Nutrition in critical illness—research is worth the EFFORT

Abstract

Multiple high-quality randomised controlled trials conducted over the past decade in critical care nutrition have shown no difference between interventions and routine care. 1 Chapman M Peake SL Bellomo R et al. Energy-dense versus routine enteral nutrition in the critically ill. N Engl J Med. 2018; 379: 1823-1834 Crossref PubMed Scopus (161) Google Scholar , 2 Harvey SE Parrott F Harrison DA et al. Trial of the route of early nutritional support in critically ill adults. N Engl J Med. 2014; 371: 1673-1684 Crossref PubMed Scopus (361) Google Scholar , 3 Arabi YM Aldawood AS Haddad SH et al. Permissive underfeeding or standard enteral feeding in critically ill adults. N Engl J Med. 2015; 372: 2398-2408 Crossref PubMed Scopus (372) Google Scholar , 4 Reignier J Boisramé-Helms J Brisard L et al. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet. 2018; 391: 133-143 Summary Full Text Full Text PDF PubMed Scopus (261) Google Scholar These findings have led to the assumption that nutrition in critical illness is an innocuous, supportive therapy only. The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trialDelivery of higher doses of protein to mechanically ventilated critically ill patients did not improve the time-to-discharge-alive from hospital and might have worsened outcomes for patients with acute kidney injury and high organ failure scores. Full-Text PDF