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01-11-2017 | Seven-Day Profile Publication

Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial

Authors: Matilde Jo Allingstrup, Jens Kondrup, Jørgen Wiis, Casper Claudius, Ulf Gøttrup Pedersen, Rikke Hein-Rasmussen, Mads Rye Bjerregaard, Morten Steensen, Tom Hartvig Jensen, Theis Lange, Martin Bruun Madsen, Morten Hylander Møller, Anders Perner

Published in: Intensive Care Medicine | Issue 11/2017

Abstract

Purpose

We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients.

Methods

We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition. In the standard of care group we aimed at providing 25 kcal/kg/day by enteral nutrition. If this was not met by day 7, patients were supplemented with parenteral nutrition. The primary outcome was physical component summary (PCS) score of SF-36 at 6 months. We performed multiple imputation for data of the non-responders.

Results

We randomised 203 patients and included 199 in the intention-to-treat analyses; baseline variables were reasonably balanced between the two groups. The EGDN group had less negative energy (p < 0.001) and protein (p < 0.001) balances in the ICU as compared to the standard of care group. The PCS score at 6 months did not differ between the two groups (mean difference 0.0, 95% CI −5.9 to 5.8, p = 0.99); neither did mortality, rates of organ failures, serious adverse reactions or infections in the ICU, length of ICU or hospital stay, or days alive without life support at 90 days.

Conclusions

EGDN did not appear to affect physical quality of life at 6 months or other important outcomes as compared to standard nutrition care in acutely admitted, mechanically ventilated, adult ICU patients.

Clinicaltrials.gov identifier no. NCT01372176.

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Title: Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial
Authors: Matilde Jo Allingstrup
Jens Kondrup
Jørgen Wiis
Casper Claudius
Ulf Gøttrup Pedersen
Rikke Hein-Rasmussen
Mads Rye Bjerregaard
Morten Steensen
Tom Hartvig Jensen
Theis Lange
Martin Bruun Madsen
Morten Hylander Møller
Anders Perner
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 11/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4880-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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