Hi I am Annika Reintam Blaser from Estonia and when we talk about enteral nutrition, it's important to clarify that it can be administered via gastric, jejunal, or even transgastric routes—and each of these approaches matters. They are not interchangeable, and the route of administration can have a significant impact on tolerance and outcomes. In my lecture, I presented the European guidelines on early enteral nutrition in critically ill patients. These guidelines represent a substantial collaborative effort, and we developed them with a clear goal: to make them practical and applicable at the bedside, supporting clinicians in their daily decision-making. However, it is equally important to recognize the limitations of our current knowledge. The evidence base is weak, and as a result, all of our recommendations are conditional. That transparency is essential. We don't want to oversell certainty where it doesn't exist. Another critical point I want the audience to remember is this: Even when early enteral nutrition is indicated, it should always be initiated slowly and carefully. Critically ill patients are vulnerable, and nutrition must be introduced in a way that supports recovery without causing harm. In summary: There are meaningful differences in route of delivery. The current guidelines are practical, but the evidence is limited. And regardless of indication, early enteral nutrition must be started with caution.

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