Trial reportThe New England journal of medicine2011
Early versus late parenteral nutrition in critically ill adults.
Trial report in The New England journal of medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 11 registered trials, which are not on this map. Cited by 542 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients
Impact of Early Parenteral Nutrition Completing Enteral Nutrition in Paediatric Critically Ill Patients
Strategies to Reduce Organic Muscle Atrophy in the Intensive Care Unit (STROMA-ICU)
Early Metabolomic Support Study
Early Versus Delayed Parenteral Nutrition in Abdominal Surgical Patients With Nutritional Risk and Initial Enteral Nutrition Intolerance: A Clinical Randomized Trial
Gradual Versus Immediate Goal-dose Enteral Nutrition in Abdominal Surgery Patients: A Clinical Randomized Controlled Trial
Impact of Tight Blood Glucose Control Within Normal Fasting Ranges With Insulin Titration Prescribed by the Leuven Algorithm in Adult Critically Ill Patients
Assessing the Influence of Timing of Enteral Feeding Support in Esophageal Cancer Patients on Muscle functTion and Survival
Trophic Nutrition in Patients Submitted to High Flow Oxygen Therapy and / or Non Invasive
The Effect of Higher Protein Dosing in Critically Ill Patients: A Multicenter Registry-based Randomized Trial: The EFFORT Ultrasound a Sub-study
The Effect of Postoperative Supplemental Parenteral Nutrition (SPN) in Gastric Cancer Patients Who Underwent Gastrectomy: A Multicenter Prospective Randomized Controlled Trial
Who cites it
542 citing papers in PubMed, 9 syntheses or guidelines pooled it, 1,639 citations in OpenAlex.
- Impact of tight blood glucose control on atrial fibrillation in critically ill patients receiving early parenteral nutrition: an individual patient data meta-analysis of two large randomized controlled trials.Journal of cardiothoracic surgery · 2026Pooled it
- Hypoalbuminemia associated perioperative mortality, reoperation, and readmission rates among total joint arthroplasty procedures: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Reporting of nutritional screening, status, and intake in trials of nutritional and physical rehabilitation following critical illness: a systematic review.The American journal of clinical nutrition · 2025Pooled it
- Energy-dense versus routine enteral nutrition in critically ill patients: a systematic review and meta-analysis.Frontiers in nutrition · 2025Pooled it
- Impact of nutritional support on mortality among critically ill patients with different nutritional risks: a systematic review with meta-analysis.Frontiers in nutrition · 2025Pooled it
- Comparative safety assessment of nasogastric versus nasojejunal feeding initiated within 48 hours post-admission versus unrestricted timing in moderate or severe acute pancreatitis: a systematic review and meta-analysis.BMC gastroenterology · 2024Pooled it
- Pooled it
- Impact of Energy and Protein Delivery to Critically Ill Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Nutrients · 2022Pooled it
- Nutrition support for acute kidney injury 2020-consensus of the Taiwan AKI task force.Journal of the Chinese Medical Association : JCMA · 2022Pooled it
- Increased ureagenesis revealing metabolic intolerance to enhanced nutrition in the PICU: a secondary analysis of the PEPaNIC RCT.Critical care (London, England) · 2026Trial
- Hypophosphatemia as a biomarker of metabolic intolerance to enhanced nutrition in the PICU: a secondary analysis of the PEPaNIC RCT.Critical care (London, England) · 2026Trial
- Combined intravenous bolus amino acid supplementation and mobilization on early muscle loss in critically ill adults: A randomized controlled trial.JPEN. Journal of parenteral and enteral nutrition · 2026Trial
- Abnormal carnitine concentrations in critical illness associated with compromised outcome.Critical care (London, England) · 2026Trial
- Altered muscle transcriptome as molecular basis of long-term muscle weakness in survivors from critical illness.Intensive care medicine · 2025Trial
- Early phosphate changes as potential indicator of unreadiness for artificial feeding: a secondary analysis of the EPaNIC RCT.Critical care (London, England) · 2025Trial
- The impact of a tailored nutrition intervention delivered for the duration of hospitalisation on daily energy delivery for patients with critical illness (INTENT): a phase II randomised controlled trial.Critical care (London, England) · 2025Trial
- Impact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study.Critical care (London, England) · 2024Trial
- Impact of withholding early parenteral nutrition on 2-year mortality and functional outcome in critically ill adults.Intensive care medicine · 2024Trial
- Glucocorticoid treatment increases cholesterol availability during critical illness: effect on adrenal and muscle function.Critical care (London, England) · 2024Trial
- Effect of an enteral amino acid blend on muscle and gut functionality in critically ill patients: a proof-of-concept randomized controlled trial.Critical care (London, England) · 2022Trial
482 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
18 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundControversy exists about the timing of the initiation of parenteral nutrition in critically ill adults in whom caloric targets cannot be met by enteral nutrition alone.
methodsIn this randomized, multicenter trial, we compared early initiation of parenteral nutrition (European guidelines) with late initiation (American and Canadian guidelines) in adults in the intensive care unit (ICU) to supplement insufficient enteral nutrition. In 2312 patients, parenteral nutrition was initiated within 48 hours after ICU admission (early-initiation group), whereas in 2328 patients, parenteral nutrition was not initiated before day 8 (late-initiation group). A protocol for the early initiation of enteral nutrition was applied to both groups, and insulin was infused to achieve normoglycemia.
resultsPatients in the late-initiation group had a relative increase of 6.3% in the likelihood of being discharged alive earlier from the ICU (hazard ratio, 1.06; 95% confidence interval [CI], 1.00 to 1.13; P=0.04) and from the hospital (hazard ratio, 1.06; 95% CI, 1.00 to 1.13; P=0.04), without evidence of decreased functional status at hospital discharge. Rates of death in the ICU and in the hospital and rates of survival at 90 days were similar in the two groups. Patients in the late-initiation group, as compared with the early-initiation group, had fewer ICU infections (22.8% vs. 26.2%, P=0.008) and a lower incidence of cholestasis (P<0.001). The late-initiation group had a relative reduction of 9.7% in the proportion of patients requiring more than 2 days of mechanical ventilation (P=0.006), a median reduction of 3 days in the duration of renal-replacement therapy (P=0.008), and a mean reduction in health care costs of €1,110 (about $1,600) (P=0.04).
conclusionsLate initiation of parenteral nutrition was associated with faster recovery and fewer complications, as compared with early initiation. (Funded by the Methusalem program of the Flemish government and others; EPaNIC ClinicalTrials.gov number, NCT00512122.).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.