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Nutritional support for critically ill patients by the Korean Society for Parenteral and Enteral Nutrition—part II: a clinical practice guideline
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Jae Gil Lee
 , You Min Sohn, Seung Hwan Lee, Yun Tae Jung, Hak-Jae Lee, Jeong Yun Park, Nak-Jun Choi, Jung Mi Song, Jee Young Lee, Ji Yeon Kim, Ji Yeong Jeong, Ye Won Sung, Eun Jeong Park, Hyun Ji Ko, Ji Yoon Cho, Bomi Kim, Yesung Oh, In Chung Lee, Jin Young Lee, A Ram Kim, Jee Yeon Lee, Seong-Eun Kim, Tae Sun Ha, Min Kwan Kwon
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Ann Clin Nutr Metab 2026;18(2):65-116. Published online July 31, 2026
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DOI: https://doi.org/10.15747/ACNM.26.0059
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 Abstract
 PDF Supplementary Material
- 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.
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Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study
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Chan-Hee Park, Hak-Jae Lee, Suk-Kyung Hong, Yang-Hee Jun, Jeong-Woo Lee, Nak-Jun Choi, Kyu-Hyouck Kyoung
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Ann Clin Nutr Metab 2022;14(2):66-71. Published online December 1, 2022
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DOI: https://doi.org/10.15747/ACNM.2022.14.2.66
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Abstract
PDF
- Purpose: Timely enteral nutrition (EN) is important in critically ill patients. However, use of EN with critically ill surgical patients has many limitations. This study aimed to analyze the current status of EN in surgical intensive care units (ICUs) in South Korea.
Materials and Methods: A multicenter, prospective, observational study was conducted on patients who received EN in surgical ICUs at four university hospitals between August 2021 and January 2022.
Results: This study included 125 patients. The mean time to start EN after admission to the surgical ICU was 6.2±4.6 days. EN was provided to 34 (27.2%) patients within 3 days after ICU admission. At 15.7±15.9 days, the target caloric requirement was achieved by 74 (59.2%) patients through EN alone. Furthermore, 104 (83.2%) patients received supplemental parenteral nutrition after a mean of 3.5±2.1 days. Only one of the four hospitals regularly used enteral feeding tubes and post-pyloric feeding tubes.
Conclusion: Establishing EN guidelines for critically ill surgical patients and setting an appropriate insurance fee for EN-related devices, such as the feeding pump and enteral feeding tube, are necessary.
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