Selected nutritional parameters were studied in critically ill surgical patients maintained by parenteral-enteral nutritional support to delineate the nutritional deficits and relate the course of these patients to the nutritional status. Of 34 patients, 21 had albumin levels of < 3.5 g% upon admission and the albumin levels decreased even further after admission. The patients with traumatic injuries had the greatest loss in body weight and urinary N excretion. Although such large numbers of these patients had depressed serum albumin levels, the survivors increased the serum albumin level to 3.5 g% with intense nutritional support, those not surviving such support were not able to increase the serum albumin level. the response of the serum albumin level to nutritional support is a good indicator as to the same factors preventing survival and effective use of the nutritional elements.