TNF and Hyperglycemia: In addition, ICU patients are often on parenteral nutrition with increased fat content, hyperglycaemia and inflammatory cytokines, such as interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), NAPDH oxidase-2 (NOX2) and NAPDH oxidase-1 (NOX1), which disrupts the body’s metabolic pathways and leads to worsening clinical outcomes (17–19).