From Calorimetry to the Kitchen Table: Patient Perceptions of ICU-Initiated Precision Nutrition

Tuesday, March 24, 2026

12:30 PM - 1:30 PM Central Time

Location: Connections Central - RST 03

Trevor Sytsma, MD (he/him/his)

Disclosure(s): No relevant financial relationship(s) to disclose.
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Carrie Dombeck, MA

Project Leader
Duke University

Disclosure information not submitted.
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Alyssa King, MS, RD, LDN

Dietitian
Duke University

Disclosure information not submitted.
Michael Clark, MD, PhD

Disclosure(s): No relevant financial relationship(s) to disclose.
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Amy Corneli, PhD, MPH

Professor in Population Health Sciences, Professor in Medicine
Duke University

Disclosure information not submitted.
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Jamilah Taylor, BA

Senior Research Associate
Duke University

Disclosure information not submitted.
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Kenneth Schmader, MD

Professor of Medicine
Duke University

Disclosure information not submitted.
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Suresh Agarwal, MD, FCCM

Professor of Surgery
Duke University

Disclosure information not submitted.
Paul Wischmeyer, MD, EDIC, FASPEN (he/him/his)

Duke University School of Medicine, North Carolina

Disclosure information not submitted.
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Krista Haines, DO

Duke University, North Carolina

Disclosure information not submitted.

Introduction: Precision nutrition strategies, including the use of indirect calorimetry (IC) to guide energy targets, are increasingly used in the ICU. However, little is known about whether critically ill patients are aware of this individualized care or whether such awareness influences nutrition behavior after discharge. We hypothesized that most older patients would not recall the use of IC or their individualized nutrition targets, and that this limited awareness would affect post-discharge engagement with nutrition recommendations. To explore this, we conducted a qualitative study of trauma patients admitted to the ICU who received IC-based hospital nutrition and a structured 30-day supplement program at home.

Methods: Twenty patients aged ≥ 60 years were interviewed following enrollment in the intervention arm of a pilot randomized controlled trial. The intervention included ICU-based nutrition support guided by IC, structured bedside conversations about nutrition, and a 30-day oral nutrition supplement (ONS) program after discharge. Interviews explored understanding of nutrition goals, perceptions of ICU care, and experiences following hospitalization. Transcripts were analyzed thematically using NVivo 14 (Lumivero).

Results: Only 6 participants (30%) recalled that their hospital nutrition had been personalized or based on specific targets. Participants who did recall individualized care often perceived it positively. One said, “I was thinking they must be watching me pretty good, because I wasn’t losing weight.” Most participants did not recall that IC had been used, but expressed high levels of trust in their ICU providers. Some perceived a disconnect between the high level of attention received in the hospital and the absence of clear guidance once home. Participants who remembered structured conversations were more likely to adhere to ONS after discharge.

Conclusions: Despite receiving goal-directed ICU nutrition guided by indirect calorimetry, most participants did not recall individualized targets or tools. Trust in ICU care was strong, but lack of patient-facing communication may limit the impact of precision nutrition after discharge. Clearer messaging about ICU nutrition strategies may strengthen engagement and adherence during recovery.