Nutritional Requirements in ICU

RequirementRecommended AmountNotes
Energy25–30 kcal/kg/day (acute phase)Reduce to 15–20 kcal/kg/day in first 48–72h (permissive underfeeding); increase with recovery
Protein1.2–2.0 g/kg/dayHigher in burns, post-surgical, and prolonged ICU stays; difficult to meet with EN alone
Carbohydrate~60% of non-protein caloriesLimit glucose infusion rate to <4 mg/kg/min to avoid lipogenesis
Fat~40% of non-protein caloriesLipid emulsions provide essential fatty acids; caution with propofol (counts as fat calories)
Fibre10–20 g/day (enteral)Supports gut microbiome and motility; avoid in high risk of gut ischaemia
Vitamins and trace elementsPer standard ICU feed formulationSelenium, zinc, and vitamin C have specific immunological roles; vitamin B1 (thiamine) essential before glucose in malnourished patients