Nutrition and Feeding Optimization with smART+ System
Trial question
What is the role of controlled enteral nutrition with the smART+ platform in critically ill patients?
Study design
Single center
Open label
RCT
Population
100 patients.
Inclusion criteria: adult critically ill patients who were mechanically ventilated and enterally fed.
Key exclusion criteria: imminent death; pregnancy; abnormalities of the feeding canal from nose/mouth to stomach.
Interventions
N=50 smART+ platform (utilizing the smART+ system to provide feeding optimization to the patient).
N=50 usual care (nutrition regulation according to local standard of care).
Primary outcome
Rate of mean feeding deviation from daily targeted nutrition between days 2-14
10.5%
34.3%
34.3 %
25.7 %
17.1 %
8.6 %
0.0 %
SmART+
platform
Usual
care
Significant
decrease ▼
NNT = 4
Significant decrease in the rate of mean feeding deviation from daily targeted nutrition between days 2-14 (10.5% vs. 34.3%; RR 0.31, 95% CI 0.16 to 0.46).
Secondary outcomes
Significant decrease in length of stay in the ICU (10.4 days vs. 13.7 days; HR 0.58, 95% CI 0.38 to 0.88).
Significant decrease in length of ventilation (9.5 days vs. 12.8 days; HR 0.6, 95% CI 0.39 to 0.92).
Significant increase in feeding delivery within 90-110% of target (75.7% vs. 23.3%; RR 3.25, 95% CI 1.63 to 4.87).
Safety outcomes
No significant differences in erythromycin and noradrenaline use, death in the ICU.
Significant difference in metoclopramide use (2 days vs. 25 days).
Conclusion
In adult critically ill patients who were mechanically ventilated and enterally fed, smART+ platform was superior to usual care with respect to the rate of mean feeding deviation from daily targeted nutrition between days 2-14.
Reference
Ilya Kagan, Moran Hellerman-Itzhaki, Itai Bendavid et al. Controlled enteral nutrition in critical care patients - A randomized clinical trial of a novel management system. Clin Nutr. 2023 Sep;42(9):1602-1609.
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