Randomized Controlled Trial

. 2022 Feb 16;26(1):46.

doi: 10.1186/s13054-022-03921-5.

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Lu Ke^#^{1

2}, Jiajia Lin^#¹, Gordon S Doig³, Arthur R H van Zanten⁴, Yang Wang⁵, Juan Xing⁶, Zhongheng Zhang⁷, Tao Chen⁸, Lixin Zhou⁹, Dongpo Jiang¹⁰, Qindong Shi¹¹, Jiandong Lin¹², Jun Liu¹³, Aibin Cheng¹⁴, Yafeng Liang¹⁵, Peiyang Gao¹⁶, Junli Sun¹⁷, Wenming Liu¹⁸, Zhenyu Yang¹⁹, Rumin Zhang²⁰, Wei Xing²¹, An Zhang²², Zhigang Zhou²³, Tingfa Zhou²⁴, Yang Liu²⁵, Fei Tong²⁶, Qiuhui Wang²⁷, Aijun Pan²⁸, Xiaobo Huang²⁹, Chuming Fan³⁰, Weihua Lu³¹, Dongwu Shi³², Lei Wang³³, Wei Li³⁴, Liming Gu³⁵, Yingguang Xie³⁶, Rongqing Sun³⁷, Feng Guo³⁸, Lin Han³⁹, Lihua Zhou⁴⁰, Xiangde Zheng⁴¹, Feng Shan⁴², Jianbo Liu⁴³, Yuhang Ai⁴⁴, Yan Qu⁴⁵, Liandi Li⁴², Hailing Li⁴⁶, Zhiguo Pan⁴⁷, Donglin Xu⁴⁸, Zhiqiang Zou⁴⁹, Yan Gao⁵⁰, Chunli Yang⁵¹, Qiuye Kou⁵², Xijing Zhang⁵³, Jinglan Wu⁵⁴, Chuanyun Qian⁵⁵, Weixing Zhang⁵⁶, Minjie Zhang⁵⁷, Yuan Zong⁵⁸, Bingyu Qin⁵⁹, Fusen Zhang⁶⁰, Zhe Zhai⁶¹, Yun Sun⁶², Ping Chang⁶³, Bo Yu⁶⁴, Min Yu⁶⁵, Shiying Yuan⁶⁶, Yijun Deng⁶⁷, Liyun Zhao⁶⁸, Bin Zang⁶⁹, Yuanfei Li⁷⁰, Fachun Zhou⁷¹, Xiaomei Chen⁷², Min Shao⁷³, Weidong Wu⁷⁴, Ming Wu⁷⁵, Zhaohui Zhang⁷⁶, Yimin Li⁷⁷, Qiang Guo⁷⁸, Zhiyong Wang⁷⁹, Yuanqi Gong⁸⁰, Yunlin Song⁸¹, Kejian Qian⁸², Yongjian Feng⁸³, Baocai Fu⁸⁴, Xueyan Liu⁸⁵, Zhiping Li⁸⁶, Chuanyong Gong⁸⁷, Cheng Sun⁸⁸, Jian Yu⁸⁹, Zhongzhi Tang⁹⁰, Linxi Huang⁹¹, Biao Ma⁹², Zhijie He⁹³, Qingshan Zhou⁹⁴, Rongguo Yu⁹⁵, Zhihui Tong⁹⁶, Weiqin Li^{97

98}; Chinese Critcal Care Nutrition Trials Group (CCCNTG)

Collaborators, Affiliations

Collaborators

Chinese Critcal Care Nutrition Trials Group (CCCNTG):
Lu Ke, Jiajia Lin, Zhihui Tong, Weiqin Li, Yang Wang, Juan Xing, Zhongheng Zhang, Feng Guo, Tao Chen, Lixin Zhou, Dongpo Jiang, Qindong Shi, Jiandong Lin, Jun Liu, Aibin Cheng, Yafeng Liang, Peiyang Gao, Junli Sun, Wenming Liu, Zhenyu Yang, Rumin Zhang, Wei Xing, An Zhang, Zhigang Zhou, Tingfa Zhou, Yang Liu, Fei Tong, Qiuhui Wang, Aijun Pan, Xiaobo Huang, Chuming Fan, Weihua Lu, Dongwu Shi, Lei Wang, Wei Li, Liming Gu, Yingguang Xie, Rongqing Sun, Lin Han, Lihua Zhou, Xiangde Zheng, Feng Shan, Liandi Li, Jianbo Liu, Yuhang Ai, Yan Qu, Hailing Li, Zhiguo Pan, Donglin Xu, Zhiqiang Zou, Yan Gao, Chunli Yang, Qiuye Kou, Xijing Zhang, Jinglan Wu, Chuanyun Qian, Weixing Zhang, Minjie Zhang, Yongjian Feng, Yuan Zong, Bingyu Qin, Fusen Zhang, Zhe Zhai, Yun Sun, Ping Chang, Bo Yu, Min Yu, Shiying Yuan, Yijun Deng, Liyun Zhao, Bin Zang, Yuanfei Li, Fachun Zhou, Xiaomei Chen, Min Shao, Weidong Wu, Ming Wu, Zhaohui Zhang, Yimin Li, Qiang Guo, Zhiyong Wang, Yuanqi Gong, Yunlin Song, Kejian Qian, Baocai Fu, Xueyan Liu, Zhiping Li, Chuanyong Gong, Cheng Sun, Jian Yu, Zhongzhi Tang, Linxi Huang, Biao Ma, Zhijie He, Qingshan Zhou, Rongguo Yu

Affiliations

¹ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210000, Jiangsu Province, China.
² National Institute of Healthcare Data Science, Nanjing University, Nanjing, China.
³ Northern Clinical School, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
⁴ Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands.
⁵ Department of Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁶ Benq Medical Center, Nanjing, China.
⁷ Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁸ Tropical Clinical Trials Unit, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
⁹ First People's Hospital of Foshan, Foshan, China.
¹⁰ Daping Hospital, Army Medical University, Chongqing, China.
¹¹ First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China.
¹² First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
¹³ Suzhou Municipal Hospital, Suzhou, China.
¹⁴ North China University of Science and Technology Affiliated Hospital, Tangshan, China.
¹⁵ Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China.
¹⁶ Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, China.
¹⁷ Luoyang Central Hospital Affiliated To Zhengzhou University, Luoyang, China.
¹⁸ Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China.
¹⁹ The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
²⁰ Zibo Central Hospital, Zibo, China.
²¹ Department of Intensive Care Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.
²² The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²³ First People's Hospital of Kunming, Kunming, China.
²⁴ Linyi City People Hospital, Shandong, China.
²⁵ Tangshan Gongren Hospital, Tangshan, China.
²⁶ Hebei Medical University Second Affiliated Hospital, Shijiazhuang, China.
²⁷ Wuxi People's Hospital, Wuxi, China.
²⁸ Anhui Provincial Hospital, Hefei, China.
²⁹ Department of Critical Care Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
³⁰ First People's Hospital of Yunnan, Kunming, China.
³¹ Yijishan Hospital of Wannan Medical College, Wuhu, China.
³² Shanxi Provincial People's Hospital, Taiyuan, China.
³³ Shanxi Medical University First Affiliated Hospital, Taiyuan, China.
³⁴ The People's Hospital of Fujian Province, Fuzhou, China.
³⁵ People's Hospital of Yuxi City, Yuxi, China.
³⁶ Jining First People's Hospital, Jining, China.
³⁷ The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³⁸ Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³⁹ People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
⁴⁰ Affiliated Hospital of Inner Mongolia Medical College, Huhehaote, China.
⁴¹ Dazhou Central Hospital, Dazhou, China.
⁴² Qindao University Medical College Affiliated Hospital, Qindao, China.
⁴³ Inner Mongolia People's Hospital, Huhehaote, China.
⁴⁴ Xiangya Hospital Central South University, Changsha, China.
⁴⁵ Qingdao Municipal Hospital Group, Qingdao, China.
⁴⁶ No.971 Hospital of People's Liberation Army Navy, Qingdao, China.
⁴⁷ General Hospital of Southern Theatre Command, Guangzhou, China.
⁴⁸ Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
⁴⁹ Union Hospital of Fujian Medical University, Fuzhou, China.
⁵⁰ The General Hospital of Shenyang Military, Shenyan, China.
⁵¹ Jiangxi Provincial People's Hospital, Nanchang, China.
⁵² The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
⁵³ Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
⁵⁴ Shenzhen Nanshan People's Hospital, Shenzhen, China.
⁵⁵ Kuming Medical University First Affiliated Hospital, Kuming, China.
⁵⁶ Peking University Shenzhen Hospital, Guandong, China.
⁵⁷ General ICU, Jinan University First Affiliated Hospital, Jinan, China.
⁵⁸ Shaanxi Provincial People's Hospital, Xi'an, China.
⁵⁹ Henan Provincial People's Hospital, Zhengzhou, China.
⁶⁰ Tai'an City Central Hospital, Tai'an, China.
⁶¹ The Fourth Hospital of Harbin Medical University, Harbin, China.
⁶² Anhui Medical University Second Affiliated Hospital, Hefei, China.
⁶³ Southern Medical University Zhujiang Hospital, Guangzhou, China.
⁶⁴ Department of Critical Care Medicine, the Second Xiangya Hospital of Central South University, Changsha, 410000, Hunan, China.
⁶⁵ First People's Hospital of Yichang, Yichang, China.
⁶⁶ Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
⁶⁷ Yancheng First People's Hospital, Yancheng, China.
⁶⁸ Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China.
⁶⁹ China Medical University Affiliated Shengjing Hospital, Shenyang, China.
⁷⁰ Changsha Central Hospital Affiliated to University of South China, Changsha, China.
⁷¹ Chongqing Medical University First Affiliated Hospital, Chongqing, China.
⁷² Department of Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
⁷³ The First Affiliated Hospital of Anhui Medical University, Hefei, China.
⁷⁴ Shanxi Bethune Hospital, Taiyuan, China.
⁷⁵ Health Science Center, The Second People's Hospital of Shenzhen, First Affiliated Hospital of Shenzhen University, Shenzhen, China.
⁷⁶ Yichang Central People's Hospital, Yichang, China.
⁷⁷ First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁷⁸ First Affiliated Hospital of Soochow University, Suzhou, China.
⁷⁹ Hebei Medical University, Third Affiliated Hospital, Shijiazhuang, China.
⁸⁰ The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
⁸¹ The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
⁸² The First Affiliated Hospital of Nanchang University, Jiangxi, China.
⁸³ Neurosurgical ICU, Jinan University First Affiliated Hospital, Jinan, China.
⁸⁴ Yantai Mountain Hospital, Yantai, China.
⁸⁵ Shenzhen People's Hospital, Shenzhen, China.
⁸⁶ Hunan Provincial People's Hospital, Changsha, China.
⁸⁷ Tianjing Hospital of Integration of Chinese and Western Medicine, Tianjing, China.
⁸⁸ Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁸⁹ The Second Hospital of Dalian Medical University, Liaoning, China.
⁹⁰ Wuhan General Hospital of Guangzhou Military Region, Wuhan, China.
⁹¹ Shantou University Medical College First Affiliated Hospital, Shantou, China.
⁹² Jining Medical College Affiliated Hospital, Jining, China.
⁹³ Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
⁹⁴ Hubei Provincial People's Hospital, Wuhan, China.
⁹⁵ Fujian Provincial Hospital, Fujian, China.
⁹⁶ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210000, Jiangsu Province, China. njzyantol@hotmail.com.
⁹⁷ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210000, Jiangsu Province, China. ctgchina@medbit.cn.
⁹⁸ National Institute of Healthcare Data Science, Nanjing University, Nanjing, China. ctgchina@medbit.cn.

^# Contributed equally.

PMID: 35172856
PMCID: PMC8848648
DOI: 10.1186/s13054-022-03921-5

Randomized Controlled Trial

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Lu Ke et al. Crit Care. 2022.

. 2022 Feb 16;26(1):46.

doi: 10.1186/s13054-022-03921-5.

Authors

Collaborators

Chinese Critcal Care Nutrition Trials Group (CCCNTG):
Lu Ke, Jiajia Lin, Zhihui Tong, Weiqin Li, Yang Wang, Juan Xing, Zhongheng Zhang, Feng Guo, Tao Chen, Lixin Zhou, Dongpo Jiang, Qindong Shi, Jiandong Lin, Jun Liu, Aibin Cheng, Yafeng Liang, Peiyang Gao, Junli Sun, Wenming Liu, Zhenyu Yang, Rumin Zhang, Wei Xing, An Zhang, Zhigang Zhou, Tingfa Zhou, Yang Liu, Fei Tong, Qiuhui Wang, Aijun Pan, Xiaobo Huang, Chuming Fan, Weihua Lu, Dongwu Shi, Lei Wang, Wei Li, Liming Gu, Yingguang Xie, Rongqing Sun, Lin Han, Lihua Zhou, Xiangde Zheng, Feng Shan, Liandi Li, Jianbo Liu, Yuhang Ai, Yan Qu, Hailing Li, Zhiguo Pan, Donglin Xu, Zhiqiang Zou, Yan Gao, Chunli Yang, Qiuye Kou, Xijing Zhang, Jinglan Wu, Chuanyun Qian, Weixing Zhang, Minjie Zhang, Yongjian Feng, Yuan Zong, Bingyu Qin, Fusen Zhang, Zhe Zhai, Yun Sun, Ping Chang, Bo Yu, Min Yu, Shiying Yuan, Yijun Deng, Liyun Zhao, Bin Zang, Yuanfei Li, Fachun Zhou, Xiaomei Chen, Min Shao, Weidong Wu, Ming Wu, Zhaohui Zhang, Yimin Li, Qiang Guo, Zhiyong Wang, Yuanqi Gong, Yunlin Song, Kejian Qian, Baocai Fu, Xueyan Liu, Zhiping Li, Chuanyong Gong, Cheng Sun, Jian Yu, Zhongzhi Tang, Linxi Huang, Biao Ma, Zhijie He, Qingshan Zhou, Rongguo Yu

Affiliations

¹ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210000, Jiangsu Province, China.
² National Institute of Healthcare Data Science, Nanjing University, Nanjing, China.
³ Northern Clinical School, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
⁴ Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands.
⁵ Department of Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁶ Benq Medical Center, Nanjing, China.
⁷ Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁸ Tropical Clinical Trials Unit, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
⁹ First People's Hospital of Foshan, Foshan, China.
¹⁰ Daping Hospital, Army Medical University, Chongqing, China.
¹¹ First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China.
¹² First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
¹³ Suzhou Municipal Hospital, Suzhou, China.
¹⁴ North China University of Science and Technology Affiliated Hospital, Tangshan, China.
¹⁵ Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China.
¹⁶ Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, China.
¹⁷ Luoyang Central Hospital Affiliated To Zhengzhou University, Luoyang, China.
¹⁸ Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China.
¹⁹ The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
²⁰ Zibo Central Hospital, Zibo, China.
²¹ Department of Intensive Care Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.
²² The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²³ First People's Hospital of Kunming, Kunming, China.
²⁴ Linyi City People Hospital, Shandong, China.
²⁵ Tangshan Gongren Hospital, Tangshan, China.
²⁶ Hebei Medical University Second Affiliated Hospital, Shijiazhuang, China.
²⁷ Wuxi People's Hospital, Wuxi, China.
²⁸ Anhui Provincial Hospital, Hefei, China.
²⁹ Department of Critical Care Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
³⁰ First People's Hospital of Yunnan, Kunming, China.
³¹ Yijishan Hospital of Wannan Medical College, Wuhu, China.
³² Shanxi Provincial People's Hospital, Taiyuan, China.
³³ Shanxi Medical University First Affiliated Hospital, Taiyuan, China.
³⁴ The People's Hospital of Fujian Province, Fuzhou, China.
³⁵ People's Hospital of Yuxi City, Yuxi, China.
³⁶ Jining First People's Hospital, Jining, China.
³⁷ The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³⁸ Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³⁹ People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
⁴⁰ Affiliated Hospital of Inner Mongolia Medical College, Huhehaote, China.
⁴¹ Dazhou Central Hospital, Dazhou, China.
⁴² Qindao University Medical College Affiliated Hospital, Qindao, China.
⁴³ Inner Mongolia People's Hospital, Huhehaote, China.
⁴⁴ Xiangya Hospital Central South University, Changsha, China.
⁴⁵ Qingdao Municipal Hospital Group, Qingdao, China.
⁴⁶ No.971 Hospital of People's Liberation Army Navy, Qingdao, China.
⁴⁷ General Hospital of Southern Theatre Command, Guangzhou, China.
⁴⁸ Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
⁴⁹ Union Hospital of Fujian Medical University, Fuzhou, China.
⁵⁰ The General Hospital of Shenyang Military, Shenyan, China.
⁵¹ Jiangxi Provincial People's Hospital, Nanchang, China.
⁵² The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
⁵³ Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
⁵⁴ Shenzhen Nanshan People's Hospital, Shenzhen, China.
⁵⁵ Kuming Medical University First Affiliated Hospital, Kuming, China.
⁵⁶ Peking University Shenzhen Hospital, Guandong, China.
⁵⁷ General ICU, Jinan University First Affiliated Hospital, Jinan, China.
⁵⁸ Shaanxi Provincial People's Hospital, Xi'an, China.
⁵⁹ Henan Provincial People's Hospital, Zhengzhou, China.
⁶⁰ Tai'an City Central Hospital, Tai'an, China.
⁶¹ The Fourth Hospital of Harbin Medical University, Harbin, China.
⁶² Anhui Medical University Second Affiliated Hospital, Hefei, China.
⁶³ Southern Medical University Zhujiang Hospital, Guangzhou, China.
⁶⁴ Department of Critical Care Medicine, the Second Xiangya Hospital of Central South University, Changsha, 410000, Hunan, China.
⁶⁵ First People's Hospital of Yichang, Yichang, China.
⁶⁶ Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
⁶⁷ Yancheng First People's Hospital, Yancheng, China.
⁶⁸ Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China.
⁶⁹ China Medical University Affiliated Shengjing Hospital, Shenyang, China.
⁷⁰ Changsha Central Hospital Affiliated to University of South China, Changsha, China.
⁷¹ Chongqing Medical University First Affiliated Hospital, Chongqing, China.
⁷² Department of Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
⁷³ The First Affiliated Hospital of Anhui Medical University, Hefei, China.
⁷⁴ Shanxi Bethune Hospital, Taiyuan, China.
⁷⁵ Health Science Center, The Second People's Hospital of Shenzhen, First Affiliated Hospital of Shenzhen University, Shenzhen, China.
⁷⁶ Yichang Central People's Hospital, Yichang, China.
⁷⁷ First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁷⁸ First Affiliated Hospital of Soochow University, Suzhou, China.
⁷⁹ Hebei Medical University, Third Affiliated Hospital, Shijiazhuang, China.
⁸⁰ The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
⁸¹ The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
⁸² The First Affiliated Hospital of Nanchang University, Jiangxi, China.
⁸³ Neurosurgical ICU, Jinan University First Affiliated Hospital, Jinan, China.
⁸⁴ Yantai Mountain Hospital, Yantai, China.
⁸⁵ Shenzhen People's Hospital, Shenzhen, China.
⁸⁶ Hunan Provincial People's Hospital, Changsha, China.
⁸⁷ Tianjing Hospital of Integration of Chinese and Western Medicine, Tianjing, China.
⁸⁸ Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁸⁹ The Second Hospital of Dalian Medical University, Liaoning, China.
⁹⁰ Wuhan General Hospital of Guangzhou Military Region, Wuhan, China.
⁹¹ Shantou University Medical College First Affiliated Hospital, Shantou, China.
⁹² Jining Medical College Affiliated Hospital, Jining, China.
⁹³ Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
⁹⁴ Hubei Provincial People's Hospital, Wuhan, China.
⁹⁵ Fujian Provincial Hospital, Fujian, China.
⁹⁶ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210000, Jiangsu Province, China. njzyantol@hotmail.com.
⁹⁷ Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210000, Jiangsu Province, China. ctgchina@medbit.cn.
⁹⁸ National Institute of Healthcare Data Science, Nanjing University, Nanjing, China. ctgchina@medbit.cn.

^# Contributed equally.

PMID: 35172856
PMCID: PMC8848648
DOI: 10.1186/s13054-022-03921-5

Erratum in

Correction to: Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.
Ke L, Lin J, Doig GS, van Zanten ARH, Wang Y, Xing J, Zhang Z, Chen T, Zhou L, Jiang D, Shi Q, Lin J, Liu J, Cheng A, Liang Y, Gao P, Sun J, Liu W, Yang Z, Zhang R, Xing W, Zhang A, Zhou Z, Zhou T, Liu Y, Tong F, Wang Q, Pan A, Huang X, Fan C, Lu W, Shi D, Wang L, Li W, Gu L, Xie Y, Sun R, Guo F, Han L, Zhou L, Zheng X, Shan F, Liu J, Ai Y, Qu Y, Li L, Li H, Pan Z, Xu D, Zou Z, Gao Y, Yang C, Kou Q, Zhang X, Wu J, Qian C, Zhang W, Zhang M, Zong Y, Qin B, Zhang F, Zhai Z, Sun Y, Chang P, Yu B, Yu M, Yuan S, Deng Y, Zhao L, Zang B, Li Y, Zhou F, Chen X, Shao M, Wu W, Wu M, Zhang Z, Li Y, Guo Q, Wang Z, Gong Y, Song Y, Qian K, Feng Y, Fu B, Liu X, Li Z, Gong C, Sun C, Yu J, Tang Z, Huang L, Ma B, He Z, Zhou Q, Yu R, Tong Z, Li W; Chinese Critical Care Nutrition Trials Group (CCCNTG). Ke L, et al. Crit Care. 2022 Apr 21;26(1):115. doi: 10.1186/s13054-022-03982-6. Crit Care. 2022. PMID: 35449019 Free PMC article. No abstract available.

Abstract

Background: Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes.

Methods: We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment.

Results: Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups.

Conclusions: In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness.

Trial registration: ISRCTN, ISRCTN12233792 . Registered November 20th, 2017.

Keywords: Cluster-randomized trial; Evidence-based guideline; Intensive care unit; Nutrition therapy.

PubMed Disclaimer

Conflict of interest statement

Dr. Gordon S. Doig reported receiving academic research grants related to nutrition in critical illness from the Australian National Health and Medical Research Council, Fresenius Kabi Deutschland GmbH and Baxter Healthcare Pty Ltd and speakers honoraria from Fresenius Kabi Deutschland GmbH, Baxter Healthcare Australia, Pty Ltd, Nestle Healthcare, Vevy, Switzerland and Nutricia Pharmaceutical (Wuxi) Co., Ltd. China. Dr. van Zanten reports personal fees from Baxter, personal fees from Nestle, personal fees from Fresenius Kabi, grants and personal fees from Nutricia, grants from Cardinal Health, grants from Mermaid, grants from Lyric, outside the submitted work. Dr. Weiqin Li reported receiving speakers honoraria from Nutricia Pharmaceutical (Wuxi) Co., Ltd. China. The remaining authors have disclosed that they do not have any conflicts of interest.

Figures

**Fig. 1**
Evidence-based feeding guideline. A algorithm of the evidence-based feeding guideline. Feeding intolerance evaluation was implemented using the feeding intolerance score (Additional file 2: Table S1). GI denotes gastrointestinal, AGI denotes acute gastrointestinal injury, PN denotes parenteral nutrition, EN denotes enteral nutrition, and FIS denotes feeding intolerance score. B treatment of feeding intolerance. WBC denotes white blood cells, RBC denotes red blood cells, CD denotes *Clostridium difficile*, and D/C denotes discontinue

**Fig. 2**
The flow of clusters (ICUs) and participants (patients) through the trial. ICU denotes intensive care unit

**Fig. 3**
Nutritional support within the first seven days after enrollment. Error bars indicate test-based 95% confidence intervals (adjusted for cluster effect). a Proportion of patients receiving enteral and/or parenteral nutrition. P > 0.05 (adjusted for cluster effect) between feeding protocol and control groups at each day from day 1 to day 7. b Proportion of patients receiving enteral nutrition. P < 0.05 (adjusted for cluster effect) between feeding protocol and control groups at each day within seven days of enrollment except day 1. c Proportion of patients receiving parenteral nutrition P < 0.05 (adjusted for cluster effect) between feeding protocol and control groups at each day within seven days of enrollment

See this image and copyright information in PMC

References

1. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) JPEN J Parenter Enteral Nutr. 2016;40(2):159–211. doi: 10.1177/0148607115621863. - DOI - PubMed
1. Reintam Blaser A, Starkopf J, Alhazzani W, Berger MM, Casaer MP, Deane AM, Fruhwald S, Hiesmayr M, Ichai C, Jakob SM, et al. Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med. 2017;43(3):380–398. doi: 10.1007/s00134-016-4665-0. - DOI - PMC - PubMed
1. Doig GS, Simpson F, Finfer S, Delaney A, Davies AR, Mitchell I, Dobb G. Nutrition Guidelines Investigators of the ACTG: Effect of evidence-based feeding guidelines on mortality of critically ill adults: a cluster randomized controlled trial. JAMA. 2008;300(23):2731–2741. doi: 10.1001/jama.2008.826. - DOI - PubMed
1. Heyland DK, Murch L, Cahill N, McCall M, Muscedere J, Stelfox HT, Bray T, Tanguay T, Jiang X, Day AG. Enhanced protein-energy provision via the enteral route feeding protocol in critically ill patients: results of a cluster randomized trial. Crit Care Med. 2013;41(12):2743–2753. doi: 10.1097/CCM.0b013e31829efef5. - DOI - PubMed
1. Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ. Southwestern Ontario Critical Care Research N: Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT) CMAJ. 2004;170(2):197–204. - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

BE2015685/Jiangsu Provincial Key Research and Development Program

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Collaborators

Affiliations

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Authors

Collaborators

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials