Abstract
In the critically ill patient, current recommendations endorse administering nutritional support according to indirect calorimetry measurements or if not available, according to formulae, such as 25 kcal/kg ideal body weight/day or other predictive equations (1,2). However, it is universally recognized that these equations are largely inaccurate and may result in both under- or over-feeding in 40-70% of patients. Over the past few years, numerous studies have compared outcomes of patient receiving by different routes, various amounts of calories and protein (3-5). One of the most recent, by Arabi et al . (6), namely the PermiT study, compared a standard caloric regimen consisting of 70-100% of estimated caloric requirements as determined by the Penn State equation, to a permissive underfeeding regimen consisting of 40-60% of caloric requirements.
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