title: The effect of augmenting early nutritional energy delivery on quality of life and employment status one year after ICU admission.
abstract: Augmenting energy delivery during the acute phase of critical illness may reduce mortality and improve functional outcomes. The objective of this sub-study was to evaluate the effect of early augmented enteral nutrition (EN) during critical illness, on outcomes one year later. We performed prospective longitudinal evaluation of study participants, initially enrolled in The Augmented versus Routine approach to Giving Energy Trial (TARGET), a feasibility study that randomised critically ill patients to 1.5 kcal/ml (augmented) or 1.0 kcal/ml (routine) EN administered at the same rate for up to ten days, who were alive at one year. One year after randomisation Short Form-36 version 2 (SF-36v2) and EuroQol-5D-5L quality of life surveys, and employment status were assessed via telephone survey. At one year there were 71 survivors (1.5 kcal/ml 38 versus 1.0 kcal/ml 33; P=0.55). Thirty-nine (55%) patients consented to this follow-up study and completed the surveys (n = 23 and 16, respectively). The SF-36v2 physical and mental component summary scores were below normal population means but were similar in 1.5 kcal/ml and 1.0 kcal/ml groups (P=0.90 and P=0.71). EuroQol-5D-5L data were also comparable between groups (P=0.70). However, at one-year follow-up, more patients who received 1.5 kcal/ml were employed (7 versus 2; P=0.022). The delivery of 1.5 kcal/ml for a maximum of ten days did not affect self-rated quality of life one year later.
authors.affiliation: Intensive Care Registrar, Royal Adelaide Hospital, Adelaide, South Australia.
authors.forename: D B
authors.initials: DB
authors.lastname: Reid
authors.affiliation: Department of Anaesthesia, Princess Alexandra Hospital, Brisbane, Queensland.
authors.forename: L S
authors.initials: LS
authors.lastname: Chapple
authors.affiliation: Research Manager, Intensive Care Unit, Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, South Australia.
authors.forename: S N
authors.initials: SN
authors.lastname: O'Connor
authors.affiliation: Intensive Care Consultant, Austin Hospital, Melbourne, Victoria.
authors.forename: R
authors.initials: R
authors.lastname: Bellomo
authors.affiliation: Research Manager, Intensive Care Service, Royal Prince Alfred Hospital, Sydney, New South Wales.
authors.forename: H
authors.initials: H
authors.lastname: Buhr
authors.affiliation: Director of Research, Department of Intensive Care Medicine, Royal Adelaide Hospital, Discipline of Acute Care Medicine, University of Adelaide, Adelaide, South Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Chapman
authors.affiliation: Research Fellow, Department of Epidemiology and Preventative Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria.
authors.forename: A R
authors.initials: AR
authors.lastname: Davies
authors.affiliation: Research Manager, Department of Intensive Care, Austin Hospital, Melbourne, Victoria.
authors.forename: G M
authors.initials: GM
authors.lastname: Eastwood
authors.affiliation: Critical Care Dietitian, Intensive Care Service, Royal Prince Alfred Hospital, Sydney, New South Wales.
authors.forename: S
authors.initials: S
authors.lastname: Ferrie
authors.affiliation: Biostatistician, Discipline of Medicine, University of Adelaide, Adelaide, South Australia.
authors.forename: K
authors.initials: K
authors.lastname: Lange
authors.affiliation: Research Coordinator, Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Adelaide, South Australia.
authors.forename: J
authors.initials: J
authors.lastname: McIntyre
authors.affiliation: Medical Director, Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Needham
authors.affiliation: Senior Intensive Care Clinician, Discipline of Acute Care Medicine, University of Adelaide, Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Adelaide, South Australia.
authors.forename: S L
authors.initials: SL
authors.lastname: Peake
authors.affiliation: Intensive Care Specialist, The Canberra Hospital, Canberra, Australian Capital Territory.
authors.forename: S
authors.initials: S
authors.lastname: Rai
authors.affiliation: Nutrition Program Manager, Department of Epidemiology and Preventative Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria.
authors.forename: E J
authors.initials: EJ
authors.lastname: Ridley
authors.affiliation: Research Coordinator, The Canberra Hospital, Canberra, Australian Capital Territory.
authors.forename: H
authors.initials: H
authors.lastname: Rodgers
authors.affiliation: Department of Intensive Care Medicine, Royal Adelaide Hospital, Discipline of Acute Care Medicine, University of Adelaide, Adelaide, South Australia.
authors.forename: A M
authors.initials: AM
authors.lastname: Deane
mesh_terms: D016638:Critical Illness; D003625:Data Collection; D004651:Employment / Q000706:statistics & numerical data*; D004750:Enteral Nutrition / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors
keywords: critical illness; disability; nutrition; post–intensive care syndrome; quality of life