The CALORIES trial compared parenteral nutrition (PN) versus enteral nutrition (EN) in critically ill ICU patients unable to tolerate full enteral feeding. The primary outcome difference was:

• A PN was superior in achieving caloric targets, with significantly lower 30-day mortality than EN
• B EN significantly reduced 30-day mortality compared to PN; PN should be avoided in all ICU patients
• C No significant difference in 30-day mortality between PN and EN, but PN was associated with more hypoglycaemia and infection, while EN was associated with more vomiting and diarrhoea ✓
• D PN caused significantly higher rates of catheter-related bloodstream infection, but EN caused no complications

Explanation

The CALORIES trial (1,200+ ICU patients) found no significant difference in 30-day all-cause mortality between parenteral nutrition and enteral nutrition (33.1% vs 34.2%). PN was associated with more hypoglycaemia and infectious complications; EN with more vomiting and gastric feed intolerance. This supports the current practice of attempting EN first in all ICU patients and reserving PN for those in whom EN is truly contraindicated or insufficient after 48-72 hours. Supplemental PN can be added if EN fails to meet >60% of caloric requirements by day 5 per ESPEN guidelines.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.