Calorie intake was mainly provided according to the targets recommended by the active ESPEN guideline, but protein intake was lower. In patients staying in ICU ≥ 5 days, early moderate daily calorie and protein intakes were associated with improved clinical outcomes.

A total of 1,172 patients with median APACHE II score of 18.5 were included, and 24% died within 90 days.

Median length of ICU stay was 10.0 days, and 74% of patients could be weaned from invasive mechanical ventilation.

Patients reached on average 83% and 65% of ESPEN calorie and protein recommended targets, respectively.

Whereas specific reasons for ICU admission (especially respiratory diseases requiring IMV) were associated with higher intakes, a lack of nutrition on the preceding day was associated with lower calorie and protein intakes.

Compared to a lower intake, a daily moderate intake was associated with higher probability of successful weaning, and with a lower hazard of death.

There was no evidence that a high calorie or protein intake was associated with further outcome improvements.

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