Abstract Rationale Intensive care unit (ICU) survivors frequently experience reduced quality of life (QoL). Whether intra-ICU nutrition interventions improve QoL remain underexplored. This systematic review evaluates evidence for nutritional strategies for improving QoL in ICU survivors. Methods We searched MEDLINE, EMBASE, CINAHL, and CENTRAL for randomized controlled trials on nutritional interventions in ICU patients (≥18 yrs), excluding neuro-ICU studies. The efficacy of each intervention compared to its comparator was assessed for QoL outcomes. Two reviewers independently screened studies and extracted data; a third resolved conflicts. Risk of bias was evaluated using the Cochrane Risk of Bias tool. Results We screened 4,063 studies, of which 11 met inclusion criteria (8,310 ICU patients). The most common interventions were early trophic feeding or caloric restriction (27%) high-protein enteral nutrition (EN) (18%), vitamin D supplementation (18%). QoL was most frequently assessed using EuroQol 5-Dimension (EQ-5D) (54%), 36-Item Short Form Survey (SF-36) (18%), 12-Item Short Form Survey (SF-12) (18%), and RAND-36 Health Status Inventory (RAND-36) (18%). These were measured from discharge to 12 months post-discharge. One study found that high-protein EN reduced QoL after ICU discharge (treatment effect difference on EQ5D health utility -0.05 95% CI -0.10, -0.01), while another showed that combining EN with early PN improved QoL (RAND-36 mean difference 4.3 95% CI 0.95, 7.58), though this effect was not clinically significant. High-dose vitamin D improved SF-12 in less severely vitamin-D deficient patients (42.4 SD 10.6) vs. placebo (38.4 SD 10.7), while HMB improved SF-12 (27.39 95% CI 1.59, 53.19). Other studies found no significant effects on QoL. The overall risk of bias in the included studies was low, though some studies had unclear or high risk in blinding (30%) and outcome assessment (20%). Conclusion Nutritional interventions may provide potential benefits, but the overall evidence remains limited due to significant variability in interventions and patient settings. Robust and well-powered clinical trials are needed to establish their efficacy and safety in improving QoL for ICU survivors. This abstract is funded by: None
Haouili et al. (Fri,) studied this question.