were developed. The guidelines address enteral and parenteral nutrition, feeding intolerance, aspiration prevention, energy and protein assessment, immune-modulating nutrition, micronutrient supplementation, refeeding syndrome, and disease-specific nutritional therapy for critically ill adults, including those with acute kidney injury, acute liver failure, acute respiratory distress syndrome, sepsis, trauma, and obesity. The recommendations emphasize individualized nutritional therapy according to hemodynamic status, metabolic phase, organ dysfunction, nutritional risk, and treatment goals.Conclusion: These guidelines provide practical, evidence-based recommendations for nutritional therapy in critically ill adults and reflect both current international evidence and Korean clinical practice. They may support more standardized and consistent nutritional support in Korean intensive care units.