Cited by 199Clinical Nutrition and GastroenterologyNosocomial Infections in ICURespiratory Support and Mechanisms

Intensive Nutrition in Acute Lung Injury: A Clinical Trial (INTACT)

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Braunschweig, Carol A., Sheean, Patricia M., Peterson, Sarah J., Gomez Perez, Sandra, Freels, Sally, Lateef, Omar, Gurka, David, Fantuzzi, Giamila·2015·Journal of Parenteral and Enteral Nutrition

Abstract

Background: Despite extensive use of enteral (EN) and parenteral nutrition (PN) in intensive care unit (ICU) populations for 4 decades, evidence to support their efficacy is extremely limited. Methods : A prospective randomized trial was conducted evaluate the impact on outcomes of intensive medical nutrition therapy (IMNT; provision of >75% of estimated energy and protein needs per day via EN and adequate oral diet) from diagnosis of acute lung injury (ALI) to hospital discharge compared with standard nutrition support care (SNSC; standard EN and ad lib feeding). The primary outcome was infections; secondary outcomes included number of days on mechanical ventilation, in the ICU, and in the hospital and mortality. Results : Overall, 78 patients (40 IMNT and 38 SNSC) were recruited. No significant differences between groups for age, body mass index, disease severity, white blood cell count, glucose, C‐reactive protein, energy or protein needs occurred. The IMNT group received significantly higher percentage of estimated energy (84.7% vs 55.4%, P < .0001) and protein needs (76.1 vs 54.4%, P < .0001) per day compared with SNSC. No differences occurred in length of mechanical ventilation, hospital or ICU stay, or infections. The trial was stopped early because of significantly greater hospital mortality in IMNT vs SNSC (40% vs 16%, P = .02). Cox proportional hazards models indicated the hazard of death in the IMNT group was 5.67 times higher ( P = .001) than in the SNSC group. Conclusions : Provision of IMNT from ALI diagnosis to hospital discharge increases mortality.

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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 [134]

    The Results (page unavailable) report significantly higher mortality with intensive nutrition than with standard care (39% versus 16%), and the Discussion says the trial was stopped early because of that difference. Although several other outcomes did not differ, this study did not conclude that the feeding approaches were equivalent. (LLM, conf=0.88)

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Authors
Braunschweig, C. A., Sheean, P. M., Peterson, S. J., Gomez Perez, S., Freels, S., Lateef, O., Gurka, D., & Fantuzzi, G.
Affiliations
  • University of Illinois Chicago (US)
  • Loyola University Chicago (US)
  • Rush University Medical Center (US)
Corresponding author
Braunschweig, Carol A.
Venue
Journal of Parenteral and Enteral Nutrition
Publisher
Wiley
Published
2014-04-09
Volume
39
Issue
1
Pages
13-20
ISSN
  • 0148-6071 (ISSN-L)
  • 1941-2444
OpenAlex
W1999372553
Cited by
199
References
43
Citations by year
2026: 6 · 2025: 7 · 2024: 15 · 2023: 9 · 2022: 14 · 2021: 25 · 2020: 9 · 2019: 24 · 2018: 27 · 2017: 29 · 2016: 19 · 2015: 11 · 2014: 2 · 2013: 1
FWCI
18.94
Type
journal article
Language
en
Open access
Locations
  • Journal of Parenteral and Enteral Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL093142)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
acute lung injury, enteral nutrition, parenteral nutrition, nutritional support, in-hospital mortality, mechanical ventilation duration, infection, ICU length of stay, energy and protein requirements
MeSH terms
Adult, Aged, Blood Cell Count, Blood Glucose, Body Weight, C-Reactive Protein, Energy Intake, Dietary Proteins, Enteral Nutrition, Female, Humans, Intensive Care Units, Male, Middle Aged, Parenteral Nutrition, Prospective Studies, Respiration, Artificial, Body Mass Index, Proportional Hazards Models, Treatment Outcome, Hospital Mortality, APACHE, Acute Lung Injury

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