Outcomes Six Months after Delivering 100% or 70% of Enteral Calorie Requirements during Critical Illness (TARGET). A Randomized Controlled Trial

Deane, Adam M.; Little, Lorraine; Bellomo, Rinaldo; Chapman, Marianne J.; Davies, Andrew R.; Ferrie, Suzie; Horowitz, Michael; Hurford, Sally; Lange, Kylie; Litton, Edward; Mackle, Diane; O’Connor, Stephanie; Parker, Jane; Peake, Sandra; Presneill, Jeffrey; Ridley, Emma J.; Singh, Vanessa; Haren, Frank Van; Williams, Patricia J.; Young, Paul; Iwashyna, Theodore J.

doi:10.1164/rccm.201909-1810oc

Cited by 60 publications

(63 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, a recent RCT demonstrated that full feeding (103% adequacy) compared to lesser calorie delivery (69% adequacy) during the acute phase of critical illness resulted in similar quality of life, functional outcomes, disability and mortality 6 months after randomisation. 33 These studies suggest that a one-size-fits-all approach to setting the optimal energy dose may lead to oversimplification and individualised nutrition therapy may be preferable.…”

Section: Optimal Energy Dose In Critically Illmentioning

confidence: 99%

How to Feed the Critically Ill—A Review

Lew

Ong

Mukhopadhyay

et al. 2020

Ann Acad Med Singap

View full text Add to dashboard Cite

Introduction: Number of recently published studies on nutritional support in the intensive care unit (ICU) have resulted in a paradigm shift of clinical practices. This review summarises the latest evidence in four main topics in the ICU, namely: (1) function of validated nutrition screening/assessment tools, (2) types and validity of body composition measurements, (3) optimal energy and protein goals, and (4) delivery methods. Methods: Recent studies that investigated the above aims were outlined and discussed. In addition, recent guidelines were also compared to highlight the similarities and differences in their approach to the nutrition support of critically ill patients. Results: Regardless of nutritional status and body composition, all patients with >48 hours of ICU stay are at nutrition risk and should receive individualised nutrition support. Although a recent trial did not demonstrate an advantage of indirect calorimetry over predictive equations, it was recommended that indirect calorimetry be used to set energy targets with better accuracy. Initiation of enteral nutrition (EN) within 24–48 hours was shown to be associated with improved clinical outcomes. The energy and protein goals should be achieved gradually over the first week of ICU stay. This practice should be protocolised and regularly audited as critically ill patients receive only part of their energy and protein goals. Conclusions: Metabolic demands of critically ill patients can be variable and nutrition support should be tailored to each patient. Given that many nutrition studies are on-going, we anticipate improvements in the individualisation of nutrition support in the near future. Key words: Critical care, Critical illness, Intensive care, Nutrition, Nutritional intake, Nutrition support

show abstract

Section: Optimal Energy Dose In Critically Illmentioning

confidence: 99%

How to Feed the Critically Ill—A Review

Lew

Ong

Mukhopadhyay

et al. 2020

Ann Acad Med Singap

View full text Add to dashboard Cite

show abstract

“…An energy target of at least 70% of the estimated requirements still confers a survival advantage ( 5 ), and overfeeding is notably detrimental in critically ill individuals with obesity ( 2 ). So, we disagree that control individuals in the aforementioned trial ( 1 ) had been truly underfed. Moreover, a smaller but well-powered study ( 6 ) has already addressed physical quality of life at 6 months after ICU admission by comparing two different strategies of energy provision, in which the control group received 64% of the calories administered to the intervention group, and found no superiority for the latter.…”

mentioning

confidence: 92%

“…In a recent paper published in the Journal , Deane and colleagues ( 1 ) explored the effects of two different strategies of caloric intake (70% vs. 100%) in critically ill patients undergoing invasive mechanical ventilation. The main hypothesis was that optimal energy delivery, or approximately 100% of recommended caloric intake, impacted long-term mortality, quality of life, returning to work, and disability.…”

mentioning

confidence: 99%

Too Many Calories for All?

Antônio

Loss

Viana

2020

Am J Respir Crit Care Med

View full text Add to dashboard Cite

“…The letter also raises concerns that our study compared “overfeeding” with usual feeding practice, particularly given the proportion of patients with obesity in our cohort. The body mass index of our study participants (29.2 kg/m 2 ) reflects the adult body mass index in our region ( 5 ). Those assigned the energy-dense formula received a mean (SD) of 29.1 (6.2) kcal/kg of ideal body weight/d and 23.2 (7.1) kcal/kg of actual body weight/d from the enteral route ( see Table E4 in the online supplement of Ref.…”

mentioning

confidence: 93%

“…Those assigned the energy-dense formula received a mean (SD) of 29.1 (6.2) kcal/kg of ideal body weight/d and 23.2 (7.1) kcal/kg of actual body weight/d from the enteral route ( see Table E4 in the online supplement of Ref. 5 ). We are not aware of any published data establishing that this dose of energy delivered via the enteral route represents overfeeding and/or is a risk factor for increased death.…”

mentioning

confidence: 99%