When should early enteral feeding be initiated in critically ill patients?

• A. Immediately upon admission
• B. After fluid resuscitation is complete
• C. After vasopressor support is discontinued
• D. After 72 hours

Answer: (B)

Early enteral feeding is beneficial because it supports gut mucosal integrity and immune function in critically ill patients, but it must be started only after the patient is stabilized and has adequate perfusion. Starting feeding once fluid resuscitation is complete ensures the gut receives blood flow rather than risking ischemia or intolerance from ongoing shock or hypoperfusion. This timing captures the balance between harnessing the advantages of early nutrition and maintaining safety in a fragile circulation. Delaying until vasopressors are stopped or waiting as long as 72 hours would miss the benefits, while starting immediately in an unstable patient can worsen outcomes.