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Cited by 69Clinical Nutrition and GastroenterologyHyperglycemia and glycemic control in critically ill and hospitalized patientsNosocomial Infections in ICU

Calorie delivery and clinical outcomes in the critically ill: a systematic review and meta-analysis

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Parikh, Harshel G., Miller, Asaf, Chapman, Marianne, Moran, John L., Peake, Sandra L.·2016·Critical Care and Resuscitation
DOI 10.1016/s1441-2772(23)00927-4
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Abstract

OBJECTIVES: To determine the effect of calorie delivery on hospital mortality among critically ill adults receiving enteral nutrition (EN). Secondary outcomes included the effect of calorie delivery on intensive care unit and hospital length of stay (LOS), duration of mechanical ventilation (MV) and incidence of new-onset pneumonia. METHODS: We identified randomised clinical trials of EN, with or without supplemental parenteral nutrition (PN), involving adult ICU patients for whom mortality data were available, and when there was a significant difference in calorie supplementation between intervention arms (P < 0.05). We searched English language electronic databases (1946-2014), bibliographies of nutrition society guidelines and high-impact nutrition and critical care journals. We calculated summary odds ratio (OR) estimates and 95% confidence intervals using a random effects estimator, and used meta-regression to assess the effect on mortality of average calories delivered. RESULTS: Of 1545 articles identified, 16 eligible studies involving 3473 patients were included. Five studies involved supplemental PN. Mean calorie delivery ranged from 126 kcal/day (SD, 115 kcal/day) to 2086 kcal/day (SD, 460 kcal/day). Mortality was 26.0% in the lower calorie delivery group and 26.5% in the higher calorie delivery group. There was no effect of increased calorie delivery on mortality (OR, 1.02; 95% CI , 0.85-1.24; P = 0.27; I2 = 16.3%). ICU and hospital LOS and incidence of newonset pneumonia did not differ between groups. Duration of MV was decreased with lower calorie delivery (weighted mean difference, 2.92 days; 95% CI, -4.49 to -1.35 days; P < 0.001; I2 = 14.7%). Meta-regression analysis did not show an overall effect on mortality of average calories delivered (P = 0.73; I2 = 40.8%). CONCLUSION: Delivery of increased calories via the enteral route, with or without supplemental PN, was not associated with a survival benefit.

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  • Studies (134, 138) and the meta-analysis derived from them (144, 145, 146) concluded there was no difference between normocaloric and hypocaloric diets in critically ill patients.

    “These studies (134, 138) and the metaanalysis derived from them (144, 145, 146) concluded that there was no difference between normocaloric versus hypocaloric diets in critically ill patients.”

    From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [144]

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References 72 · Cited by 69

Authors
Parikh, H. G., Miller, A., Chapman, M., Moran, J. L., & Peake, S. L.
Affiliations
  • Royal Hobart Hospital (AU)
  • Royal Adelaide Hospital (AU)
  • Queen Elizabeth Hospital (AU)
Corresponding author
Parikh, Harshel G.
ORCID
Venue
Critical Care and Resuscitation
Publisher
Elsevier BV
Published
2016-03
Volume
18
Issue
1
Pages
17-e19
ISSN
1441-2772 (ISSN-L)
DOI
10.1016/s1441-2772(23)00927-4
OpenAlex
W2299956548
Cited by
69
References
72
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 7 · 2021: 10 · 2020: 4 · 2019: 14 · 2018: 9 · 2017: 7 · 2016: 2
FWCI
1.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Critical Care and Resuscitation (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
enteral nutrition, critically ill adults, in-hospital mortality, supplemental parenteral nutrition, length of hospital stay, mechanical ventilation duration, intensive care unit patients
MeSH terms
Energy Intake, Critical Care, Humans, Outcome Assessment, Health Care, Nutritional Support

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