Enhanced exclusive enteral nutrition delivery during the first 7 days is associated with decreased 28-day mortality in critically ill patients with normal lactate level: a post hoc analysis of a multicenter randomized trial
Authors' conclusion
During the first week of critical illness, enhanced nutrition delivery is associated with reduced mortality in critically ill patients receiving exclusive EN, only for those with lactate concentration ≤ 2 mmol/L.
Study context
- Population
- Critically ill patients staying in the ICU ≥7 days and receiving exclusive enteral nutrition (EN)included in the analysis
- Participants
- 1,322 patients
- Comparison
- Higher vs lower EN delivery during the first 7 days
- Primary endpoint
- 28-day mortality
- Follow-up
- 28 days
Methodological detailspost hoc analysis, multicentre
- Post hoc analysis
- Multicentre
Primary result
As reported in the abstract
28-day mortality by EN dose delivered during the first week
Adjusted hazard ratio (95% CI)P value
Energy delivery +5 kcal/kg≈14% reduction
0.865(0.768–0.974)
P = 0.016Protein intake +0.2 g/kgsimilar mortality reduction
0.868(0.770–0.979)
Further findings
28-day mortality, lactate ≤ 2 mmol/L (subgroup)
| Adjusted HR (95% CI) | ||
|---|---|---|
| Energy delivery | 0.804 (0.674–0.960) | |
| Protein delivery | 0.804 (0.672–0.962) | |
| 0.512Adjusted hazard ratio (log scale) |
Daily energy and protein delivery, first week
- Median (IQR) daily energy delivery, kcal/kg
- 14.6 (10.3-19.6)
- Median (IQR) daily protein delivery, g/kg
- 0.6 (0.4-0.8)
28-day mortality, lactate > 2 mmol/L (subgroup)
- Benefit of enhanced nutrition delivery not observed
Original publication
Enhanced exclusive enteral nutrition delivery during the first 7 days is associated with decreased 28-day mortality in critically ill patients with normal lactate level: a post hoc analysis of a multicenter randomized trial. Crit Care. Published 20 January 2024. doi:10.
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