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...Nutritional support in intensive care unit icu patients topic module clinical priorities for solving complex patient problems thomas w felbinger md phd chairman dept of anesthesiology critical and pain medicineneuperlach medical center the munich municipal hospitals ltd germany learning objectives knowledge about organ failures influencing substrate metabolism enteral nutrition during vasopressor thereray timing to start spn an on insufficient morbid adipositas content introduction with hemodynamic instability supplemental parenteral glutamine antioxidants adjustments cvvh morbidly obese critically ill summary references key messages use vasoactive substances should not entirely preclude absence increasing doses or levels lactic acid change symptoms en slowly adjusted may be applied safely under close monitoring full is necessary compromised often needed long term particular presence gi supplementation high dose cannot recommended unselected complicated by shock multi dysfunction syndr...