Energy balance
Higher cumulative energy intake (caloric dose) during the first week of ICU stay is inversely associated with recovery speed; the lowest caloric doses are associated with the fastest recovery.
When managing nutrition in the first week of critical illness, aiming for high caloric targets is counterproductive. Data shows a linear relationship where higher calorie intake leads to slower recovery. Clinicians should prioritize tolerating lower caloric intakes (hypocaloric feeding) rather than aggressively pushing calories, as this is associated with faster ICU discharge.
The lowest dose of macronutrients was associated with the fastest recovery and any higher dose, administered parenterally or enterally, was associated with progressively more delayed recovery.
Why this rating
Observational analysis within a large RCT, showing a linear, progressive inverse relationship across multiple time points (Days 3, 5, 7).
Source
Role of Disease and Macronutrient Dose in the Randomized Controlled EPaNIC Trial
Michaël P. Casaer et al. · American Journal of Respiratory and Critical Care Medicine · 2012
DOI 10.1164/rccm.201206-0999oc
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