ASPEN guidelines recommend feeding start at approximately 25% of the estimated goal, with advancement to goal over 3-5 days. ASPEN recommend fluid and electrolyte status be monitored as needed. The NICE guidelines recommend starting nutrition support at maximum of 10kcal/kg/d with slow increase to meet or exceed full needs by 4-7 days. (eg,15 days), they recommend starting at 5 kcal/kg/d. For patients at high risk of developing refeeding syndrome, The NICE guidelines recommend vitamin repletion immediately before and during the first 10 days of feeding (thiamine, vitamin B, and a balanced multivitamin/trace element supplement).