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- Title
Outcomes Six Months after Delivering 100% or 70% of Enteral Calorie Requirements during Critical Illness (TARGET). A Randomized Controlled Trial.
- Authors
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 L.; Presneill, Jeffrey J.; Ridley, Emma J.; Singh, Vanessa; Haren, Frank van; Williams, Patricia; Young, Paul
- Abstract
Rationale: The long-term effects of delivering approximately 100% of recommended calorie intake via the enteral route during critical illness compared with a lesser amount of calories are unknown.Objectives: Our hypotheses were that achieving approximately 100% of recommended calorie intake during critical illness would increase quality-of-life scores, return to work, and key life activities and reduce death and disability 6 months later.Methods: We conducted a multicenter, blinded, parallel group, randomized clinical trial, with 3,957 mechanically ventilated critically ill adults allocated to energy-dense (1.5 kcal/ml) or routine (1.0 kcal/ml) enteral nutrition.Measurements and Main Results: Participants assigned energy-dense nutrition received more calories (percent recommended energy intake, mean [SD]; energy-dense: 103% [28] vs. usual: 69% [18]). Mortality at Day 180 was similar (560/1,895 [29.6%] vs. 539/1,920 [28.1%]; relative risk 1.05 [95% confidence interval, 0.95-1.16]). At a median (interquartile range) of 185 (182-193) days after randomization, 2,492 survivors were surveyed and reported similar quality of life (EuroQol five dimensions five-level quality-of-life questionnaire visual analog scale, median [interquartile range]: 75 [60-85]; group difference: 0 [95% confidence interval, 0-0]). Similar numbers of participants returned to work with no difference in hours worked or effectiveness at work (n = 818). There was no observed difference in disability (n = 1,208) or participation in key life activities (n = 705).Conclusions: The delivery of approximately 100% compared with 70% of recommended calorie intake during critical illness does not improve quality of life or functional outcomes or increase the number of survivors 6 months later.
- Subjects
CALORIE; CRITICALLY ill; QUALITY of life; NUTRITION; CONFIDENCE intervals; RESEARCH; TIME; RESEARCH methodology; INGESTION; NUTRITIONAL requirements; EVALUATION research; MEDICAL cooperation; CATASTROPHIC illness; TREATMENT effectiveness; COMPARATIVE studies; BLIND experiment; ENTERAL feeding
- Publication
American Journal of Respiratory & Critical Care Medicine, 2020, Vol 201, Issue 7, p814
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.201909-1810OC