The effect of short-term caloric restriction on gene expression in critically ill patients has not been studied. In this sub-study of the PermiT trial, we examined gene expression patterns in peripheral white blood cells (buffy coat) associated with moderate caloric restriction (permissive underfeeding) in critically ill patients compared to standard feeding.

The present study shows that different caloric intake via enteral nutrition lead to differential expression of a wide variety in genes, most notably those related to metabolism, autophagy and other cellular functions, indicating that differences in caloric intake trigger different cellular pathways.

Evidence from recent randomized controlled trials and systematic reviews showed that short-term caloric restriction in the acute phase of critically ill patients was not associated with significant differences in mortality, and might be associated with reduced bloodstream infections, acute kidney injury and mechanical ventilation duration.

A total of 50 patients were enrolled in this study, 25 in each group.

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