The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality. Enteral nutrition (EN) is generally recommended over parenteral nutrition (PN) and is beneficial when administered within 24-48 h after ICU admission. In contrast, early PN does not provide substantial advantages in terms of morbidity and mortality, and the time when it is safe and beneficial remains unclear. The most advantageous recommendation seems to be administration of a hypocaloric (<20 kcal · kg-1 · d-1), high-protein diet (amino acids at doses of ≥2 g · kg-1 · d-1), at least during the first week of critical illness. Another important factor for reducing morbidity is the maintenance of blood glucose concentrations at 120-150 mg/dL, which is accomplished with the use of insulin and lower doses of glucose of 1-2 g · kg-1 · d-1, because this prevents the risk of hypoglycemia and is associated with a better prognosis according to recent studies. A fat emulsion is used as a source of required calories because of insulin resistance in the majority of patients. In addition, lipid oxidation in these patients is ∼25% higher than in healthy subjects.

• Klíčová slova
• energy expenditure, energy metabolism, enteral nutrition, glucose control, indirect calorimetry, metabolism, parenteral nutrition, timing for nutrition commencement,
• MeSH
• dietní proteiny aplikace a dávkování   MeSH
• dietní sacharidy aplikace a dávkování   MeSH
• dietní tuky aplikace a dávkování   MeSH
• dospělí MeSH
• energetický metabolismus MeSH
• energetický příjem * MeSH
• enterální výživa MeSH
• inzulin krev   MeSH
• jednotky intenzivní péče MeSH
• krevní glukóza metabolismus   MeSH
• kritický stav epidemiologie   terapie   MeSH
• lidé MeSH
• metaanalýza jako téma MeSH
• morbidita MeSH
• mortalita MeSH
• nutriční nároky MeSH
• parenterální výživa MeSH
• pozorovací studie jako téma MeSH
• randomizované kontrolované studie jako téma MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH
• Názvy látek
• dietní proteiny MeSH
• dietní sacharidy MeSH
• dietní tuky MeSH
• inzulin MeSH
• krevní glukóza MeSH