Document Detail

The tight calorie control study (TICACOS): a prospective, randomized, controlled pilot study of nutritional support in critically ill patients.
MedLine Citation:
PMID:  21340655     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine whether nutritional support guided by repeated measurements of resting energy requirements improves the outcome of critically ill patients.
METHODS: This was a prospective, randomized, single-center, pilot clinical trial conducted in an adult general intensive care (ICU) unit. The study population comprised mechanically ventilated patients (n = 130) expected to stay in ICU more than 3 days. Patients were randomized to receive enteral nutrition (EN) with an energy target determined either (1) by repeated indirect calorimetry measurements (study group, n = 56), or (2) according to 25 kcal/kg/day (control group, n = 56). EN was supplemented with parenteral nutrition when required.
RESULTS: The primary outcome was hospital mortality. Measured pre-study resting energy expenditure (REE) was similar in both groups (1,976 ± 468 vs. 1,838 ± 468 kcal, p = 0.6). Patients in the study group had a higher mean energy (2,086 ± 460 vs. 1,480 ± 356 kcal/day, p = 0.01) and protein intake (76 ± 16 vs. 53 ± 16 g/day, p = 0.01). There was a trend towards an improved hospital mortality in the intention to treat group (21/65 patients, 32.3% vs. 31/65 patients, 47.7%, p = 0.058) whereas length of ventilation (16.1 ± 14.7 vs. 10.5 ± 8.3 days, p = 0.03) and ICU stay (17.2 ± 14.6 vs. 11.7 ± 8.4, p = 0.04) were increased.
CONCLUSIONS: In this single-center pilot study a bundle comprising actively supervised nutritional intervention and providing near target energy requirements based on repeated energy measurements was achievable in a general ICU and may be associated with lower hospital mortality.
Pierre Singer; Ronit Anbar; Jonathan Cohen; Haim Shapiro; Michal Shalita-Chesner; Shaul Lev; Elad Grozovski; Miryam Theilla; Sigal Frishman; Zecharia Madar
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-02-22
Journal Detail:
Title:  Intensive care medicine     Volume:  37     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-16     Completed Date:  2011-08-01     Revised Date:  2013-04-02    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  601-9     Citation Subset:  IM    
Department of General Intensive Care, Rabin Medical Center, Campus Beilinson, 49100, Petah Tikva, Israel.
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MeSH Terms
Critical Care / methods*
Energy Intake*
Energy Metabolism
Hospital Mortality
Intensive Care Units
Middle Aged
Nutritional Requirements
Nutritional Support / methods*
Prospective Studies
Respiration, Artificial
Treatment Outcome
Comment In:
Intensive Care Med. 2011 Apr;37(4):564-5   [PMID:  21340654 ]
Intensive Care Med. 2013 Mar;39(3):538   [PMID:  23306665 ]
Intensive Care Med. 2013 Mar;39(3):537   [PMID:  23306664 ]

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