Are energy and protein targets being met in the ICU?

Background Multiple barriers exist to achieving energy and protein targets in the critically ill. Elke et al [1] used data from ICU’s worldwide which estimated average energy delivery of only 1057 kcals/day and protein delivery 49 g/d (0.7 g/ kg/d). Weijs et al [2] demonstrated that meeting energy and protein requirements is associated with decreased mortality. Local data from 2012 found an average delivery of 1424 kCal and 56.8 g protein/d (0.75 g/kg/d) once at target rate (TR) and that 40% of patients were taking > 5 days to reach TR. As a result alterations were made to the ICU feeding protocol; 1.GRV threshold increased to 300 ml, 2. Daily monitoring of energy and protein provision, 3.Introduction of protein modules.