Nutrition Support
for the Critically

Nutritional support in the critically ill patient is like mother’s milk, right? Indeed, there was a time,
long ago and on a planet far away, when we felt we knew all the answers to feeding the critically ill.
At the end of the 1970s, when I was undertaking my Fellowship in Critical Care Medicine, it was
assumed that total parenteral nutrition (TPN) would ultimately take care of our sick patients’ needs.
To underscore the naivety of this concept, soon after my graduation as a neophyte intensivist at a
major university medical center, I was appointed Chair of the Hospital TPN Committee. A classic
case of the blind leading the blind!