TY - JOUR
T1 - Outcomes Six Months after Delivering 100% or 70% of Enteral Calorie Requirements during Critical Illness (TARGET). A Randomized Controlled Trial
AU - Deane, Adam M.
AU - Little, Lorraine
AU - Bellomo, Rinaldo
AU - Chapman, Marianne J.
AU - Davies, Andrew R.
AU - Ferrie, Suzie
AU - Horowitz, Michael
AU - Hurford, Sally
AU - Lange, Kylie
AU - Litton, Edward
AU - Mackle, Diane
AU - O'Connor, Stephanie
AU - Parker, Jane
AU - Peake, Sandra L.
AU - Presneill, Jeffrey J.
AU - Ridley, Emma J.
AU - Singh, Vanessa
AU - van Haren, Frank
AU - Williams, Patricia
AU - Young, Paul
AU - Iwashyna, Theodore J.
AU - on behalf of the TARGET Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group
N1 - Deane, Adam M Little, Lorraine Bellomo, Rinaldo Chapman, Marianne J Davies, Andrew R Ferrie, Suzie Horowitz, Michael Hurford, Sally Lange, Kylie Litton, Edward Mackle, Diane O'Connor, Stephanie Parker, Jane Peake, Sandra L Presneill, Jeffrey J Ridley, Emma J Singh, Vanessa van Haren, Frank Williams, Patricia Young, Paul Iwashyna, Theodore J eng Am J Respir Crit Care Med. 2020 Jan 6. doi: 10.1164/rccm.201909-1810OC.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Rationale: The long-term effects of delivering approximately 100% of recommended calorie intake via the enteral route during critical illness compared with a lesser amount of calories are unknown.Objectives: Our hypotheses were that achieving approximately 100% of recommended calorie intake during critical illness would increase quality-of-life scores, return to work, and key life activities and reduce death and disability 6 months later.Methods: We conducted a multicenter, blinded, parallel group, randomized clinical trial, with 3,957 mechanically ventilated critically ill adults allocated to energy-dense (1.5 kcal/ml) or routine (1.0 kcal/ml) enteral nutrition.Measurements and Main Results: Participants assigned energy-dense nutrition received more calories (percent recommended energy intake, mean [SD]; energy-dense: 103% [28] vs. usual: 69% [18]). Mortality at Day 180 was similar (560/1,895 [29.6%] vs. 539/1,920 [28.1%]; relative risk 1.05 [95% confidence interval, 0.95-1.16]). At a median (interquartile range) of 185 (182-193) days after randomization, 2,492 survivors were surveyed and reported similar quality of life (EuroQol five dimensions five-level quality-of-life questionnaire visual analog scale, median [interquartile range]: 75 [60-85]; group difference: 0 [95% confidence interval, 0-0]). Similar numbers of participants returned to work with no difference in hours worked or effectiveness at work (n = 818). There was no observed difference in disability (n = 1,208) or participation in key life activities (n = 705).Conclusions: The delivery of approximately 100% compared with 70% of recommended calorie intake during critical illness does not improve quality of life or functional outcomes or increase the number of survivors 6 months later.
AB - Rationale: The long-term effects of delivering approximately 100% of recommended calorie intake via the enteral route during critical illness compared with a lesser amount of calories are unknown.Objectives: Our hypotheses were that achieving approximately 100% of recommended calorie intake during critical illness would increase quality-of-life scores, return to work, and key life activities and reduce death and disability 6 months later.Methods: We conducted a multicenter, blinded, parallel group, randomized clinical trial, with 3,957 mechanically ventilated critically ill adults allocated to energy-dense (1.5 kcal/ml) or routine (1.0 kcal/ml) enteral nutrition.Measurements and Main Results: Participants assigned energy-dense nutrition received more calories (percent recommended energy intake, mean [SD]; energy-dense: 103% [28] vs. usual: 69% [18]). Mortality at Day 180 was similar (560/1,895 [29.6%] vs. 539/1,920 [28.1%]; relative risk 1.05 [95% confidence interval, 0.95-1.16]). At a median (interquartile range) of 185 (182-193) days after randomization, 2,492 survivors were surveyed and reported similar quality of life (EuroQol five dimensions five-level quality-of-life questionnaire visual analog scale, median [interquartile range]: 75 [60-85]; group difference: 0 [95% confidence interval, 0-0]). Similar numbers of participants returned to work with no difference in hours worked or effectiveness at work (n = 818). There was no observed difference in disability (n = 1,208) or participation in key life activities (n = 705).Conclusions: The delivery of approximately 100% compared with 70% of recommended calorie intake during critical illness does not improve quality of life or functional outcomes or increase the number of survivors 6 months later.
KW - critical illness
KW - disability and health
KW - enteral nutrition
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85082780053&partnerID=8YFLogxK
U2 - 10.1164/rccm.201909-1810OC
DO - 10.1164/rccm.201909-1810OC
M3 - Article
C2 - 31904995
SN - 1535-4970
VL - 201
SP - 814
EP - 822
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 7
ER -