Indirect calorimetry-guided nutrition during weaning from prolonged mechanical ventilation: a double-blind randomized controlled trial
Primary result · Successful weaningResult — go to the resultAbsolute difference 8%Authors' conclusion
The observed rates of successful weaning and one-year survival were numerically higher, and median time to liberation was shorter, with IC-guided nutrition than with predictive-equation-guided feeding, although between-group differences were not statistically significant. Closer alignment between measured energy expenditure and delivered energy intake was independently associated with successful weaning.
Study context
- Population
- Adults ventilated ≥ 21 days (prolonged mechanical ventilation), Reuth Tel-Aviv Rehabilitation Hospital, Nov 2019-Apr 2023randomized
- Participants
- 211 adults
- Comparison
- Indirect calorimetry (IC)-guided energy targets vs predictive-equation-guided feeding
- ICn = 111
- Controln = 100reference
- Primary endpoint
- Successful weaning (≥ 7 consecutive days of spontaneous breathing) and time to successful weaning
Methodological detailsdouble-blind, single-centre, 1-year follow-up
- Double-blind
- Single-centre
- 1-year follow-up
Primary result
Successful weaning
Absolute difference
8%
P = 0.33
By group
As reported in the abstract
Secondary outcomes
| Outcome | IC | Control | Absolute difference (95% CI) | P value | |
|---|---|---|---|---|---|
| 1-year mortality | 48% | 56% | −8% (−21.2% to 5.5%) | P = 0.29 | |
| −30−20−10010Difference (linear scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Energy-gap and successful weaning (post hoc, per-protocol, n = 198)Post hoc analysis | 1.02 (1.00–1.05) | P = 0.02 | |
| 0.512Hazard ratio (log scale) |
Successful weaning and 1-year mortality
| HR (95% CI) | ||
|---|---|---|
| Successful weaningAdjusting for study arm | 0.54 (0.36–0.82) | |
| 0.20.5125Hazard ratio (log scale) |
- Energy-gap and successful weaning (post hoc, per-protocol, n = 198): independently associated with higher likelihood of successful weaning
Energy alignment
- IC-guided feeding gave closer alignment between measured energy expenditure and delivered intake and reduced overfeeding vs predictive equations
Original publication
Indirect calorimetry-guided nutrition during weaning from prolonged mechanical ventilation: a double-blind randomized controlled trial. Crit Care. Published 28 August 2026. doi:10.
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