How to maximize efficacy of nutrition support in the adult critically ill patients        WU Guo-hao. Department of Surgery, Zhongshan Hospital, Fudan University, Shanghai200032，China
Abstract    Critically ill patients are hypermetabolic and have increased nutrient requirements. Nutritional support is now considered as a standard of care for the critically ill patients. However, many questions about the appropriate substrate, timing, route and amount of nutritional support in critically ill patients remain understudied. Enteral nutrition is favored over parenteral nutrition when the gastrointestinal tract is functional. Early enteral nutrition is recommended for critically ill patients. Parenteral nutrition is indicated for patients who cannot tolerate enteral feedings. Supplemental parenteral nutrition combined with enteral nutrition can be considered to cover the energy and protein targets when enteral nutrition alone fails to achieve the caloric goal. Clinical studies have demonstrated that new formulae enriched with specific nutrients improves the outcomes of critically ill surgical patients.