Nutritional maze symbolizing the complexities of sepsis nutrition.

Sepsis Nutrition: Are We All on the Same Page?

Lena Kashyap in Health & Wellness December 2025 • 4 min read.

"A Canadian survey reveals surprising variations in how registered dietitians approach nutrition for severe sepsis patients – and why it matters."

Severe sepsis, a life-threatening condition triggered by the body's overwhelming response to an infection, affects a significant portion of intensive care unit (ICU) patients and contributes to a notable number of deaths. Optimizing nutrition has emerged as a critical strategy to improve outcomes for these vulnerable patients.

However, providing evidence-based nutrition care for individuals with severe sepsis presents a unique challenge. Canadian Registered Dietitians (RDs) must navigate a complex landscape of North American guidelines and research studies, often encountering discrepancies due to varying data interpretations and publication timelines.

To shed light on this issue, a recent survey explored the opinions and practices of Canadian RDs regarding the nutrition care of severely septic patients. The findings reveal a surprising degree of variability, highlighting the need for additional information and strategies to optimize patient management.

Decoding the Discrepancies: Key Findings from the Canadian RD Survey

Nutritional maze symbolizing the complexities of sepsis nutrition.

The 2017 survey, distributed to 112 eligible Canadian RDs working in intensive care environments across 10 provinces, achieved a 57% response rate. The survey delved into various facets of sepsis, critical illness, and nutrition, ensuring anonymity to encourage honest responses.

The survey results exposed a wide range of opinions and practices among Canadian RDs in several key areas:

Energy Requirements: Significant variability existed in how RDs determined the energy needs of severe sepsis patients.
Enteral Nutrition (EN) Practices: Approaches to enteral nutrition varied considerably.
EN with Vasoactive Agents: The use of enteral nutrition in conjunction with vasoactive agents (medications that affect blood vessel tone) also differed widely.
Parenteral Nutrition (PN): Practices related to parenteral nutrition, a method of providing nutrients intravenously, showed substantial variation.
Supplemental Micronutrients: The use of supplemental micronutrients was inconsistent among RDs.

This practice variability likely reflects the gaps in both evidence and guidelines for managing severe sepsis. Specifically, further research is needed to address several critical areas:

Bridging the Gap: The Path Forward for Sepsis Nutrition

The Canadian RD survey underscores the urgent need for further research to personalize nutritional requirements for patients with evolving sepsis. This includes optimizing enteral nutrition for those at high risk of gastrointestinal dysfunction, refining parenteral nutrition strategies, and clarifying the role of micronutrients.

Ultimately, the goal is to translate research findings into standardized, evidence-based guidelines that empower RDs to deliver consistent, high-quality nutrition care for all severe sepsis patients. Coordinated, multi-center efforts guided by protocolized sepsis care plans will be essential to achieve this objective.

Given the high incidence and mortality associated with severe sepsis, the benefits of optimal nutrition, supported by robust evidence, cannot be overstated. By addressing the identified gaps in knowledge and practice, we can strive to improve patient outcomes and save lives.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3148/cjdpr-2018-029, Alternate LINK

Title: Survey Of Nutrition Practice In Patients With Severe Sepsis Among Canadian Registered Dietitians

Subject: Nutrition and Dietetics

Journal: Canadian Journal of Dietetic Practice and Research

Publisher: Dietitians of Canada

Authors: Trisha Baydock, Savita Bector, Lorian M. Taylor, Gregory Hansen

Published: 2019-03-01

Everything You Need To Know

What exactly is severe sepsis, and why is nutrition so important in its management?

Severe sepsis is a life-threatening condition where the body has an overwhelming response to an infection. This can lead to multiple organ failure and death, especially in intensive care unit (ICU) patients. Registered Dietitians (RDs) focus on optimizing nutrition as a strategy to improve outcomes for those affected.

What were the main findings of the Canadian survey regarding nutrition practices for severe sepsis?

The 2017 Canadian survey of Registered Dietitians (RDs) revealed significant variations in how RDs approach nutrition for patients with severe sepsis. These discrepancies were noted in determining energy requirements, enteral nutrition (EN) practices, EN use with vasoactive agents, parenteral nutrition (PN) practices, and the use of supplemental micronutrients.

What is the difference between enteral nutrition and parenteral nutrition, and how do they relate to the management of severe sepsis?

Enteral nutrition (EN) involves delivering nutrients directly into the gastrointestinal tract, usually through a feeding tube. Parenteral nutrition (PN), on the other hand, delivers nutrients intravenously, bypassing the digestive system. The survey indicated variations among Registered Dietitians (RDs) in when and how they use both EN and PN for severe sepsis patients, reflecting the lack of standardized guidelines.

What are vasoactive agents, and why is it important to understand how they interact with nutrition in severe sepsis patients?

Vasoactive agents are medications that affect blood vessel tone, often used to maintain blood pressure in critically ill patients. The survey revealed that Registered Dietitians (RDs) varied in their approaches to using enteral nutrition (EN) in conjunction with vasoactive agents. This is a crucial area, as the interaction between nutrition and these medications can significantly impact patient outcomes.

What are the key areas that require further research to improve nutritional support for patients with severe sepsis, according to the Canadian survey?

The Canadian RD survey highlights the necessity for additional research to personalize nutritional requirements for patients with severe sepsis. Optimizing enteral nutrition (EN) for those at high risk of gastrointestinal dysfunction, refining parenteral nutrition (PN) strategies, and clarifying the role of micronutrients are essential to improve care. Standardized guidelines are required to address the gaps in current practices and ensure consistency in nutrition management.