Table 2 Comparison of Outcomes and Differences of Recent Nutrition Delivery Trials in ICU2.
From: Winning the war against ICU-acquired weakness: new innovations in nutrition and exercise physiology
| Â | Trials not supporting goal (>80% kcal/day) nutritional delivery in the ICU | Trials supporting goal (> 80% kcal/day) nutritional delivery in the ICU | ||||||
|---|---|---|---|---|---|---|---|---|
| Â | EPaNIC (NEJM, 2011) (BB) | EDEN Trial (Pilot) (CCM, 2011) (29) | Eden Trial (Full RCT) (JAMA, 2012) (28) | Arabi Trial (AJCN, 2011) (27) | Early PN (JAMA, 2013) (19) | TICACOS (ICM, 2011) (AA) | SPN (Lancet, 2013) (20) | Wei et al. (CCM, 2015) (30) |
Age (mean) | 64 | 53 | 52 | 51 | 69 | 61 | 61 | 62 |
ICU LOS | 3.5 | Â | Â | 13.1 | 9 | 12 | 13 | 18 |
Hospital LOS | 15 | Â | Â | Â | 25 | 25 | 31.5 | Â |
MV days | 2 | 5.6 | 5 | 11.9 | 6.9 | 10.75 | 6.64 | 15 |
Mortality (%) | Â | Â | Â | Â | Â | Â | Â | Â |
ICU | 6.2 | Â | Â | 19.6 | Â | 25.4 | 10 | 26 |
Hospital | 10.65 | 21 | Â | 36 | 21% | 38.3 | 24 | 32 |
Post discharge | 11.2 | Â | 22.7 | 38.6 | Â | 47 | 23 | Â |
Primary outcome | Sig. reduced LOS in ICU for late PN (median 3 days) vs. early PN (median 4 days) | No outcome changes in trophic versus full feeding groups for ventilation days, mortality, or infection | No outcome changes in trophic versus full feeding groups for ventilation days, mortality, or infection | Nonsig. trend to lower 28-day mortality for trophic (18.3%) compared with target feeding (23.3%) (p <0.07) | No sig. change in crude day-60 mortality (standard care (22.8%) vs. early PN (21.5%)) | Sig. lower hospital mortality for goal calorie group (28.5%) vs. underfed control group (48.2%) | Sig. reduced nosocomial infections for EN + SPN (27%) vs. EN (38%) after day 9 | Sig. improved survival and 3-month HRQoL with improved nutrition delivery |
Secondary outcome | Sig. higher infectious complications, duration of MV, and hospital LOS for early PN | Full feeding group more likely to be discharged home than rehabilitation unit (p <0.04) | No change in HRQoL at 12 months | No difference in LOS or duration of MV | Sig. shorter duration of MV | Longer duration of MV and ICU LOS, and higher infection rate for goal calorie study group | No sig. difference in the ICU LOS, hospital LOS, or mortality | Sig. improvement in HRQoL in MICU patients at 3 and 6 months with improved nutrition delivery |
| Â | Â | Â | Â | Â | Improved HRQoL for early PN group | Â | Â | Â |
| Â | Â | Â | Â | Â | No change in infection in PN vs. EN | Â | Â | Â |
Protein delivery | 0.8 g/kg/day in all patients | 0.8 g/kg/day in both groups (including full feed group) | 0.6-0.8 g/kg/day in both groups (including full feed group) | 0.6 g/kg/day in all patients | 1.1-1.2 g/kg/day in early PN group | >1.0 g/kg/day in supplemental PN group | 1.0-1.1 g/kg/day in supplemental PN group | Observational trial |
| Â | Â | Â | Â | Â | Â | Â | Â | Protein intake not able to be quantified |