The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Effect of high versus standard protein provision on functional recovery in people with critical illness (PRECISe): an investigator-initiated, double-blinded, multicentre, parallel-group, randomised controlled trial in Belgium and the Netherlands
Open accessAbstract
Background Increased protein provision might ameliorate muscle wasting and improve long-term outcomes in critically ill patients. The aim of the PRECISe trial was to assess whether higher enteral protein provision (ie, 2·0 g/kg per day) would improve health-related quality of life and functional outcomes in critically ill patients who were mechanically ventilated compared with standard enteral protein provision (ie, 1·3 g/kg per day). Methods The PRECISe trial was an investigator-initiated, double-blinded, multicentre, parallel-group, randomised controlled trial in five Dutch hospitals and five Belgian hospitals. Inclusion criteria were initiation of invasive mechanical ventilation within 24 h of intensive care unit (ICU) admission and an expected duration of invasive ventilation of 3 days or longer. Exclusion criteria were contraindications for enteral nutrition, moribund condition, BMI less than 18 kg/m 2, kidney failure with a no dialysis code, or hepatic encephalopathy. Patients were randomly assigned to one of four randomisation labels, corresponding with two study groups (ie, standard or high protein; two labels per group) in a 1:1:1:1 ratio through an interactive web-response system. Randomisation was done via random permuted-block randomisation in varying block sizes of eight and 12, stratified by centre. Participants, care providers, investigators, outcome assessors, data analysts, and the independent data safety monitoring board were all blinded to group allocation. Patients received isocaloric enteral feeds that contained 1·3 kcal/mL and 0·06 g of protein/mL (ie, standard protein) or 1·3 kcal/mL and 0·10 g of protein/mL (ie, high protein). The study-nutrition intervention was limited to the time period during the patient's ICU stay in which they required enteral feeding, with a maximum of 90 days. The primary outcome was EuroQoL 5-Dimension 5-level (EQ-5D-5L) health utility score at 30 days, 90 days, and 180 days after randomisation, adjusted for baseline EQ-5D-5L health utility score. This trial was registered with ClinicalTrials.gov (NCT04633421) and is closed to new participants. Findings Between Nov 19, 2020, and April 14, 2023, 935 patients were randomly assigned. 335 (35·8%) of 935 patients were female and 600 (64·2%) were male. 465 (49·7%) of 935 were assigned to the standard protein group and 470 (50·3%) were assigned to the high protein group. 430 (92·5%) of 465 patients in the standard protein group and 419 (89·1%) of 470 patients in the high protein group were assessed for the primary outcome. The primary outcome, EQ-5D-5L health utility score during 180 days after randomisation (assessed at 30 days, 90 days, and 180 days), was lower in patients allocated to the high protein group than in those allocated to the standard protein group, with a mean difference of -0·05 (95% CI -0·10 to -0·01; p=0·031). Regarding safety outcomes, the probability of mortality during the entire follow-up was 0·38 (SE 0·02) in the standard protein group and 0·42 (0·02) in the high protein group (hazard ratio 1·14, 95% CI 0·92 to 1·40; p=0·22). There was a higher incidence of symptoms of gastrointestinal intolerance in patients in the high protein group (odds ratio 1·76, 95% CI 1·06 to 2·92; p=0·030). Incidence of other adverse events did not differ between groups. Interpretation High enteral protein provision compared with standard enteral protein provision resulted in worse health-related quality of life in critically ill patients and did not improve functional outcomes during 180 days after ICU admission. Funding Netherlands Organisation for Healthcare Research and Development and Belgian Health Care Knowledge Centre.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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
“The EQ-5D-5L health utility score was lower in patients in the high-protein group; there was also more gastrointestinal intolerance of the higher protein EN.146”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [146]
In the citing paper
“The EQ-5D-5L health utility score was lower in patients in the high-protein group; there was also more gastrointestinal intolerance of the higher protein EN.146”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [146]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011) · Quality of Life Research · doi:10.1007/s11136-011-9903-x · Cited by 9,795
Functional Disability 5 Years after Acute Respiratory Distress Syndrome
Herridge, M. S., Tansey, C. M., Matte, A. L., TOMLINSON, G. A., Diaz-Granados, N., Cooper, A., Guest, C. B., Mazer, C. D., Mehta, S., Stewart, T. E., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1011802 · Cited by 2,892
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
Self-citationDutch Tariff for the Five-Level Version of EQ-5D
M. Versteegh, M., M. Vermeulen, K., M. A. A. Evers, S., de Wit, G. A., Prenger, R., & A. Stolk, E. (2016) · Value in Health · doi:10.1016/j.jval.2016.01.003 · Cited by 1,113
Mixed-Effects Models in S and S-PLUS
(2000) · Statistics and Computing · doi:10.1007/b98882 · Cited by 930
ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit
Singer, P., Blaser, A. R., Berger, M. M., Calder, P. C., Casaer, M., Hiesmayr, M., Mayer, K., Montejo-Gonzalez, J. C., Pichard, C., Preiser, J.-C., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.07.011 · Cited by 793
Compher, C., Bingham, A. L., McCall, M., Patel, J., Rice, T. W., Braunschweig, C., & McKeever, L. (2022) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2267 · Cited by 747
Sample Size Calculations in Clinical Research
Chow, S.-C., Wang, H., & Shao, J. (2007) · doi:10.1201/9781584889830 · Cited by 562
Cuthbertson, B. H., Rattray, J., Campbell, M. K., Gager, M., Roughton, S., Smith, A., Hull, A., Breeman, S., Norrie, J., Jenkinson, D., et al. (2009) · BMJ · doi:10.1136/bmj.b3723 · Cited by 488
Needham, D. M., Sepúlveda, K. A., Dinglas, V. D., Chessare, C. M., Friedman, L. A., Bingham, C. O., & Turnbull, A. E. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201702-0372oc · Cited by 474
Cited by
Sorted by citations
Paulus, M. C., Melchers, M., van Es, A., Kouw, I. W. K., & van Zanten, A. R. H. (2025) · Critical Care · doi:10.1186/s13054-025-05396-6 · Cited by 112
“The recently conducted PRECISe trial revealed a lower EuroQoL 5-Dimension 5-Level (EQ-5D-5L) health utility score with higher enteral protein provision (2.0 g/kg/day) compared to standard protein provision (1.3 g/kg/day), which was most pronounced in female patients [63].”
InfluentialSelf-citationAugmented Enteral Protein During Critical Illness
Summers, M. J., Chapple, L. S., Karahalios, A., Bellomo, R., Chapman, M. J., Ferrie, S., Finnis, M., French, C., Hurford, S., Kakho, N., et al. (2025) · JAMA · doi:10.1001/jama.2025.9110 · Cited by 70
Self-citationMottale, R., Dupuis, C., Szklarzewska, S., & Preiser, J. (2025) · Annals of Intensive Care · doi:10.1186/s13613-025-01588-z · Cited by 50
“These findings reinforce concerns that higher protein strategies may not only fail to provide clinical benefit but could also adversely affect long-term outcomes in selected ICU populations [127].”
Eggmann, S., Parry, S. M., Broadley, T., Lynch, G. S., Bongetti, A. J., Ridley, E. J., Ayre, E., Bailey, M., Bellomo, R., Berney, S. C., et al. (2025) · Intensive Care Medicine · doi:10.1007/s00134-025-08186-4 · Cited by 29
Self-citationPost-Intensive Care Syndrome as a Burden for Patients and Their Caregivers: A Narrative Review
Schembari, G., Santonocito, C., Messina, S., Caruso, A., Cardia, L., Rubulotta, F. M., Noto, A., Bignami, E. G., & Sanfilippo, F. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13195881 · Cited by 40
“Moreover, another randomized evidence has suggested that, when compared to standard enteral protein provision (1.3 g/kg/day), a high enteral protein regimen (2.0 g/kg/day) resulted in worse HRQOL in ICU patients, without improving functional outcomes 6 months after admission [105].”
BackgroundInfluential
Metadata
- Authors
- Bels, J. L. M., Thiessen, S., van Gassel, R. J. J., Beishuizen, A., De Bie Dekker, A., Fraipont, V., Lamote, S., Ledoux, D., Scheeren, C., De Waele, E., van Zanten, A. R. H., Bormans-Russell, L., van Bussel, B. C. T., Dictus, M. M. J., Fivez, T., Harks, I., van der Horst, I. C. C., Jonckheer, J., Marechal, H., Massion, P. B., Meex, I., Paulus, M. C., Rinket, M., van Santen, S., Tartaglia, K., Deane, A. M., Demuydt, F., Puthucheary, Z., Vloet, L. C. M., Weijs, P. J. M., van Kuijk, S. M. J., van de Poll, M. C. G., Mesotten, D., Bels, J. L., van Bussel, B. C., van Gassel, R. J., van der Horst, I. C., van Kuijk, S. M., van de Poll, M. C., van Santen, S., van den Berk, D., van den Hogen, E., van Loon, L.-A., van Loon, L. J., Dictus, M. M., Fiez, T., Meex, I., Mesotten, D., Tartaglia, K., Thiessen, S., Boer, W., Engelen, K., Vander Laenen, M., Willaert, X., Jonckheer, J., De Waele, E., Demol, J., Geers, J., van Malderen, M.-C., Opdenacker, G., Verhelst, C., Paulus, M. C., van Zanten, A. R., Bouw-Ruiter, M., Kouw, I., Melchers, M., Osinga, M., Swaen-Dekkers, Y., De Bie Dekker, A., Harks, I., Beishuizen, A., Rinket, M., Cornet, A. D., Krol, T., Vermeijden, W., Bormans-Russell, L., Scheeren, C., van der Woude, M., Zandijk, E., Lamote, S., Lagast, S., Boscart, I., Ledoux, D., Massion, P., Fraipont, V., Marechal, H., Demuydt, F., Vloet, L., Weijs, P. M., Puthucheary, Z., & Deane, A.
- Affiliations
- Ziekenhuis Gelderse Vallei (NL)
- Ziekenhuis Oost-Limburg (BE)
- Centre Hospitalier Universitaire de Liège (BE)
- HAN University of Applied Sciences (NL)
- Maastricht University Medical Centre (NL)
- Corresponding author
- van de Poll, Marcel C G
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2024-08
- Volume
- 404
- Issue
- 10453
- Pages
- 659-669
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4401598369
- Cited by
- 174
- References
- 34
- Citations by year
- 2026: 90 · 2025: 69 · 2024: 15
- FWCI
- 46.49
- Type
- journal article
- Language
- en
- Open access
- green
- research.wur.nl
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- TU/e Research Portal (publishedVersion)
- Socio-Environmental Systems Modeling (submittedVersion)
- ORBi (University of Liège) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion)
- Document Server@UHasselt (UHasselt) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- Nutricia Research BV
- KCE
- NWO
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Keywords
- critically ill patients, mechanical ventilation, functional recovery, health-related quality of life, muscle atrophy, ICU nutrition, catabolic phase, PRECISE trial, hepatic encephalopathy
- MeSH terms
- Aged, Belgium, Dietary Proteins, Double-Blind Method, Enteral Nutrition, Female, Humans, Intensive Care Units, Male, Middle Aged, Netherlands, Quality of Life, Respiration, Artificial, Critical Illness, Recovery of Function
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
