Dr. Ilya Kagan, Dr. Moran Hellerman-Itzhaki, Dr. Itai Bendavid, Dr. Liran Statlender, Dr. Guy Fishman, Prof. Paul E Wischmeyer, Prof. Elisabeth de Waele, Prof. Pierre Singer
See the study
A holistic solution, designed to reduce the risk of ICU-acquired complications such as malnutrition, ventilator-associated events and AKI.
The study examined the smART+ Platform’s potential to deliver targeted nutrition and improve ICU outcomes.
The patients were randomized into two groups: a control group (N = 50) that received nutrition using standard (manual) practices, and a treatment group (N = 50) that utilized the smART+ Platform. Both groups received nutrition according to ESPEN guidelines.
The study was stopped due to success in a planned interim analysis of the first 100 patients.
No treatment-related adverse events occurred in either group.
A comprehensive, ESPEN guideline-driven approach that combines nutritional assessments with technological innovation to prevent feeding-related complications in critical care.
The primary endpoint was the average deviation from the daily feeding target, defined as mean 100× absolute value of (net nutrition delivered (mL) – volume to be delivered (VTBD; mL)/VTBD)% over all study days other than those when enteral feeding was stopped on medical order.
ICU length of stay was substantially reduced.
▼3.3 DAYS
HR 1.71, 95% CI: 1.13-2.60, p = 0.012 | adjusted
Length of ventilation was substantially reduced.
▼3.3 DAYS
HR 1.64, 95% CI: 1.08-2.51, p = 0.021 | adjusted
Categories represent deviations below and above target feeding efficiency. The difference in number of days are linked to the difference in length of stay.
Patients in the smART+ group reached a feeding efficacy of 85% or more throughout the trial, while the control group reached between 60% and 70% of feeding efficacy.
The average daily total amount of GRV as well as the average maximum GRV amount are significantly higher in the control group vs. the smART+ group.
One of the core functionalities of the smART+ Platform is achieving maximum feeding efficiency by detecting and responding to gastric intolerance in real time. Reflux events cannot be compared with those in the control group since the only solution on the market that can perform this function is the smART+ Platform. Notably, massive reflux events peaked on day 6, decreasing thereafter.
The control group stayed in ICU a total of 462 days, encountering underfeeding on most days and overfeeding on some days.
ICU stay lasted for 313 days in the smART+ group, contrasting with 462 days in the control group – a notable difference of 148 days. The frequency of overfeeding and, especially, the extent of underfeeding were significantly improved compared to the control group.
In the control group, ~100%* feeding efficiency was achieved in 22 days out of 462 days, amounting to just 5% of the treatment duration. In contrast, the smART+ group reached ~100% feeding efficiency in 162 days out of 313 days, constituting 52% of the treatment duration. This clearly demonstrates that the smART+ Platform is 10 times more efficient in attaining nutritional targets compared to the control.
*~100% FE: 0.98 ≤ FE ≤ 1.02
The smART+ Platform improved adherence to feeding goals and reduced ICU length of stay and length of ventilation versus standard of care in critically ill patients.
p < 0.0001
From 13.7 days
to 10.4 days
From 12.8 days
to 9.5 days