Influence of Early vs Late SPN on Long-term Quality of Life in ICU Patients After Gastrointestinal Oncological Surgery

Inclusion Criteria: 1. ICU patients in the acute phase of critical illness after gastrointestinal oncological surgery. 2. Admitted to the ICU during the previous 24 hours with a minimum expected ICU stay of ≥5 days 3. Central venous access available for continuous infusion of the study drugs 4. Sequential Organ Failure Assessment (SOFA) score ≥2 5. Written informed consent from the patient or the patient's legal representative Exclusion Criteria: Contraindication against SPN or inability to receive SPN via central venous access 1. Received PN within 7 days before randomisation 2. Expected to receive ≥20% of energy via supplemental enteral nutrition (EN) and/or non-nutritional sources (e.g. glucose solution for drug dilution or lipids from propofol) during the first 3 nutritional treatment days 3. Inability to initiate EN prior to randomization 4. Body mass index (BMI) \<17 kg/m2 or \>35 kg/m2 5. Any severe, persistent blood coagulation disorder with uncontrolled bleeding 6. Any congenital errors of amino acid metabolism 7. Known hypersensitivity to fish, egg, soybean proteins, peanut proteins, or to any of the active substances or excipients contained in SPN. 8. Known hypersensitivity to milk protein or to any other substance contained in SPN 9. Acute liver failure with encephalopathy, including intoxication (e.g. paracetamol, death cap, golden chain) and/or liver enzymes (aspartate aminotransferase \[AST\], alanine aminotransferase \[ALT\], gamma glutamyl transferase \[GGT\]) or bilirubin exceeding 10 x ULN 10. Hemophagocytic syndrome 11. Known history of human immunodeficiency virus (HIV), hepatitis B and/or C 12. Pregnancy or lactation 13. Patient unlikely to survive to 6 months due to underlying illness 14. Receiving end-of-life-care Laboratory Exclusions: 15. Hypertriglyceridemia characterised by serum triglyceride levels \>4 mmol/L \[\>350 mg/dL\]) 16. Treatment-refractory, clinically significant major abnormality in the serum concentration of any electrolyte (sodium, potassium, magnesium, total calcium, chloride, inorganic phosphate) Concomitant Therapy Exclusions: 17. Chronic maintenance therapy with systemic glucocorticoid steroids (Hydrocortisone \>0.3 mg/kg/d) 18. Concomitant administration of chemotherapy 19. Administration of growth hormone and teduglutide within the previous 4 weeks Other Exclusions: 20. Chronic liver failure ( Child -Pugh scale B or C) e.g. secondary to drug or alcohol abuse 21. Participation in another interventional clinical trial within the previous 4 weeks 22. Previous inclusion in the present study