***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND & AIMS Adverse consequences may be experienced by critically ill patients who are underfed during their stay in the intensive care unit . The objective of this study is to determine the prevalence of iatrogenic underfeeding ( receiving < 80 % of prescribed energy requirements ) and the variation of these rates in different geographic regions of the world and in different nutritionally ' at-risk ' patient population s. METHODS This was a prospect i ve , multi-institutional study in 201 units from 26 countries . We included 3390 mechanically ventilated patients who remained in the unit and received artificial nutrition for at least 96 h. We report time to start of enteral nutrition and % nutrition received in various geographic regions of the world and we focus on subgroups of ' high risk ' patients ( those with > 7 days of mechanical ventilation , body mass index of < 25 or ≥35 , and those with a Nutrition Risk In the Critically ill ( NUTRIC ) score of ≥5 ) . We report rates of novel enteral nutrition delivery techniques and supplemental parenteral nutrition in these high risk patients . RESULTS On average , enteral feedings were started 38.8 h ( st and ard deviation : 39.6 ) after admission , patients received 61.2 % of calories and 57.6 % of protein prescribed , and 74.0 % of patients failed to meet the quality metric of receiving at least 80 % of energy targets . There were significant differences in nutrition outcomes across different geographic regions . There were no clinical ly important differences in nutrition outcomes or rates of iatrogenic underfeeding in patients in different BMI groups nor by NUTRIC score . Of all at-risk patients , 14 % were ever prescribed volume-based feeds , and 15 % of patients ever received supplemental parenteral nutrition . CONCLUSIONS Worldwide , the majority of critically ill patients , including high nutritional risk patients , fail to receive adequate nutritional intake . There is low uptake of strategies design ed to optimize nutrition delivery in these patients This document represents the first collaboration between 2 organizations — the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine — to describe best practice s in nutrition therapy in critically ill children . The target of these guidelines is intended to be the pediatric critically ill patient ( > 1 month and 2–3 days in a PICU admitting medical , surgical , and cardiac patients . In total , 2032 citations were scanned for relevance . The PubMed / MEDLINE search result ed in 960 citations for clinical trials and 925 citations for cohort studies . The EMBASE search for clinical trials culled 1661 citations . In total , the search for clinical trials yielded 1107 citations , whereas the cohort search yielded 925 . After careful review , 16 r and omized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline . We used the GRADE criteria ( Grading of Recommendations , Assessment , BACKGROUND There are many nutrition screening tools currently being applied in hospitals to identify risk of malnutrition . However , multivariate statistical models are not usually employed to take into account the importance of each variable included in the instrument 's development . OBJECTIVE To develop and evaluate the concurrent and predictive validities of a new screening tool of nutrition risk . METHODS A prospect i ve cohort study was developed , in which  4 nutrition screening tools were applied to all patients .  Length of stay in hospital and mortality were considered to test the predictive validity , and the concurrent validity was tested by comparing the Nuritional Risk in Emergency (NRE)-2017 to the other tools . RESULTS A total of 748 patients were included . The final NRE-2017 score was composed of 6 questions ( advanced age , metabolic stress of the disease , decreased appetite , changing of food consistency , unintentional weight loss , and muscle mass loss ) with answers yes or no. The prevalence of nutrition risk was 50.7 % and 38.8 % considering the cutoff points 1.0 and 1.5 , respectively . The NRE-2017 showed a satisfactory power to indentify risk of malnutrition ( area under the curve > 0.790 for all analyses ) . According to the NRE-2017 , patients at risk of malnutrition have twice as high relative risk of a very long hospital stay . The hazard ratio for mortality was 2.78 ( 1.03 - 7.49 ) when the cutoff adopted by the NRE-2017 was 1.5 points . CONCLUSION NRE-2017 is a new , easy-to-apply nutrition screening tool which uses 6 bi-categoric features to detect the risk of malnutrition , and it presented a good concurrent and predictive validity Objective : To examine the association between short-term nutritional adequacy received while in the ICU and long-term outcomes including 6-month survival and health-related quality of life in critically ill patients requiring prolonged mechanical ventilation . Design : Retrospective analysis of data prospect ively collected in the context of a multicenter r and omized controlled trial . Setting : An international sample of ICUs . Patients : Adult patients who were mechanically ventilated for more than 8 days in the ICU . Interventions : None . Measurements and Main Results :  Nutritional  adequacy was obtained from the average proportion of prescribed calories received over the amount prescribed during the first 8 days . Survival status and health-related quality of life as assessed using the Short-Form 36 v2 were obtained at 3- and 6 months post ICU admission . Of the 1,223 patients enrolled in the r and omized controlled trial , 475 met the inclusion criteria for this study . At 6-month follow-up , 302 of the 475 patients ( 64 % ) were alive . Survival time in those who received low nutritional adequacy was significantly shorter than those who received high nutritional adequacy while adjusting for important covariates ( adjusted hazard ratio , 1.7 ; 95 % CI , 1.1–2.6 ) . At 3-month follow-up , a 25 % increase in nutritional adequacy was associated with improvements in Physical Functioning and Role Physical of 7.3 ( p = 0.02 ) and 8.3 ( p = 0.004 ) points , respectively . At 6-month follow-up , adjusted increases in Physical Functioning and Role Physical scores for every 25 % increase in nutrition adequacy became smaller and were no longer statistically significant ( adjusted estimate for Physical Functioning = 4.2 , p = 0.14 ; for Role Physical = 3.2 , p = 0.25 ) . Conclusions : Greater amounts of nutritional intake received during the first week in the ICU were associated with longer survival time and faster physical recovery to 3 months but not 6 months post ICU discharge in critically ill patients requiring prolonged mechanical ventilation . Current recommendations to underfeed critically ill patients may cause harm in some long-stay patients BACKGROUND Enteral nutrition ( EN ) is recommended for patients in the intensive-care unit ( ICU ) , but it does not consistently achieve nutritional goals . We assessed whether delivery of 100 % of the energy target from days 4 to 8 in the ICU with EN plus supplemental parenteral nutrition ( SPN ) could optimise clinical outcome . METHODS This r and omised controlled trial was undertaken in two centres in Switzerl and . We enrolled patients on day 3 of admission to the ICU who had received less than 60 % of their energy target from EN , were expected to stay for longer than 5 days , and to survive for longer than 7 days . We calculated energy targets with indirect calorimetry on day 3 , or if not possible , set targets as 25 and 30 kcal per kg of ideal bodyweight a day for women and men , respectively . Patients were r and omly assigned ( 1:1 ) by a computer-generated r and omisation sequence to receive EN or SPN . The primary outcome was occurrence of nosocomial infection after cessation of intervention ( day 8) , measured until end of follow-up ( day 28 ) , analysed by intention to treat . This trial is registered with Clinical Trials.gov , number NCT00802503 . FINDINGS We r and omly assigned 153 patients to SPN and 152 to EN . 30 patients discontinued before the study end .  Mean energy delivery between day 4 and 8 was 28 kcal/kg per day ( SD 5 ) for the SPN group ( 103 % [ SD 18 % ] of energy target ) , compared with 20 kcal/kg per day ( 7 ) for the EN group ( 77 % [ 27 % ] ) . Between days 9 and 28 , 41 ( 27 % ) of 153 patients in the SPN group had a nosocomial infection compared with 58 ( 38 % ) of 152 patients in the EN group ( hazard ratio 0·65 , 95 % CI 0·43 - 0·97 ; p=0·0338 ) , and the SPN group had a lower mean number of nosocomial infections per patient ( -0·42 [ -0·79 to -0·05 ] ; p=0·0248 ) . INTERPRETATION Individually optimised energy supplementation with SPN starting 4 days after ICU admission could reduce nosocomial infections and should be considered as a strategy to improve clinical outcome in patients in the ICU for whom EN is insufficient . FUNDING Foundation Nutrition 2000Plus , ICU Quality Funds , Baxter , and Fresenius Kabi Background and Objectives : Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge . Critically ill infants in the early postoperative period are in a catabolic stress . The mismatch between estimated energy requirement ( EER ) and the intake in the postoperative period is multifactorial , predisposing them to complications such as immune deficiency , more infection , and growth failure . This study aim ed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery . Methodology : Fifty infants < 6 months of age were prospect ively r and omized in the trial for enteral nutrition ( EN ) postoperatively from day 1 to 10 , after obtaining the Institute Ethics Committee 's approval . They were equally divided into two groups on the basis of the feed they received : Control group was fed with expressed breast milk ( EBM ; 0.65 kcal/ml ) and intervention group was fed with EBM + energy supplementation/fortification with human milk fortifier ( 7.5 kcal/2 g)/Simyl medium-chain triglyceride oil ( 7.8 kcal/ml ) . Energy need for each infant was calculated as per EER at 90 kcal/kg/day , as the target requirement . The intra- and post-operative variables such as cardiopulmonary bypass and aortic cross-clamp times , ventilation duration , Intensive Care Unit ( ICU ) , and hospital length of stay and mortality were recorded . Anthropometric and hematological parameters and infection control data were recorded in a pre design ed pro forma . Data were analyzed using Stata 14.1 software . Results : The duration of mechanical ventilation , length of ICU stay ( LOIS ) , length of hospital stay ( LOHS ) , infection rate , and mortality rate were lower in the intervention group compared to the control group although none of the differences were statistically significant . Infants in control group needed mechanical ventilation for about a day more ( i.e. , 153.6 ± 149.0 h vs. 123.2 ± 107.0 h ; P = 0.20 ) than those in the intervention group . Similarly , infants in control group stayed for longer duration in the ICU ( 13.2 ± 8.9 days ) and hospital ( 16.5 ± 9.8 days ) as compared to the intervention group ( 11.0 ± 6.1 days ; 14.1 ± 7.0 days ) ( P = 0.14 and 0.17 , respectively ) . The LOIS and LOHS were decreased by 2.2 and 2.4 days , respectively , in the intervention group compared to control group . The infection rate ( 3/25 ; 5/25 ) and mortality rate ( 1/25 ; 2/25 ) were lower in the intervention group than those in the control group . The energy intake in the intervention group was 40 kcal more ( i.e. , 127.2 ± 56.1 kcal vs. 87.1 ± 38.3 kcal ) than the control group on the 10th postoperative day . Conclusions : Early enteral/oral feeding  after cardiac surgery is feasible and recommended . In addition , enriching the EBM is helpful in achieving the maximum possible calorie intake in the postoperative period . EN therapy might help in providing adequate nutrition , and it decreases ventilation duration , infection rate , LOIS , LOHS , and mortality AIMS It is unclear whether prescribing a higher amount of calories by enteral nutrition ( EN ) increases actual delivery . This prospect i ve controlled study aim ed at comparing the progression of EN of two study population s with different levels of calorie prescriptions , during the first 5 days of EN . METHODS The daily calorie prescription of group 1 ( n=346 ) was 25 and 20 kcal/kg body weight for women < 60 and > or = 60 years , respectively , and 30 and 25 kcal/kg body weight for men < 60 and > or = 60 years , respectively . The prescription of group 2 ( n=14 
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Conclusion There is still no known influence of the efficacy of EN on increasing survival and reducing the morbidity of patients with CHF  because there are few clinical trials that have evaluated this question ; however , EN is very indicated in the attempt to mitigate the weight loss in these patients