Please select the eligibility criteria that correspond to the clinical trial below.
Title: Impact of Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients
Brief Summary: In critically ill patients, a strategy aimed at an early delivery of full caloric support, with a combination of Enteral Nutrition (EN) and Parenteral Nutrition (PN) (in conditions preventing hyperglycemia and overfeeding), results in shorter ICU and hospital stay and less morbidity as compared to a strategy using only EN.


Options:
A: Inclusion Criteria:

* Expected ICU stay \> 5 days
* Expected survival \> 7 days
* No contraindication to EN
* Obtained informed consent

Exclusion Criteria:

* Refusal of consent
* Age \< 18 years
* Short bowel syndrome
* Significant persistent gastrointestinal dysfunction with ileus
* High output proximal fistula (\> 1.5 liter/d)
* Patients receiving PN
B: Inclusion Criteria:

Patients in intensive care who meet all of the following:

* Admitted to intensive care between 48 hours and 72 hours previously
* Mechanically ventilated at the time of enrollment and expected to remain ventilated until the day after tomorrow
* At least 16 years of age
* Have central venous access suitable for PN solution administration
* Have 1 or more organ system failure (respiratory, cardiovascular or renal) related to their acute illness defined as:

  1. Partial pressure of oxygen (PaO2) / Fraction of Inspired oxygen (FiO2) ratio ≤ 300 mmHg
  2. Currently on 1 or more continuous vasopressor infusion which were started at least 4 hours ago at a minimum dose of :

     1. Dopamine greater than 5 mcg/kg/min
     2. Noradrenaline ≥ 0.1mcg/kg/min
     3. Adrenaline ≥ 0.1 mcg/kg/min
     4. Any dose of total vasopressin
     5. Milrinone \>0.25mcg/kg/min)
  3. Renal dysfunction defined as

     In patients without known renal disease:
     1. serum creatinine \> 171 mmol/l OR
     2. Currently receiving renal replacement therapy

        In patients with known renal disease:
     3. an absolute increase of \> 50% in creatinine from baseline OR
     4. Currently receiving renal replacement therapy
  4. Currently has an intracranial pressure monitor or ventricular drain in situ
  5. Currently receiving extracorporeal membrane oxygenation
  6. Currently has a ventricular assist device

Exclusion Criteria:

* Both EN and PN cannot be delivered at enrollment (i.e. either an enteral tube or a central venous catheter cannot be placed or clinicians feel that EN or PN cannot be safely administered due to any other reason).
* Currently receiving PN
* Standard PN solutions cannot be delivered at enrolment (i.e. clinicians believe that a patient definitely needs a specific parenteral nutrition formulation (e.g. glutamine-supplementation or specific lipid formulation).
* Death is imminent or deemed highly likely in the next 96 hours.
* There is a current treatment limitation in place or the patient is unlikely to survive to 6 months due to underlying illness
* More than 80% of energy requirements have been satisfactorily delivered via the enteral route in the last 24 hours.
* Are known to be pregnant
C: Inclusion Criteria:

* Treatment with invasive mechanical ventilation
* Feeding via nasogastric tube within 36 hours after the initiation of endotracheal mechanical ventilation.
* Age over 18 years
* Informed consent

Exclusion Criteria:

* Mechanical ventilation started more than 36 hours before institution of enteral feeding
* Patients turned in the prone position at inclusion
* Abdominal surgery within 1 month before inclusion
* History of esophageal or gastric surgery
* EN via a gastrostomy or a jejunostomy
* Bleeding from esophagus, stomach or bowel
* Moribund patient
* Age less than 18 years
* Pregnancy.
* No informed consent.
D: Inclusion Criteria:

1. Patients admitted to any of the five intensive care units
2. Older than 18 years
3. Nutritional risk screening score (NRS) higher or equal to three upon ICU admission

Exclusion Criteria:

1. Patients with a do not resuscitate (DNR) code or moribund at the time of ICU admission
2. Patients already enrolled in another trial
3. Patients transferred from another intensive care unit with an established nutritional therapy
4. Patients suffering from ketoacidotic or hyperosmolar coma on admission
5. Patients with a body mass index (BMI) below 17 kg/m\^2
6. Short bowel syndrome
7. Patients known to be pregnant or nursing
8. Patients on mechanical ventilation at home
9. NRS score lower than three
10. Patient readmitted to ICU after randomization to the EPaNIC trial.
11. Patient not critically ill on admission. (No clinical indication for central intravenous catheter or patient ready for oral nutrition on admission.)

Answer: D