6/28/23, 11:22 PM NUTRIREA-3 Pathway Feedback Search Clinical Topics Home Studies NUTRIREA 3 NUTRIREA 3 Trial question What is the role of early calorie and protein restriction in ventilated adults with shock? Study design Multi-center Open label RCT Population 3036 patients Inclusion criteria: adults receiving invasive mechanical ventilation and vasopressor support for shock Key exclusion criteria: specific nutritional needs; pregnancy; not-to-be-resuscitated order; department of corrections inmate Interventions N=1521 early calorie and protein restriction (6 kcal/kg/day and 0.2-0.4 g/kg/day protein during the first 7 days in the ICU) N=1515 standard calorie and protein targets (25 kcal/kg/day and 1.0-1.3 g/kg/day protein during the first 7 days in the ICU) Primary outcome Median time to readiness for intensive care unit discharge 9.0 days 9 8 6.8 days 4.5 days 2.3 days Significant decrease 0.0 days Early calorie and protein restriction Standard calorie and protein targets Significant decrease in median time to readiness for ICU discharge (8 days vs. 9 days; HR 0.89, 95% CI 0.82 to 0.98) Secondary outcomes https://web.pathway.md/studies/recb2wCgYQdGxPYee 1/2 6/28/23, 11:22 PM NUTRIREA-3 Pathway No significant difference in death from all causes at day 90 (41.3% vs. 42.8%; ARD -1.5, 95% CI -5 to 2) Conclusion In adults receiving invasive mechanical ventilation and vasopressor support for shock, early calorie and protein restriction were superior to standard calorie and protein targets with respect to median time to readiness for ICU discharge. Reference Jean Reignier, Gaetan Plantefeve, Jean-Paul Mira et al. Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel- group trial (NUTRIREA-3). Lancet Respir Med. 2023 Mar 20;S2213-2600(23)00092-9. Online ahead of print. Open reference URL https://web.pathway.md/studies/recb2wCgYQdGxPYee 2/2