Early Versus Delayed Enteral Nutrition in Mechanically Ventilated Patients with Circulatory Shock: A Prospective Multicenter, Multi-National Cohort Study
Bibliographic record
Abstract
Abstract Introduction: Real-world evidence on the timing and efficacy of enteral nutrition (EN) practices in Intensive Care Unit (ICU) patients with circulatory shock are limited. We hypothesized early EN (EEN), as compared to delayed EN (DEN), is associated with improved clinical outcomes in mechanically ventilated (MV) patients with circulatory shock. Methods: We analyzed a dataset from an international, multicenter randomized clinical trial (RCT) evaluating protein dose in ICU patients. EEN was defined as initiating <48 hours from ICU admission and DEN >48 hours. We identified MV patients in circulatory shock to evaluate the association between the timing of EN initiation and clinical outcomes. Results: We included 626 patients. Median age was 60 years [18-93], 55% had septic shock, 99% received norepinephrine alone and 91% received EN alone. Forty-two percent of EEN patients had persistent organ dysfunction syndrome-plus death at day 28, compared to 53% in the DEN group (p=0.04) (adjusted OR 0.60, 95% confidence intervals, 0.38-0.93, p=0.02). EEN was associated with more ICU-free days (9.3±9.2 vs. 5.7±7.9, p=0.0002), more days alive and free of vasopressors (7.1±3.1 vs. 6.3±3.2, p=0.007), and shorter duration of MV among survivors (9.8±10.9 vs. 13.8±14.5, p=0.0002). There were no differences in ICU/60-day mortality or feeding intolerance rates between groups.Conclusion: In MV patients with circulatory shock, EEN, as compared to DEN, was associated with improved clinical outcomes. RCTs comparing the efficacy of EEN to DEN in MV patients with circulatory shock are warranted.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".