الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Nutritional support has emerged as a vital aspect of the management of ICU patients especially during the last three decades. The metabolic dilemma in critically ill patient includes protein hypercatabolism, lipolysis, hyperglycemia, insulin resistance in addition to specific vitamins or trace elements deficiency. The primary goal of any nutritional support regimen is to provide adequate macronutrients and micronutrients to meet the requirements of each patient according to his underlying disease. There was a major controversy about choosing the route for administration of nutritional support. All evidence based clinical trials in the last decade confirms that the enteral nutritional support, unless contraindicated is the main choice over parenteral route. Nutritional support must be individualized for each patient and for each coexisting disease. Every disease has a different impact on metabolic profile of the patient leading to a different composition of nutritional support regimen. Immunonutrition is the concept of modulating the activity of the immune system by interventions with immune modulating nutrients. Recent clinical trials confirmed the efficacy of immunonutrients in reducing morbidity and mortality rates in ICU patients. Evidence based clinical trails shows the great importance of providing early enteral nutritional support to ICU patients within 24-48 hours of addmition. Tailoring of nutritional support regimen according to the special status, diagnosis, needs and prognosis of each patient is the corner stone of the successful nutritional support.