6/30/23, 2:15 AM TARGET (energy-dense formulation) Pathway Feedback Search Clinical Topics Home Studies TARGET (energy-dense formulation) TARGET (energy-dense formulation) Trial question What is the role of energy-dense formulation for enteral delivery of nutrition in patients undergoing mechanical ventilation? Study design Multi-center Double blinded RCT Population Characteristics of study participants 37.4% female N = 3997 62.6% male 3997 patients (1464 female, 2493 male) Inclusion criteria: adults undergoing mechanical ventilation in ICUs Key exclusion criteria: treating clinician considered the trial enteral nutrition formula or the rate of delivery to be clinically contraindicated or inevitable death Interventions N=1971 energy dense (1.5 kcal/mL enteral nutrition for up to 28 days) N=1986 routine (1.0 kcal/mL enteral nutrition for up to 28 days) Primary outcome Rate of death from all causes within 90 days 26.8 % 26.8 25.7 20.1 % 13.4 % 6.7 % No significant difference 0.0 % https://web.pathway.md/studies/rec8VfEvkScZrmb4Z 1/2 6/30/23, 2:15 AM 0.0 % TARGET (energy-dense formulation) Pathway Energy dense Routine No significant difference in the rate of death from all causes within 90 days (26.8% vs. 25.7%; RR 1.05, 95% CI 0.94 to 1.16) Secondary outcomes No significant difference in the rate of death by day 28 (22.9% vs. 23%; RR 1, 95% CI 0.89 to 1.12) No significant difference in receipt of vasopressor support (81.1% vs. 81.4%; RR 1, 95% CI 0.97 to 1.03) No significant difference in receipt of RRT (18.9% vs. 18.5%; RR 1.02, 95% CI 0.9 to 1.16) Safety outcomes No significant differences in adverse events, serious adverse events. Significant differences in regurgitation or vomiting (18.9% vs. 15.7%), largest gastric residual volume (250 ml vs. 180 ml), increased daily blood glucose levels (225.2 mg/dL vs. 212.6 mg/dL). Conclusion In adults undergoing mechanical ventilation in ICUs, energy dense was not superior to routine with respect to the rate of death from all causes within 90 days. Reference TARGET Investigators, for the ANZICS Clinical Trials Group, Marianne Chapman et al. Energy- Dense versus Routine Enteral Nutrition in the Critically Ill. N Engl J Med. 2018 Nov 8;379(19):1823- 1834. Open reference URL https://web.pathway.md/studies/rec8VfEvkScZrmb4Z 2/2