Q: 32 year old male with history of ETOH abuse is admitted to ICU with acute upper GI bleed secondary to varices. How long patient can be left NPO or parenteral nutrition?

Answer: About 4 days.

Primary goal in Upper GI bleed secondary to varices it to stabilize the hemodynamics, avoiding extra resuscitation and minimize the risk of re-bleeding. Early parenteral nutrition (TPN) may lead to hypervolumeia and increase portal pressure. Patient may go up to 4 days without any nutrition.

Reference:

de Lédinghen V, Beau P, Mannant PR, et al. (1997). "Early feeding or enteral nutrition in patients with cirrhosis after bleeding from esophageal varices? A randomized controlled study". Dig. Dis. Sci. 42 (3): 536–41.