Just Published!  The Evidence Analysis Library is pleased to announce the publication of the Disorders of Lipid Metabolism Saturated Fat Evidence-Based Nutrition Practice Guideline. View the guideline.

Critical Illness

CI: Background Information (2006)


This guideline was not adapted from another source. Development of the guideline was conducted in accordance with the Appraisal of Guidelines Reserach Evaluation critical appraisal instrument.

Date Released

September 2006

Guideline Developer

Professional Association

Source of Funding

Funding for this guideline was provided by American Dietetic Association Dietitians in Nutrition Support Dietetic Practice Group, Novartis and Nestle Nutrition.

Members of the Critical Illness Evidence-Based Guideline Workgroup

  • Ainsley M. Malone, MS, RD, LD, CNSD, Chair
  • Pamela Charney, MS, RD, LD, CNSD
  • Charlene Compher, PhD, RD, FADA, CNSD, LDN
  • Dema Halasa Esper, MS, RD, CNSD
  • David Frankenfield, MS, RD
  • Mary Hise, PhD, RD, LD, CNSD
  • Kendra Kattlemann, PhD, RD, LN
  • Mary Marian, MS, RD, CNSD
  • Elisa Nyberg, MS, RD, LN
  • Susan Roberts, MS, RD, LD, CNSD
  • Mary K Russell, MS, RD, LDN, CNSD

Lead Evidence Analysts

  • Jarrod D. Dusin, MS, RD, LD, CNSD
  • Patti Landers, PhD, RD, LD

Project Manager

  • Tami Piemonte, MS, RD, LD

Evidence Analysts

  • Mary Beth Bilboy, PhD, MPH, RD, LDN
  • Erica Gradwell, MS, RD
  • Kala M. Kaspar, PhD, MS, RD
  • Janet Skates, MS, RD, LDN, CNSD, FADA
  • Sherry Valente, MA, RD

 The Critical Illness Evidence-Based Nutrition Practice Guideline also integrated work from the Energy Expenditure: Measuring versus Estimating  evidence analysis project. Click here to see a list of contributors from this project.

Additionally, professionals from various backgrounds were consulted as needed to enhance the quality of the evidence analysis. 

Guideline Reviewers

  • Joseph Boullata, PharmD
  • Susan Brantley, MS, RD, CNSD
  • Todd Canada, PharmD, BCNSP
  • Ronni Chernoff, PhD, RD, FADA
  • Gail Cresci, MS, RD, CNSD
  • Nancy Emenaker, PhD, MEd, RD
  • David Frankenfield, MS, RD
  • Elvira Johnson, MS, RDm, CDE, LDN
  • Marion J. Franz, MS, RD, CDE
  • M. Patricia Fuhrman, MS, RD, LD, FADA
  • Linda Griffith, PhD, RD, CNSD
  • Kendra K. Kattelmann, PhD, RD, LN
  • Jennier Lefton, MS, RD, CNSD
  • Nancy Lewis, PhD, RD, FADA
  • Ainsley M. Malone, MS, RD, LD, CNSD
  • Robert Martindale, MD, PhD
  • Carol McGinnis
  • Kathleen C. Niedert, MBA, RD, LD, FADA
  • Becky Reeves, DrPH, RD, FADA
  • Susan R. Roberts, MS, RD, LD, CNSD
  • Kimberly Robien, PhD, RD, FADA, CNSD
  • David Seres, MD
  • Margaret Tate, MS, RD
  • Beth Taylor, MS, RD, CNSD, FCCM

Disclosure of Conflict of Interest

In the interest of full disclosure, ADA has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this guideline topic. Workgroup members are required to disclose potential conflicts of interest by completing the Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content of the guideline, but they are noted here to fully inform readers. Readers of the guideline may assume that only work group members listed below have potential conflicts of interest to disclose.

No work group members have potential conflicts of interest to disclose.

Guideline Status

This is the first release of the Critical Illness Evidence-Based Nutrition Practice Guideline.

Guideline Availablility

The guideline will be available online.

 Availability of Companion Documents 

The Critical Illness Toolkit is available on the EAL Store. The Toolkit is a set companion documents which detail how the practitioner applies the Evidence-Based Nutrition Practice Guideline in practice. The Toolkit will include forms such as documentation forms, outcomes monitoring sheets, professional resources, case studies and MNT protocols for implementing the Evidence-Based Nutrition Practice Guideline.

Patient Resources

Patient education resources are available within the Critical Illness Toolkit.

Implementation Strategy

This publication of this guideline is an integral part of the plans for getting the ADA MNT evidence-based recommendations on critical illness to all dietetics practitioners engaged in, teaching about, or researching critical illness. National implementation workshops at various sites around the country and during the ADA Food Nutrition Conference Expo (FNCE) are planned. Additionally, there are recommended dissemination and adoption strategies for local use of the ADA Critical Illness Evidence-Based Nutrition Practice Guideline.

The guideline development team recommended multi-faceted strategies to disseminate the guideline and encourage its implementation. Management support and learning through social influence are likely to be effective in implementing guidelines in dietetic practice. However, additional interventions may be needed to achieve real change in practice routines.

Implementation of the Critical Illness Guideline will be achieved by announcement at professional events, presentations and training. Some strategies include:

  • National and Local Events – State dietetic association meetings and media coverage will help launch the guideline
  • Local Feedback Adaptation – Presentation by members of the work group at peer review meetings and opportunities for CEUs for courses completed
  • Education Initiatives – The guideline and supplementary resources will be freely available for use in the education and training of dietetic interns and students in approved Commission on Accreditation of Dietetics Education (CADE) programs
  • Champions – Local champions will be identified and expert members of the guideline team will prepare articles for publications. Resources will be provided that include PowerPoint presentations, full guidelines, and pre-prepared case studies.
  • Practical Tools – Some of the tools that will be developed to help implement the guideline include specially designed resources such as clinical algorithms, slide presentation, training, and toolkits. Specific distribution strategies include:

Publication in Full – The guideline will be available electronically at the ADA member website (www.adaevidencelibrary.com) and will be announced to all the dietetic practice groups. The ADA website will also provide downloadable supporting information.

 National Library of Medicine Subject Headings

The main MeSH category is designated as Therapeutics.

The sub categories under this heading include Nutrition Therapy and Diet Therapy.

Institutes of Medicine (IOM) National Healthcare Quality Report Categories

IOM Care need: Getting better

IOM Domain: Effectiveness, Patient centeredness


Copyright Statement 

The American Dietetic Association encourages the free exchange of evidence in nutrition practice guidelines and promotes the adaptation of the guidelines for local conditions. However, please note that guidelines are subject to copyright provisions. To replicate or reproduce this guideline, in part or in full, please obtain agreement from the American Dietetic Association. Contact eal@adaevidencelibrary.com for copyright permission.

When modifying the guidelines for local circumstances, significant departures from these comprehensive guidelines should be fully documented and the reasons for the differences explicitly detailed.

©2005 American Dietetic Association