Division of Metabolic & Cellular Medicine, School of Clinical Sciences, University of Liverpool, Liverpool, L69 3GA, UK. rdg@liverpool.ac.uk
Enteral nutrition (EN) gives a legacy of under nutrition in intensive care patients but few appreciate that parenteral nutrition (PN) carries the other risk of overfeeding if used injudiciously. Over-feeding presents a significant metabolic stress but tight glycaemic control is now masking the traditional warning signs and does not on its own negate the need to give patients the right amount at the right time.