Feeding patients enterally (nasogastric or nasojejunal tube feedings) has been the standard of care for critically ill patients, based on weak evidence that it reduces infection rates; hence the adage "feed the gut, if you can." That last caveat is included because so many critically ill patients have gastric motility impairment (with inability to achieve necessary throughput of feedings) or are in vasopressor-dependent shock (making their doctors fearful of prescribing full feeding rates). In these patients, some believe that early total parenteral nutrition could be beneficial because it