Vol. 7, Issue 1, Part B (2025)

Critically ill patients commonly experience a hypermetabolic and catabolic state that contributes to rapid nutritional deterioration, impaired immune function, delayed wound healing, and increased susceptibility to infections and mortality. In such scenarios, timely and appropriate nutritional support becomes a cornerstone of intensive care management. This review explores the importance of nutritional therapy in critical illness, emphasizing its role in improving clinical outcomes such as reduced ICU and hospital stays, lower incidence of nosocomial infections, preservation of muscle mass, and decreased mortality. International guidelines—including those from ESPEN, ASPEN, and NICE—provide evidence-based recommendations that underscore early initiation of enteral nutrition (EN), individualized assessment of energy and protein requirements, and cautious escalation to avoid complications such as refeeding syndrome. Furthermore, clinical trials like the EPaNIC, CALORIES, TARGET, and NUTRIREA-2 studies highlight the nuanced impact of nutritional interventions on patient outcomes and support the prioritization of enteral over parenteral nutrition when feasible. Despite well-established guidelines, the implementation of nutritional therapy remains challenged by factors such as hemodynamic instability, gastric intolerance, limited use of indirect calorimetry, and inadequate nutrition support infrastructure in many ICUs. Addressing these barriers requires greater emphasis on multidisciplinary collaboration, specialized training, and standardization of nutrition assessment protocols. Looking ahead, the integration of personalized nutrition strategies based on metabolic biomarkers and real-time monitoring, alongside the application of artificial intelligence in nutrition planning, promises to enhance the precision and efficacy of nutritional care. These innovations, coupled with strengthened roles for clinical dietitians, can optimize outcomes for critically ill patients. In conclusion, nutritional therapy should be recognized not merely as a supportive measure but as an essential therapeutic intervention that significantly influences the trajectory of recovery and long-term health in critical care settings.