Mixed

In critically ill ICU patients, early parenteral nutrition (PN) combined with enteral nutrition delays recovery and increases infection risk compared to withholding PN for the first week (late PN), regardless of illness severity.

For critically ill patients in the ICU, current guidelines recommending early, full-calorie parenteral nutrition when enteral feeding is insufficient should be reconsidered. Evidence suggests that withholding parenteral nutrition for the first week (allowing a caloric deficit) leads to faster recovery, fewer infections, and shorter ICU stays, regardless of how sick the patient is. The focus should be on tolerating hypocaloric enteral feeding rather than aggressively reaching caloric targets via IV nutrition early on.