The right antibiotic for the right bug. Vasopressors adjusted to keep blood pressure where it needs to be. Ventilator settings dialed in for each patient. Nothing is left to a general guess because in critical illness, the margin for error is small.

That makes sense. That's how it should be.

But here's something I keep thinking about: when it comes to nutrition, do we still rely too much on general targets rather than what the individual patient actually needs?

Critical illness changes the body's metabolism significantly. How much energy a patient needs, how much protein, how fast or slow to feed — these can vary quite a bit depending on the phase of illness, the level of inflammation, and how the body is responding.

There are ways to measure this more precisely. Yet in many clinical settings, nutrition plans are still based on broad population averages rather than the patient in front of you.

Maybe it comes down to priorities. Stabilize first, optimize later. That's understandable.

But if we already invest so much effort in getting everything else right for each individual patient — shouldn't nutrition eventually be held to the same standard?

No firm answer here. Just a question worth asking out loud.

Because progress often starts with questioning what we've simply accepted as normal.