This multicentric randomized controlled trial aims to evaluate whether indirect calorimetry (IC)-guided nutritional support improves patient-centered outcomes in critically ill adult patients compared to standard formula-based nutritional strategies. The study includes mechanically ventilated patients expected to remain in the ICU for more than 72 hours. The intervention group will receive nutritional targets based on measured resting energy expenditure using the QNRG+ device, with a gradual escalation of energy delivery following current ESPEN guidelines. The primary outcome is quality of life at 3 months post-ICU admission, assessed using the EQ-5D-5L. Secondary outcomes include functional recovery, muscle preservation, infection rates, and rehospitalization. This study is the first to assess the long-term impact of IC-guided nutrition on recovery and quality of life using a patient-centered approach.
≥18 years old
On Mechanical Ventilation
Expected ICU length of stay >72 hours
Refusal of the family or patient
Patient transferred from another ICU
Pregnant patient
Patient is planned for a withdrawal of care or is actively dying
Parallel
Indirect Calorimetry Group
Other intervention* Nutritional targets measured by IC starting on Day 4 * Repeated IC measurements 2 times weekly performed with the QNRG+ device * Gradual escalation to 80%-100% caloric coverage by Day 4
Control Group - Formula-Based Group
Other intervention* Nutritional targets determined using predictive equations (pragmatic, set at local level) * Escalation as per local protocol
Quality of life (EQ-5D-5L)
Measured using the EQ-5D-5L: 0-100
Mortality
Nosocomial infection
Defined as the initiation of a new antibiotic treatment lasting at least 72 hours, associated with a documented diagnosis of infection in the patient's chart
Pressure soar
Energy deficit in kcal
according to the energy target defined by IC or predictive formula depending on the randomization group
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HEIDEGGER CP
Lead sponsor
University Hospital, Geneva
Sponsor institution
University Hospital, Zürich
Collaborator
GHOL Nyon Hospital
Collaborator
