Trial reportNature communications2023
A pilot study of alternative substrates in the critically Ill subject using a ketogenic feed.
Trial report in Nature communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 16 papers, 1 of them a synthesis 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.
Alternative Substrates in the Critically Ill Subject
Exogenous Ketone Ester Supplementation in ICU Delirium (KETONES ICU)
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- The intensive care medicine research agenda for the management of ICU acquired weakness: a multinational, interprofessional perspective.Intensive care medicine · 2025Pooled it
- Individualising blood glucose control in ICU patients: evidence and practical implementations.Critical care (London, England) · 2026Review
- Multiple organ dysfunction syndrome: molecular mechanisms and therapeutic strategies.Signal transduction and targeted therapy · 2026Review
- Current concepts on feeding the critically ill patient: a narrative review.Critical care (London, England) · 2026Review
- Diabetes Management Strategies in Intensive Care Settings.The Medical clinics of North America · 2026Review
- Dietary interventions in acute kidney injury: From molecular mechanism to clinical trials.Experimental physiology · 2026Review
- Functional and muscle recovery after critical illness: current and future nutritional, physical and metabolic strategies.Annals of intensive care · 2026Review
- Ketogenic Nutrition in Combination With PPARα Activation Induced Metabolic Failure and Exacerbated Muscle Weakness in Septic Mice.Journal of cachexia, sarcopenia and muscle · 2025Article
- Ketogenic diet strategy in patients with sepsis: a multicentre prospective randomised interventional trial protocol.BMJ open · 2025Article
- Potential therapeutic benefit of exogenous ketone ester administration in delirium: a narrative review.Critical care (London, England) · 2025Review
- Early Sepsis Metabolic Changes in Kidney and Liver Precede Clinical Evidence of Organ Dysfunction.American journal of respiratory cell and molecular biology · 2025Article
- Unveiling Organ Failure in the Critically Ill: Insights through the Metabolite Lens.American journal of respiratory cell and molecular biology · 2025Article
- Review
- On how to feed critically ill children in intensive care: A slowly shifting paradigm.Clinical nutrition (Edinburgh, Scotland) · 2025Review
- Nutritional Strategies for the Treatment and Prevention of Sepsis Outside the Intensive Care Unit.Nutrients · 2024Review
- Nutritional Ketosis as a Therapeutic Approach in Critical Illness: A Systematic Review.Cureus · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 7 institutions in 1 country.
Funding
Abstract
Bioenergetic failure caused by impaired utilisation of glucose and fatty acids contributes to organ dysfunction across multiple tissues in critical illness. Ketone bodies may form an alternative substrate source, but the feasibility and safety of inducing a ketogenic state in physiologically unstable patients is not known. Twenty-nine mechanically ventilated adults with multi-organ failure managed on intensive care units were randomised (Ketogenic n = 14, Control n = 15) into a two-centre pilot open-label trial of ketogenic versus standard enteral feeding. The primary endpoints were assessment of feasibility and safety, recruitment and retention rates and achievement of ketosis and glucose control. Ketogenic feeding was feasible, safe, well tolerated and resulted in ketosis in all patients in the intervention group, with a refusal rate of 4.1% and 82.8% retention. Patients who received ketogenic feeding had fewer hypoglycaemic events (0.0% vs. 1.6%), required less exogenous international units of insulin (0 (Interquartile range 0-16) vs.78 (Interquartile range 0-412) but had slightly more daily episodes of diarrhoea (53.5% vs. 42.9%) over the trial period. Ketogenic feeding was feasible and may be an intervention for addressing bioenergetic failure in critically ill patients. Clinical Trials.gov registration: NCT04101071.
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.