Nutritional support in sepsis : when less may be more
CITATION: Van Niekerk, G., Meaker, C. & Engelbrecht, A. M. 2020. Nutritional support in sepsis : when less may be more. Critical Care, 24:53, doi:10.1186/s13054-020-2771-4.
The original publication is available at https://ccforum.biomedcentral.com
Despite sound basis to suspect that aggressive and early administration of nutritional support may hold therapeutic benefits during sepsis, recommendations for nutritional support have been somewhat underwhelming. Current guidelines (ESPEN and ASPEN) recognise a lack of clear evidence demonstrating the beneficial effect of nutritional support during sepsis, raising the question: why, given the perceived low efficacy of nutritionals support, are there no high-quality clinical trials on the efficacy of permissive underfeeding in sepsis? Here, we review clinically relevant beneficial effects of permissive underfeeding, motivating the urgent need to investigate the clinical benefits of delaying nutritional support during sepsis.