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The 2015 Clinical Practice Guidelines summarize the evidence from approximately 354 randomized controlled trials in the area of critical care nutrition since 1980.

The included studies have undergone a formal review process by the Canadian Clinical Practice Guidelines Committee and provide the latest and best evidence for clinical practice in the various areas of critical care nutrition. These guidelines were developed in collaboration with the Canadian Critical Care Society (CCCS) and the Canadian Critical Care Trials Group (CCCTG).

List of new randomized controlled trials included under each topic (n=41)

Summary of Recommendations 2015 vs. 2013

> Also available in Spanish!

Highlights of the 2015 Canadian Clinical Practice Guidelines
Summarizes the evidence from 41 new randomized controlled trials since the 2013 Guidelines

There are a total of 46 recommendations under 12 main topics and several sub topics

New! There are 2 new sections in the 2015 CPGs. Enteral Glutamine vs Parenteral Dipeptide Supplementation is under the topic PN Glutamine (topic 9) and Vitamin C is under the topic Antioxidant Strategies (topic 11).

Updated August 2015

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1. The use of Enteral Nutrition vs. Parenteral Nutrition (EN vs. PN)

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2. Early Vs Delayed Nutrient Intake

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3. Nutritional Prescription (dose) of Enteral Nutrition

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3.1 Indirect Calorimetry vs. Predictive

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3.2 Achieving Target Dose of Enteral Nutrition

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3.3 Intentional Underfeeding

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3.3a Trophic Feeds vs Full Feeds

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3.3b Hypocaloric Enteral Nutrition

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4. Composition of Enteral Nutrition

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4.1 Immune Enhancing Diets

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4.1a Diets Supplemented with Arginine and Select Other Nutrients

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4.1b i) Fish Oils, Borage Oils and Antioxidants

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4.1b ii) Fish oils supplementation

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4.1c Glutamine

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4.1d Ornithine KetoGlutarate (OKG)

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4.2 Carbohydrate/Fat

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4.2a High fat/Low Carbohydrate

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4.2b Low fat/High Carbohydrate

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4.2c High Protein vs. Low Protein

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4.3 Protein vs. Peptides

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4.4 pH

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4.5 Fibre

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5. Strategies to Optimize Delivery and Minimize risk of Enteral Nutrition

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5.1 Feeding Protocols

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5.2 Motility Agents

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5.3 Small Bowel vs. Gastric

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5.4 Body position

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5.5 Threshold of Gastric Residual Volumes

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5.6 Discarding Gastric Residual Volumes

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6. Enteral Nutrition: Other

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6.1 Closed vs. Open system

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6.2 Probiotics

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6.3 Continuous vs. other methods of administration

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6.4 Gastrostomy vs. Nasogastric feeding

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6.5 Other Formulas

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7. Enteral Nutrition plus Parenteral Nutrition

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7.1 Combination Enteral and Parenteral Nutrition

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7.2 Early vs Delayed Supplemental PN

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8. Parenteral Nutrition vs. Standard care

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9. Composition of Parenteral Nutrition

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9.1 Branched Chain Amino Acids

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9.2 Type of lipids

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9.3 Zinc (alone or in combination)

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9.4 Parenteral Glutamine

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9.4a Parenteral Glutamine Supplementation

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9.4b Combined Parenteral and Enteral Glutamine Supplementation

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New!
9.4c Enteral Glutamine vs Parenteral Dipeptide Supplementation

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10. Strategies to Optimize Parenteral Nutrition

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10.1 Dose of Parenteral Nutrition

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10.2 Use of lipids

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10.3 Mode of lipid delivery

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10.4 Insulin and Glucose Control

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10.4a Optimal glucose control: Insulin therapy

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10.4b Optimal glucose control: Carbohydrate restricted formula and insulin therapy

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11. Supplemental Antioxidants

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11.1 Combined Vitamins and Trace Elements

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11.2 Parenteral Selenium (alone or in combination)

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New!
11.3 Vitamin C Supplementation

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12. Vitamin D

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