A 55-year-old man in the ICU following a major hepatectomy has SIRS criteria met on day 2. Nutritional support is being planned. Enteral nutrition should be commenced within:
- A 24–48 hours post-operatively via nasogastric tube ✓
- B Day 5–7 post-operatively after ileus resolves
- C Only after return of bowel sounds
- D Only when CRP normalizes
Correct answer: A. 24–48 hours post-operatively via nasogastric tube
Explanation
ESPEN and ASPEN guidelines recommend early enteral nutrition within 24–48 hours in critically ill or post-major surgery patients, even when bowel sounds are absent. Early EN maintains gut mucosal integrity, reduces bacterial translocation, decreases infection rates, and improves outcomes. Absence of bowel sounds or flatus is not a prerequisite to start EN. Delaying until day 5–7 significantly increases infection-related complications and ICU length of stay.
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.