How could we make nutrition in the intensive care unit simple?

A uniform approach may be applied to any process which may be defined as simple i.e. one which is orderly, easily understood, repeatable and reproducible and not complicated or complex. The approach to nutrition for critically ill patients in the intensive care unit (ICU) cannot be described as uniform or simple for a number of reasons. These patients frequently present with multiple, simultaneous problems and their course may be dynamic, unordered, complex, coherent only in retrospect and not repeatable. In addition, their nutritional status may vary from normal to moderate or even severe malnourishment, be influenced by the presence of co-morbidities such as obesity, cancer, or the sarcopenia related to age and may vary over the ICU course in the presence of changing organ function. In order to advance optimal nutritional support as an integral part of the treatment plan of critically ill ICU patients, what is required is a pragmatic approach which, while taking into account their complexity, provides a uniform, simple approach which can be readily applied. The aim of this article is to suggest such an approach(1) with consideration given to screening and assessment, therapy and monitoring of nutritional support.