Evidence map›Paper›PMID 25271389›Full record

Trial reportThe New England journal of medicine2014

Trial of the route of early nutritional support in critically ill adults.

Sheila E Harvey, Francesca Parrott, David A Harrison, Danielle E Bear, Ella Segaran, Richard Beale, Geoff Bellingan, Richard Leonard, Michael G Mythen, Kathryn M Rowan and 1 more

5 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 185 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
185citing papers in PubMed, 20 pooled it
42.5field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03270345 completednot on this mapstarted 2018, after this paper: background citation

Multicentre International One-Day Prevalence Study on Pressure Injuries in Intensive Care Units

TypeobservationalSponsorEuropean Society of Intensive Care MedicineRan2018 to 2018Enrolled13,340ConditionsPressure Injury
NCT03469882 nacompletednot on this mapstarted 2018, after this paper: background citation

High Protein Intake and Early Exercise in Adult Intensive Care Patients: Impact on Functional Outcomes. A Randomized Controlled Phase II Trial.

TypeinterventionalSponsorHospital Sao DomingosRan2018 to 2020Enrolled180ConditionsCritically Ill PatientsArmsHigh protein nutrition, Cycle ergometry exercise, Usual care group
NCT03634943 completednot on this mapstarted 2018, after this paper: background citation

Evaluation of Nutritional Practices in the Critical Care Patient at the Intensive Care Unit

TypeobservationalSponsorHospital Universitari de BellvitgeRan2018 to 2022Enrolled642ConditionsNutritional Support, Intensive Care Unit, Critical IllnessArmsPatients with Nutritional Support
NCT04607057 phase4unknown statusnot on this mapstarted 2020, after this paper: background citation

The Effect of Postoperative Supplemental Parenteral Nutrition (SPN) in Gastric Cancer Patients Who Underwent Gastrectomy: A Multicenter Prospective Randomized Controlled Trial

TypeinterventionalSponsorSeoul National University HospitalRan2020 to 2022Enrolled224ConditionsGastric Cancer, Gastrectomy, MalnutritionArmsParenteral Nutrition Solutions
NCT05998902 phase3completednot on this mapstarted 2023, after this paper: background citation

Trophic Enteral Feeding Combined With Supplemental Parenteral Nutrition Treatment in Patients With Severe Stroke (OPENS-2): a Multicentre, Prospective, Randomised, Open-label, Blinded-endpoint Trial

TypeinterventionalSponsorWen Jiang-3Ran2023 to 2026Enrolled546ConditionsSevere Stroke, Acute Stroke, DysphagiaArmsTrophic enteral feeding combined with supplemental parenteral nutrition, Full enteral feeding
3 · Its place in the literature

Who cites it

185 citing papers in PubMed, 20 syntheses or guidelines pooled it, 591 citations in OpenAlex.

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  10. [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020
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125 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Sheila E HarveyFrom the Clinical Trials Unit, Intensive Care National Audit and Research Centre (S.E.H., F.P., D.A.H., K.M.R.), the Departments of Nutrition and Dietetics (D.E.B.) and Adult Critical Care (D.E.B., R.B.), Guy's and St. Thomas' NHS Foundation Trust, the Department of Intensive Care, Imperial College Healthcare NHS Trust (E.S., R.L.), the Division of Asthma, Allergy and Lung Biology, King's College London (R.B.), National Institute for Health Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust and University College London (G.B., M.G.M.), and the Department of Surgery and Cancer, Imperial College London (R.L.) - all in London.
Francesca Parrott
David A Harrison
Danielle E Bear
Ella Segaran
Richard Beale
Geoff Bellingan
Richard Leonard
Michael G Mythen
Kathryn M Rowan
CALORIES Trial Investigators
Intensive Care National Audit & Research Centre · GBImperial College Healthcare NHS Trust · GBImperial College London · GBKing's College London · GBNational Institute for Health Research · GBUniversity College London · GB

Funding

Department of Health 07/52/03
6 · The paper itself

Abstract

backgroundUncertainty exists about the most effective route for delivery of early nutritional support in critically ill adults. We hypothesized that delivery through the parenteral route is superior to that through the enteral route.

methodsWe conducted a pragmatic, randomized trial involving adults with an unplanned admission to one of 33 English intensive care units. We randomly assigned patients who could be fed through either the parenteral or the enteral route to a delivery route, with nutritional support initiated within 36 hours after admission and continued for up to 5 days. The primary outcome was all-cause mortality at 30 days.

resultsWe enrolled 2400 patients; 2388 (99.5%) were included in the analysis (1191 in the parenteral group and 1197 in the enteral group). By 30 days, 393 of 1188 patients (33.1%) in the parenteral group and 409 of 1195 patients (34.2%) in the enteral group had died (relative risk in parenteral group, 0.97; 95% confidence interval, 0.86 to 1.08; P=0.57). There were significant reductions in the parenteral group, as compared with the enteral group, in rates of hypoglycemia (44 patients [3.7%] vs. 74 patients [6.2%]; P=0.006) and vomiting (100 patients [8.4%] vs. 194 patients [16.2%]; P<0.001). There were no significant differences between the parenteral group and the enteral group in the mean number of treated infectious complications (0.22 vs. 0.21; P=0.72), 90-day mortality (442 of 1184 patients [37.3%] vs. 464 of 1188 patients [39.1%], P=0.40), in rates of 14 other secondary outcomes, or in rates of adverse events. Caloric intake was similar in the two groups, with the target intake not achieved in most patients.

conclusionsWe found no significant difference in 30-day mortality associated with the route of delivery of early nutritional support in critically ill adults. (Funded by the United Kingdom National Institute for Health Research; CALORIES Current Controlled Trials number, ISRCTN17386141.).

Indexed as

Enteral NutritionParenteral NutritionAdultAgedCritical IllnessEnergy IntakeFemaleHumansHypoglycemiaIntensive Care UnitsMaleMiddle AgedVomiting

Identifiers

PMID25271389
OpenAlexW2109559031

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.