Can a feeding protocol improve clinical outcomes in critically ill patients?

Conditions

Critically ill patients Injury, Occupational Diseases, Poisoning Critically ill patients

Yanhua Li, Yue Wang, Yuhan Zhang, F ZHANG, Lu Ke et al. (6 authors)

Frontiers in Nutrition2026-06-10

10.3389/fnut.2026.1870956

Early energy delivery and 28-day mortality in critically ill patients with sepsis: Post hoc analysis of a multicenter cluster-randomised controlled trial.

Wang Q, Ke J, Chen Y, Xu H, Wu D, Ke L, Liang F, Chen Y, Chinese Critical Care Nutrition Trials Group (CCCNTG).

2025-09-18

10.1016/j.jcrc.2025.155265

Semi-elemental versus polymeric formula for enteral nutrition in critically ill patients: a secondary analysis of a multicenter cluster-randomized controlled trial

Wei Wei, Wenchao Lu, Guofeng Chen, Jindan Gao, Jun Zhang et al. (16 authors)

Frontiers in Nutrition2025-07-23

10.3389/fnut.2025.1587270

Association between early enteral nutrition and clinical outcomes among critically ill patients with circulatory shock: A secondary analysis of a large-scale randomized controlled trial.

Jiang W, Weibang Pan, Cai T, Lee Z, Lv G, Bai Y, Liu M, Zhang Z, Stoppe C, Patel J, Ke L, Mao W, Wang X, Chinese Critical Care Nutrition Trials Group (CCCNTG).

2025-02-031 citations

10.1016/j.clnu.2025.01.029

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.

Chen Y, Liu Z, Wang Q, Gao F, Xu H, Ke L, Lee ZY, Stoppe C, Heyland DK, Liang F, Lin J, Chinese Critical Care Nutrition Trials Group (CCCNTG).

2024-01-203 citations

10.1186/s13054-024-04813-6

Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial

Cheng Lv, Xingwei Jiang, Yi Long, Zirui Liu, Jiajia Lin et al. (17 authors)

Frontiers in Nutrition2022-09-0216 citations

10.3389/fnut.2022.902986

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.

Ke L, Lin J, Doig GS, van Zanten ARH, Wang Y, Xing J, Zhang Z, Chen T, Zhou L, Jiang D, Shi Q, Lin J, Liu J, Cheng A, Liang Y, Gao P, Sun J, Liu W, Yang Z, Zhang R, Xing W, Zhang A, Zhou Z, Zhou T, Liu Y, Tong F, Wang Q, Pan A, Huang X, Fan C, Lu W, Shi D, Wang L, Li W, Gu L, Xie Y, Sun R, Guo F, Han L, Zhou L, Zheng X, Shan F, Liu J, Ai Y, Qu Y, Li L, Li H, Pan Z, Xu D, Zou Z, Gao Y, Yang C, Kou Q, Zhang X, Wu J, Qian C, Zhang W, Zhang M, Zong Y, Qin B, Zhang F, Zhai Z, Sun Y, Chang P, Yu B, Yu M, Yuan S, Deng Y, Zhao L, Zang B, Li Y, Zhou F, Chen X, Shao M, Wu W, Wu M, Zhang Z, Li Y, Guo Q, Wang Z, Gong Y, Song Y, Qian K, Feng Y, Fu B, Liu X, Li Z, Gong C, Sun C, Yu J, Tang Z, Huang L, Ma B, He Z, Zhou Q, Yu R, Tong Z, Li W, Chinese Critcal Care Nutrition Trials Group (CCCNTG).

2022-02-1629 citations

10.1186/s13054-022-03921-5

Interventions

Current interventions as of 15/01/2020: The R language will be used for randomization for this study. All the participating centers will be stratified according to the nature of its hospital (region

Eligibility

Sex/Gender

All

Age

18 Years to 110 Years

Inclusion criteria

Inclusion criteria: Current inclusion criteria as of 15/01/2020: 1. Informed consent form obtained from the patient or next of kin 2. Aged 18 years or older 3. Within 24 h of ICU admission 4. With one or more organ failure (SOFA for any single organ system=2) 5. Expected to stay in ICU more than 7 days 6. Oral diet is not likely to be restored within 3 days _____ Previous inclusion criteria: 1. All patients expected to stay in the ICU for over 3 days 2. Aged 18 years and older

Exclusion criteria

Exclusion criteria: Current exclusion criteria as of 15/01/2020: 1. Received EN in the past 3 days 2. Receiving palliative treatment or expected to die within 48 hours 3. Women in pregnancy 4. Long-term use of steroids or immunosuppressive agents 5. Patients with malignant diseases receiving radiotherapy or chemotherapy. _____ Previous exclusion criteria: 1. Subjects receiving EN in previous 7 days 2. Contraindications for nasogastric or nasoenteric tube placement 3. Subjects who have already undergone percutaneous endoscopic jejunostomy (PEJ), percutaneous endoscopic gastrostomy (PEG) and surgical jejunostomy 4. Age younger than 18 years old 5. Women who are pregnant or undergo breast feeding 6. Burn patients

Design outcomes

Primary

Measure	Time frame
Current primary outcome measure as of 15/01/2020: All-cause mortality at day 28 after randomization (the day of randomization will be set as day 1) _____ Previous primary outcome measure: 28-day mortality is measured using the vital status at 28 days after enrollment	—

Secondary

Measure	Time frame
Current secondary outcome measures as of 15/01/2020: Process measures: 1. Time to start EN 2. Time to start PN 3. Mean nutrition support days within the first 7 days after enrollment 3.1 Mean nutritional support (either EN or PN or both) days within the first 7 days after enrollment 3.2 Mean EN support days within the first 7 days after enrollment 3.3 Mean PN support days within the first 7 days after enrollment 4. Target-reaching rate of EN on day 3 and day 7 after enrollment 5. EN tolerance score in the first 7days after Enrollment 6. Days requiring prokinetic agents within the first 7 days after enrollment 7. Proportion of patients receiving PN prescription within the first 7 days after enrollment 8. Mean energy per day over the first 7 days for patients who were fed 9. Proportion of patients never fed during the first 7 days after enrollment 10. Proportion of patients fed within 24 h after enrollment 11. Mean energy delivered for patients who were fed within the first 7 days after enrollment 11.1 Mean energy delivered from EN within the first 7 days after enrollment 11.2 Mean energy delivered from PN within the first 7 days after enrollment 12. Proportion of patients who received a post-pyloric feeding tube (patients receiving EN) within the first 7 days after enrollment Organ dysfunction-related outcomes: 1. New onset organ failure within the first 7 days 1.1 New-onset respiratory failure; 1.2 New-onset cardiovascular failure; 1.3 New-onset renal failure 2. New receipt of organ support therapy within the first 7 days 2.1 New receipt of mechanical ventilation (non-invasive included) 2.2 New receipt of renal replacement therapy 2.3 New receipt of vasoactive agents 2.4 Days requiring CRRT within the first 7 days after enrollment 2.5 Days requiring insulin within the first 7 days after enrollment 2.6 Days requiring MV within the first 7 days after enrollment Additional outcomes: 1. Incidence of secondary infection in the ICU 2. Length of ICU stay _____ Previou	—

Measure

Time frame

Current secondary outcome measures as of 15/01/2020: Process measures: 1. Time to start EN 2. Time to start PN 3. Mean nutrition support days within the first 7 days after enrollment 3.1 Mean nutritional support (either EN or PN or both) days within the first 7 days after enrollment 3.2 Mean EN support days within the first 7 days after enrollment 3.3 Mean PN support days within the first 7 days after enrollment 4. Target-reaching rate of EN on day 3 and day 7 after enrollment 5. EN tolerance score in the first 7days after Enrollment 6. Days requiring prokinetic agents within the first 7 days after enrollment 7. Proportion of patients receiving PN prescription within the first 7 days after enrollment 8. Mean energy per day over the first 7 days for patients who were fed 9. Proportion of patients never fed during the first 7 days after enrollment 10. Proportion of patients fed within 24 h after enrollment 11. Mean energy delivered for patients who were fed within the first 7 days after enrollment 11.1 Mean energy delivered from EN within the first 7 days after enrollment 11.2 Mean energy delivered from PN within the first 7 days after enrollment 12. Proportion of patients who received a post-pyloric feeding tube (patients receiving EN) within the first 7 days after enrollment Organ dysfunction-related outcomes: 1. New onset organ failure within the first 7 days 1.1 New-onset respiratory failure; 1.2 New-onset cardiovascular failure; 1.3 New-onset renal failure 2. New receipt of organ support therapy within the first 7 days 2.1 New receipt of mechanical ventilation (non-invasive included) 2.2 New receipt of renal replacement therapy 2.3 New receipt of vasoactive agents 2.4 Days requiring CRRT within the first 7 days after enrollment 2.5 Days requiring insulin within the first 7 days after enrollment 2.6 Days requiring MV within the first 7 days after enrollment Additional outcomes: 1. Incidence of secondary infection in the ICU 2. Length of ICU stay _____ Previou

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Countries

China

Contacts

Public ContactJuan Xing

Outcome results

None listed