The DOI matches its Crossref record; 34 of the 35 references it cites were found in a registry or an index.
The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial
Abstract
Background On the basis of low-quality evidence, international critical care nutrition guidelines recommend a wide range of protein doses. The effect of delivering high-dose protein during critical illness is unknown. We aimed to test the hypothesis that a higher dose of protein provided to critically ill patients would improve their clinical outcomes. Methods This international, investigator-initiated, pragmatic, registry-based, single-blinded, randomised trial was undertaken in 85 intensive care units (ICUs) across 16 countries. We enrolled nutritionally high-risk adults (≥18 years) undergoing mechanical ventilation to compare prescribing high-dose protein (≥2·2 g/kg per day) with usual dose protein (≤1·2 g/kg per day) started within 96 h of ICU admission and continued for up to 28 days or death or transition to oral feeding. Participants were randomly allocated (1:1) to high-dose protein or usual dose protein, stratified by site. As site personnel were involved in both prescribing and delivering protein dose, it was not possible to blind clinicians, but patients were not made aware of the treatment assignment. The primary efficacy outcome was time-to-discharge-alive from hospital up to 60 days after ICU admission and the secondary outcome was 60-day morality. Patients were analysed in the group to which they were randomly assigned regardless of study compliance, although patients who dropped out of the study before receiving the study intervention were excluded. This study is registered with ClinicalTrials.gov, NCT03160547. Findings Between Jan 17, 2018, and Dec 3, 2021, 1329 patients were randomised and 1301 (97·9%) were included in the analysis (645 in the high-dose protein group and 656 in usual dose group). By 60 days after randomisation, the cumulative incidence of alive hospital discharge was 46·1% (95 CI 42·0%-50·1%) in the high-dose compared with 50·2% (46·0%-54·3%) in the usual dose protein group (hazard ratio 0·91, 95% CI 0·77-1·07; p=0·27). The 60-day mortality rate was 34·6% (222 of 642) in the high dose protein group compared with 32·1% (208 of 648) in the usual dose protein group (relative risk 1·08, 95% CI 0·92-1·26). There appeared to be a subgroup effect with higher protein provision being particularly harmful in patients with acute kidney injury and higher organ failure scores at baseline. Interpretation Delivery 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. Funding None.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“but demonstrated higher mortality in patients with renal failure.145”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [145]
In the citing paper
“The recruited patients' energy intake was very variable, although similar in the groups (around 14 kcal/kg/d) receiving high and low-dose proteins.”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [60]
In the citing paper
“Recently [60], a comparison between 1.6 ± 0.5 g/kg/d compared with 0.9 ± 0.3 g/kg/d administered protein did not find any significant difference in outcomes, but an increased mortality in patients with acute kidney injury randomized to high protein intakes.”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [60]
Citations
Cites
A Proportional Hazards Model for the Subdistribution of a Competing Risk
Fine, J. P., & Gray, R. J. (1999) · Journal of the American Statistical Association · doi:10.1080/01621459.1999.10474144 · Cited by 14,290
Vincent, J. L., Moreno, R., Takala, J., Willatts, S., De Mendonça, A., Bruining, H., Reinhart, C. K., Suter, P. M., & Thijs, L. G. (1996) · Intensive Care Medicine · doi:10.1007/bf01709751 · Cited by 11,674
A global clinical measure of fitness and frailty in elderly people
Rockwood, K. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.050051 · Cited by 8,968
Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury
Mehta, R. L., Kellum, J. A., Shah, S. V., Molitoris, B. A., Ronco, C., Warnock, D. G., Levin, A., & the Acute Kidney Injury Network (2007) · Critical Care · doi:10.1186/cc5713 · Cited by 7,046
A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing Risk
Gray, R. J. (1988) · The Annals of Statistics · doi:10.1214/aos/1176350951 · Cited by 4,957
McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., McCarthy, M. S., Davanos, E., Rice, T. W., Cresci, G. A., et al. (2016) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607115621863 · Cited by 3,982
Self-citationESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904
Quality of life and pharmacoeconomics in clinical trials
Pater, J. L. (1996) · Controlled Clinical Trials · doi:10.1016/s0197-2456(97)82191-5 · Cited by 2,410
Acute skeletal muscle wasting in critical illness
Puthucheary, Z. A., Rawal, J., McPhail, M., Connolly, B., Ratnayake, G., Chan, P., Hopkinson, N. S., Padhke, R., Dew, T., Sidhu, P. S., et al. (2013) · JAMA · doi:10.1001/jama.2013.278481 · Cited by 2,103
SARC-F: A simple questionnaire to rapidly diagnose sarcopenia
Malmstrom, T. K., & Morley, J. E. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.05.018 · Cited by 1,319
Cited by
Sorted by citations
Items 201–300 of 401
Does early enteral calories in ARDS improve outcome? A retrospective evaluation of the EDEN trial
Torres, J., Pak, Y., & Tayek, J. A. (2023) · Clinical Nutrition Open Science · doi:10.1016/j.nutos.2023.04.003 · Cited by 1
Highlights in the clinical nutrition literature: A critical appraisal of current research
Stoppe, C., Elke, G., Silvstre, S. C. D. M., & Kappus, M. (2024) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2599 · Cited by 1
Self-citationWittholz, K., Hinckfus, C., Karahalios, A., Panganiban, H. P., Phillips, N., Rotherham, H., Rechnitzer, T., Abdelhamid, Y. A., Deane, A. M., & Fetterplace, K. (2024) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2620 · Cited by 3
Die Rolle des muskuloadipösen Status bei der Beurteilung des Risikoprofils vor Lebertransplantation
Deeb, A. A., Rauchfuß, F., & Settmacher, U. (2024) · Die Chirurgie · doi:10.1007/s00104-024-02111-z · Cited by 1
Araújo, F., Posadas-Calleja, J. G., Raman, M., Tosh, M., Wischmeyer, P. E., Barreto, P. A., & Gillis, C. (2024) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2673 · Cited by 2
Efficacy and safety of high protein intake in critically ill patients
Wu, W., Leng, F., Dong, M., Song, J., Zhang, J., Han, F., Qian, Y., & Zhong, M. (2025) · Chinese Medical Journal · doi:10.1097/cm9.0000000000003528 · Cited by 1
“[1] However, the optimal daily protein intake for critically ill patients remains undetermined.”
Lee, I., Kim, J., Ku, M., Choi, Y., Park, S., Bang, J., & Kim, J. (2025) · Acute and Critical Care · doi:10.4266/acc.003312 · Cited by 1
“Numerous studies have been conducted to determine the appropriate amount and timing of protein delivery to reduce mortality in critically ill patients [17-19].”
Significant Published Articles in 2024 for Pharmacy Nutrition Support Practice
Dickerson, R. N., Afolabi, T. M., Bingham, A. L., Canada, T. W., Chan, L. N., Cogle, S. V., Tucker, A. M., & Kumpf, V. J. (2025) · Hospital Pharmacy · doi:10.1177/00185787251337596 · Cited by 1
“20 Given these findings, a systematic review and meta-analysis were conducted to integrate existing evidence with the latest research.”
InfluentialSummers, M. J., Bels, J. L. M., Karahalios, A., Presneill, J., Plummer, M. P., Lee, Z., Heyland, D. K., Mesotten, D., Stoppe, C., van de Poll, M. C. G., et al. (2025) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2025.05.034 · Cited by 1
Self-citationKanda, N., Yoshida, M., Kashiwagi, S., Takano, H., Ohbe, H., & Nakamura, K. (2025) · Clinical Nutrition · doi:10.1016/j.clnu.2025.05.025 · Cited by 1
Impaired muscle metabolism in the ICU: interrogating the underlying pathophysiology
Chapple, L. S., Lynch, G. S., & Rooyackers, O. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001285 · Cited by 1
Enriching patient populations in ICU trials: reducing heterogeneity through machine learning
Oh, W., Veshtaj, M., & Sakhuja, A. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001280 · Cited by 1
Chen, Z., Deng, J., Zhao, X., Lin, Z., Wang, D., Wu, Y., Huang, K., & Pan, S. (2025) · Nutrition Research · doi:10.1016/j.nutres.2025.07.008 · Cited by 1
Deutz, N. E. P., Have, G. A. M. T., Nghiem, P. P., Mackey, M. L., Rice, S. A., Thaden, J. J., Horner, M. B. W., & ENGELEN, M. P. K. J. (2025) · Clinical Nutrition · doi:10.1016/j.clnu.2025.07.026 · Cited by 2
“Recently, several publications observed that high amino acid or protein intake in ICU patients could have adverse outcomes including increasing mortality [40–42].”
Optimizing Nutrition to Reduce the Duration of Ventilation
Preiser, J., Ridley, E. J., & van Zanten, A. R. H. (2025) · Anesthesiology · doi:10.1097/aln.0000000000005612 · Cited by 1
Abdelhamid, Y. A., Bongetti, A. J., Caldow, M. K., Karahalios, A., Wittholz, K., Fetterplace, K., Beach, L. J., Haines, K. J., Tascone, B., Souza, D. P. D., et al. (2025) · Clinical Nutrition · doi:10.1016/j.clnu.2025.10.001 · Cited by 2
Nagai, T., Komeda, Y., Yoshida, S., Handa, K., Masaki, S., Kono, M., Honjo, H., Matsui, S., Tsuji, N., Kashida, H., et al. (2025) · Gastro Hep Advances · doi:10.1016/j.gastha.2025.100842 · Cited by 1
“The PRotEin provision in Critical IllneSs (PRECISe study) suggested that excessive protein intake through enteral nutrition (EN) might exacerbate intestinal inflammation, 9 highlighting the need to reconsider current nutritional strategies.”
Importance of older age for nutrition management
Loss, S. H., Viana, L. V., & Viana, M. V. (2025) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001183 · Cited by 1
Nutrition recovery after critical illness: toward a personalized, multimodal approach
Dupuis, C., & Preiser, J. C. (2025) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001197 · Cited by 1
Nguyen, T. L., Le, Q. D., Dinh, T. N. H., Ho, V. H., Tran, C. D., Duong, V. P., Duong, H. T., Pham, P. T., Le, T. P. T., & Bui, T. P. (2026) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-025-02240-4 · Cited by 2
Rehani, C., Pelekhaty, S. L., & Kozar, R. A. (2026) · Surgical Clinics of North America · doi:10.1016/j.suc.2025.12.003 · Cited by 1
Nutritional rehabilitation strategies in abdominal surgery
Abdul-Hamid, S., Fradley, W., & Phillips, B. (2026) · Current opinion in clinical nutrition and metabolic care · doi:10.1097/mco.0000000000001216
Kawaguchi, Y., Murotani, K., Hayashi, N., & Kamoshita, S. (2026) · Gastroenterology report · doi:10.1093/gastro/goag014 · Cited by 1
“A multicenter randomized study involving the same patient population (i.e. EFFORT Protein) in 2023 studied patients with acute kidney injury or a high Sequential Organ Failure Assessment score [25].”
InfluentialPreexisting malnutrition in the ICU
Fukushima, R., & Nakamura, K. (2026) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001371 · Cited by 1
Is there really no harm in trying? The Cahill cycle and high-dose protein in critical illness
Puthucheary, Z., & van de Poll, M. C. G. (2026) · American Journal of Respiratory and Critical Care Medicine · doi:10.1093/ajrccm/aamag108 · Cited by 1
Optimal nutritional support is key to liberation from mechanical ventilation
Rosa, S. D., & Lassola, S. (2026) · Critical Care Science · doi:10.62675/2965-2774.20260049 · Cited by 1
What does “PICS” mean in major burns? Persistent critical illness or post-intensive care syndrome
Berger, M. M., Koekkoek, K. W. A. C., Montoro, L., & Pantet, O. (2026) · Burns · doi:10.1016/j.burns.2026.107991 · Cited by 1
Postoperative metabolic support in the ICU
Vanderwegen, E., Vanhorebeek, I., & Gunst, J. (2026) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2026.04.003 · Cited by 1
Ralfe, M. A., Schneider, A., Raff, L., & Sousse, L. E. (2026) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.70108 · Cited by 1
You, Z., Li, Q., Pu, Y., Hou, H., He, S., Yu, Z., Xue, C., Li, Y., & Wen, C. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1788894 · Cited by 2
Paulus, M. C., Hajeer, F., & van Zanten, A. R. H. (2026) · Critical Care · doi:10.1186/s13054-026-06107-5 · Cited by 1
“Mortality in critical illness is multifactorial and may not be substantially altered by differences in protein dosing within currently accepted ranges [5, 6, 16–18].”
InfluentialInterpreting protein dose trials in critical illness: a guide for the bedside clinician
Chapple, L. S., Bels, J. L. M., Lee, Z., Summers, M. J., Ferrie, S., Stoppe, C., Mesotten, D., Deane, A. M., van de Poll, M. C. G., & Ridley, E. J. (2026) · Critical Care · doi:10.1186/s13054-026-06116-4 · Cited by 1
“…an acute kidney injury (AKI) as defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria receiving 1.7 versus 1.0 g protein/kg/day [25] Meta-analysis :- High certainty of increased mortality with higher protein in patients with an AKI [31] Evidence is inconclusive, but in patients…”
InfluentialSelf-citationHigh-Protein Diets: What to Tell Our Patients
Garibotto, G., Verzola, D., Picciotto, D., & Russo, E. (2026) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2026.01.023 · Cited by 1
Tian, P., Fan, M., & Huang, C. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1859625 · Cited by 1
“The EFFORT Protein trial by Heyland et al. (27) tested higher protein dosing in nutritionally high-risk patients but did not show a consistent overall benefit, raising the possibility that patient selection, timing, and actual exposure may be more important than the nominal target alone.”
InfluentialStoian, M., Stoian, A., Bănescu, C. V., Bândilă, S. R., Danilesco, A., Finta, H., & Azamfirei, L. (2026) · Nutrients · doi:10.3390/nu18172840 · Cited by 1
“High-dose protein did not improve time-to-discharge alive or mortality and was associated with an unfavorable signal in patients with acute kidney injury, although these subgroup findings require prospective confirmation [11,31].”
InfluentialNutritional management during critical illness in those with previous obesity surgery
Correia, M. I. T. D., & Rosenfeld, R. S. (2024) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001014 · Cited by 1
Impact of an enteral nutrition protocol in critically ill patients with burn injuries
Jutba, A. S. (2024) · International Journal of Burns and Trauma · doi:10.62347/ygqw7641 · Cited by 1
Chapple, L. S., Neuts, A., O’Connor, S. N., Williams, P. J., Hurford, S., Young, P. J., Hammond, N. E., Knowles, S., Chapman, M. J., & Peake, S. (2024) · Australian Critical Care · doi:10.1016/j.aucc.2024.07.079 · Cited by 1
Advancements in nutritional support for critically ill patients
Huynen, P., Casaer, M. P., & Gunst, J. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001254 · Cited by 3
“This hypothesis was not confirmed by recent RCTs, however kg per day) protein doses for up to 28 days after randomization, did not show any benefit from high protein doses, with both groups receiving equal nonprotein energy intake [10 && ].”
Loh, C. T. I., Hasan, M. S., Swaminathan, P., Ng, C. C., Chan, W. Y., Tengku, A., Yap, S. T., Yunos, N. M., Stoppe, C., Lew, C. C. H., et al. (2025) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2025.07.020 · Cited by 2
Self-citationInitiation of enteral nutrition in critically ill patients
Ma, W. C., Lau, Y. H., See, K. C., & Lew, C. C. H. (2025) · Singapore Medical Journal · doi:10.4103/singaporemedj.smj-2024-151 · Cited by 1
“[11] Furthermore, its secondary analyses revealed no benefits of higher protein delivery in specific subgroups, such as obese [14] and malnourished patients.”
Lee, Z., Stoppe, C., Hartl, W. H., Elke, G., Heyland, D. K., & Lew, C. C. H. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.11.019 · Cited by 1
Self-citationSchuetz, P. (2024) · Chest · doi:10.1016/j.chest.2024.02.021 · Cited by 1
Nutritional Support for Necrotizing Soft Tissue Infection Patients: From ICU to Outpatient Care
Akam, E., Pelekhaty, S. L., Knisley, C. P., Ley, M. G., Loran, N. V., & Ley, E. J. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14093167 · Cited by 1
Timing matters: the delicate balance in amino acids infusion duration in cardiac surgery
Stoppe, C. (2026) · British Journal of Anaesthesia · doi:10.1016/j.bja.2026.03.031 · Cited by 1
Self-citationImmunonutrition – auf der Suche nach dem Optimum
Hill, A. (2023) · Die Anaesthesiologie · doi:10.1007/s00101-023-01276-2
Ridley, E. J., & Rice, T. W. (2023) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(23)00128-5 · Cited by 1
Self-citationProfitieren kritisch Kranke von einer hohen Proteinzufuhr?
Lorenz, J. (2023) · Allgemeinmedizin up2date · doi:10.1055/a-2015-5285
Nutritional Management of the Surgical Patient in Critical Care
Donnelly, N., & Langan, A. (2023) · Wiley eBooks · doi:10.1002/9781119809128.ch8
Fokus Sepsis und allgemeine Intensivmedizin 2022/2023
Dietrich, M., Bernhard, M., Beynon, C., Fiedler, M. O., Hecker, A., Jungk, C., Nußhag, C., Michalski, D., Schmitt, F. C. F., Brenner, T., et al. (2023) · Die Anaesthesiologie · doi:10.1007/s00101-023-01334-9
EFFORT Protein trial: questions remain
Zijlstra, G. J. (2023) · The Lancet · doi:10.1016/s0140-6736(23)01254-0
EFFORT Protein trial: questions remain - Authors' reply.
Patel, J. J., Lee, Z., Stoppe, C., & Heyland, D. (2023) · The Lancet · doi:10.1016/s0140-6736(23)01253-9
Self-citationManaging the Chronically Ventilated Critically Ill Population
Chichra, A., Tickoo, M., & Honiden, S. (2023) · Journal of Intensive Care Medicine · doi:10.1177/08850666231203601
“55 What then should we target beyond the acute-subacute phase of critical illness as we support patients through the recovery phase?”
Editorial: Intermittent feeding in critically ill patients
Deana, C., Vecchiarelli, P., Picetti, E., & Molfino, A. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1295405
Zhang, Y., Yang, P., Yu, L., Yuan, J., Gu, X., Yuan, Z., Chen, L., Zhang, X., & Chen, Q. (2023) · Research Square · doi:10.21203/rs.3.rs-3419331/v1
Gusdon, A., Savarraj, J. P. J., Feng, D., Starkman, A., Li, G., Bodanapally, U. K., Zimmerman, W., Ryan, A. S., Choi, H., & Badjatia, N. (2023) · Research Square · doi:10.21203/rs.3.rs-3600439/v1
Potapov, A. L., Агабабян, Т. А., Дмитриевич, Д. А., Сергеевна, П. И., Nevolskikh, A. A., Иванов, С. А., & Каприн, А. Д. (2023) · Journal of Modern Oncology · doi:10.26442/18151434.2023.3.202258
Significant Published Articles in 2023 for Pharmacy Nutrition Support Practice
Dickerson, R. N., Bingham, A. L., Canada, T. W., Chan, L. N., Cober, M. P., Cogle, S. V., Tucker, A. M., & Kumpf, V. J. (2024) · Hospital Pharmacy · doi:10.1177/00185787241237131
“16 This multicenter randomized trial evaluated a low-calorie, low-protein nutrition regimen (6 kcal/kg/day, protein 0.2-0.4 g/kg/day) versus a standard regimen (25 kcal/kg/day, protein 1-1.3 g/ kg/day) for 7 days in mechanically ventilated patients receiving vasopressors.”
InfluentialIn the Critically Ill Obese Should We Tip the Scale With More Protein?*
Taylor, B. E., & McClave, S. A. (2024) · Critical Care Medicine · doi:10.1097/ccm.0000000000006159
A Year of Changes: The End of the Pandemic Marks the Beginning of New Priorities
Krause, M., Tzeng, E., Kertai, M. D., & Abrams, B. A. (2024) · Seminars in Cardiothoracic and Vascular Anesthesia · doi:10.1177/10892532241255427
Yang, J., Tang, Y., Chen, L., Zhang, Y., Jin, J., & Wei, Y. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4818814
Nutritional Prescription in ICU Patients: Does it Matter?
Havaldar, A. A., & Selvam, S. (2024) · Indian Journal of Critical Care Medicine · doi:10.5005/jp-journals-10071-24755
Les 10 questions clés de la réussite d’un support nutritionnel adéquat en réanimation
Pardo, E., Occhiali, É., Guichon, C., Dupuis, C., Cabasson, S., Mourissoux, G., Galerneau, L.-M., Vinay, A., Susset, V., Dhif, N., et al. (2024) · Anesthésie & Réanimation · doi:10.1016/j.anrea.2024.03.022
Zheng, L., Yuan, X., Wang, P., Zheng, H., Lin, J., Li, C., Chen, T., Tong, Z., Liu, Y., Ke, L., et al. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.09.001
Nutrition: One Size Does Not Fit All
Merriweather, J. L. (2024) · Springer eBooks · doi:10.1007/978-3-031-53019-7_4
Nutrition in critically ill adult patients
Palibrk, I., Đukanović, M., & Stefanovic, D. (2024) · Medicinska istrazivanja · doi:10.5937/medi57-50990
ICU nutrition research: did the evidence get better? Remaining sources of bias
Koretz, R. L. (2024) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001080
“…Ilgin 2023 [ Only abstract available (cid:1) (cid:1) Lira-Marcial Only abstract (paper Queiroz 2023 Only study protocol Stoppe 2023 [24 Part of Heyland 2023 trial Looking for associations in previously published RCT Xu 2022 [ Patients not necessarily in ICU Heffernan 2022 Used nonrandomized…”
Dotare, T., Maeda, D., Matsue, Y., Fujimoto, Y., Sunayama, T., Iso, T., Nakade, T., Yatsu, S., Ishiwata, S., Nakamura, Y., et al. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.11.006
Nutrition in ICU Patients with Acute Kidney Injury
Hiesmayr, M., & Fischer, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-66541-7_41
Protein Requirements: Refocusing on an Essential Nutrient
Pardo, E., & Preiser, J. (2024) · Springer eBooks · doi:10.1007/978-3-031-66541-7_9
The Energy Intake: How Much, and at What Time?
Lauwers, C., Casaer, M. P., & Gunst, J. (2024) · Springer eBooks · doi:10.1007/978-3-031-66541-7_8
Zhou, L., Doig, G. S., Lv, C., Ke, L., & Li, W. (2024) · Critical Care and Resuscitation · doi:10.1016/j.ccrj.2024.10.002
Hartwell, J. L., Evans, D. J., & Martin, M. J. (2024) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000004482
Critical care nutrition: a Bayesian re-analysis of trial data
Angeloni, N. A., Angriman, F., & Adhikari, N. K. J. (2024) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001094
TSS-strategy for starting nutritional support in critically ill patients
Ershov, V. I., & Dobrynin, A. S. (2024) · Clinical nutrition and metabolism · doi:10.17816/clinutr640063
Kreymann, K. G. (2024) · Springer eBooks · doi:10.1007/978-3-662-67524-3_1
Missing data and long-term outcomes from nutrition research in the critically ill
Schouteden, E., Bels, J. L. M., van de Poll, M. C. G., & Presneill, J. (2024) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001098
“For example, the 60-day mortality was 32 35% in the EFFORT Protein RCT [30] and mortality by day 180 was 38 42% in the PRECISe randomized controlled trial [22 && ] – predictors of death and other causes of attrition of patients from the trial may be different, and outcomes of interest for the…”
Çavuşoğlu, E. C., & Akkaş, Ö. A. (2025) · Sağlık Bilimlerinde Değer · doi:10.33631/sabd.1540265
Desai, S. R., & Hwang, N. C. (2025) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2025.01.023
Nutritional research in critical illness, we are making steady progress!
Casaer, M. P., & Deane, A. (2025) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001108
Alissa, A. S., Korayem, G. B., Aljuhani, O. A., AlFaifi, M., Alnajjar, L. I., Souaan, N. A. L., Albassam, M., Alrayes, A., Albishi, S. M., Alqahtani, R. A., et al. (2025) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s487662
“15,19,21 Yet, the safety of early advancement of protein intake within the first three days in critically ill patients with COVID-19 remains under-explored.”
InfluentialSupersize or Right Size? Protein Intake in Critically Ill Obese Patients
Pfeilsticker, F. J. D. A., Lourenço, I. D., Figueiredo, E. J., & Passos, R. D. H. (2025) · Critical Care Medicine · doi:10.1097/ccm.0000000000006510
Evaluation of nutrition therapy in critically ill patients with Clostridioides difficile infection
Kroninger, A., Davids, B. L., & Franck, A. J. (2025) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2025.03.017
Nutrition management of a patient following emergent pneumonectomy due to chest wall trauma
Pelekhaty, S. L., & Brody, R. A. (2025) · Nutrition in Clinical Practice · doi:10.1002/ncp.11291
“26 Furthermore, the potential of harm with high ‐ protein delivery to patients with AKI was not observed on subanalysis when patients received CRRT or dialysis at any point during hospitalization.”
InfluentialNutritional management of adult patients hospitalised with COVID-19 by dietitians in KwaZulu-Natal
Pillay, K., & Ebrahim, N. (2025) · South African Journal of Clinical Nutrition · doi:10.1080/16070658.2025.2495429
“21 The findings indicated that a higher dose of protein in mechanically ventilated ICU patients did not appear to improve the mortality and discharge rates.”
Effect of acute phase protein dose on clinical outcomes in critically ill patients
Shiraishi, S., Tatsumi, H., Haruna, J., Ishihara, E., Akatsuka, M., & Masuda, Y. (2025) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2025.05.024 · Cited by 1
Nutritional Care Process in Hospitalized Patients with Obesity-Related Multimorbidity
Rivera-Carranza, T., Girón, A. L.-T., Mimiaga-Hernández, C., & Aguilar‐Vargas, A. (2025) · Obesities · doi:10.3390/obesities5020039
Arabi, Y. M., & Preiser, J. (2025) · Oxford University Press eBooks · doi:10.1093/med/9780198864714.003.0006
A key step toward gaining a deeper understanding of individual responses to protein supplementation.
Schuetz, P. (2025) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2025.05.030
Toledo, D. O., Yacoub, G. B., Gallafassi, E. D. A., Ribeiro, F. A., Moraes, J. R., Nogueira, P. B. D. P., Malheiro, D. T., & Silva, J. M. (2025) · Clinical Nutrition Open Science · doi:10.1016/j.nutos.2025.05.010
Elusive guidance to dosing of protein in critical illness
McClave, S. A., Miller, K. R., & Martindale, R. G. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001281
Practical implications of “personalized nutrition therapy”
Stephens, K. R., & Busch, R. A. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001287 · Cited by 1
Understanding the rationale for recent paradigm shifts in critical care nutrition
Miller, K. R., & McClave, S. A. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001291
Alleviating muscle weakness in ICU through nutritional interventions; too good to be true?
Vanderwegen, E., Gunst, J., & Casaer, M. P. (2025) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2025.104141
Fontaine, E. M. (2025) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001145
Construction and application of emergency critical care patient care plan based on Delphi method
Wang, H., Ma, J., Li, X., Yan, M., Zhang, P., Sun, J., & Liang, L. (2025) · Medicine · doi:10.1097/md.0000000000042752
“[1] Critically ill patients often present with unclear diagnoses, unstable vital signs, and rapidly changing conditions.”
Lo, S., Lin, H.-C., Wang, Y., Chen, Y.-C., & Yang, S. (2025) · Nutrients · doi:10.3390/nu17182995
Nutrition in ICU Proteins and Amino Acids
Dresen, E. (2025) · Springer eBooks · doi:10.1007/978-3-032-00818-3_3
von Loeffelholz, C., & Elke, G. (2025) · Springer eBooks · doi:10.1007/978-3-032-00818-3_4 · Cited by 1
Metadata
- Authors
- Heyland, D. K., Patel, J., Compher, C., Rice, T. W., Bear, D. E., Lee, Z.-Y., González, V. C., O'Reilly, K., Regala, R., Wedemire, C., Ibarra-Estrada, M., Stoppe, C., Ortiz-Reyes, L., Jiang, X., & Day, A. G.
- Affiliations
- Queen's University (CA)
- Medical College of Wisconsin (US)
- Hospital of the University of Pennsylvania (US)
- Vanderbilt University Medical Center (US)
- Guy's and St Thomas' NHS Foundation Trust (GB)
- University of Malaya (MY)
- Fundacion Allende (AR)
- King's College Hospital NHS Foundation Trust (GB)
- Legacy Salmon Creek Medical Center (US)
- Universidad de Guadalajara (MX)
- Universitätsklinikum Würzburg (DE)
- Corresponding author
- Heyland, Daren K
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2023-02
- Volume
- 401
- Issue
- 10376
- Pages
- 568-576
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4318022770
- Cited by
- 401
- References
- 35
- Citations by year
- 2026: 118 · 2025: 114 · 2024: 113 · 2023: 56
- FWCI
- 70.39
- Type
- journal article
- Language
- en
- Update notices
- erratum (2023-03-25)
- Open access
- closed
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Society for Parenteral and Enteral Nutrition
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- critically ill patients, intensive care nutrition, protein supplementation, nutritional risk, mechanical ventilation, 60-day mortality, hospital discharge, ICU length of stay, mechanical circulatory support, sepsis, acute kidney injury, acute respiratory failure, acute coronary syndrome, acute stroke, acute heart failure, acute liver failure, acute neurological injury, acute pancreatitis
- MeSH terms
- Adult, Critical Care, Hospitalization, Humans, Intensive Care Units, Registries, Respiration, Artificial, Critical Illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
