TARGET – The Augmented versus Routine approach to Giving Energy Trial
About the TARGET Study
TARGET is a 4,000 patient, multicentre, double-blinded, randomised, controlled, parallel-group, phase III clinical trial. The primary aim of the study is to determine if augmentation of calorie delivery using energy dense enteral nutrition in mechanically ventilated patients improves 90 day survival when compared to routine care. A secondary aim is to determine if augmentation of calorie delivery using energy dense enteral nutrition in mechanically ventilated patients improved functional outcomes at 180 days when compared to routine care. Eligible patients will be randomised 1:1 to receive TARGET protocol enteral nutrition (EN) formulation of either 1 kcal/ml or 1.5 kcal/ml. Protein content in both TARGET protocol EN formulations will be similar.
TARGET protocol EN will be administered for up to 28 days during the ICU stay.
Registration: ClinicalTrials.gov (NCT02306746) https://clinicaltrials.gov/ct2/show/NCT02306746
The results of the primary outcome (All-cause mortality at Day 90) were published on 22 October 2018 in the New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMoa1811687
The TARGET Trial found that increasing energy delivery above amounts provided in routine care did not increase survival at 90 days in critically ill adults.
- TARGET is the largest blinded randomised trial of enteral nutrition (EN) in the critically ill
- TARGET is the first randomised trial to deliver full-recommended calories with EN
- The results of TARGET found no evidence of survival benefit or harm with increased calorie delivery
- The results of TARGET do not support current guideline recommendations
TARGET Nutrition Study investigates link between nutrition and recovery in critically ill patients. Media release October 2018
The TARGET Investigators, for the ANZICS Clinical Trials Group, Chapman M, Peake SL, Bellomo R, Davies A, Deane A, Horowitz M, Hurford S, Lange K, Little L, Mackle D, O'Connor S, Presneill J, Ridley E, Williams P, Young P. Energy-Dense versus Routine Enteral Nutrition in the Critically Ill. N Engl J Med 2018;379:1823-34. Results NEJM; Oct 2018
The TARGET Investigators on behalf of the Australian and New Zealand Intensive Care Society Clinical Trials Group. Statistical analysis plan for the Augmented versus Routine Approach to Giving Energy Trial (TARGET). Crit Care Resusc 2018;20:15-21. Statistical Analysis Plan; March 2018
The TARGET Investigators on behalf of the Australian and New Zealand Intensive Care Society Clinical Trials Group. Study protocol for the Augmented versus Routine Approach to Giving Energy Trial (TARGET). Crit Care Resusc 2018;20:6-14. Protocol; March 2018
Peake SL, Young PJ, Chapman M; TARGET Investigators. Comment on Permissive Underfeeding or Standard Enteral Feeding in Critical Illness. N Engl J Med 2015;373:1173-4. Letter to the Editor NEJM PERMit Trial; Sept 2015
Endorsement: The TARGET Study was endorsed by the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS-CTG).
Funding: The TARGET Study was funded by a project grant from the National Health and Medical Research Council (NHMRC GNT1078026).
Contact: For further information about this study, please contact the ANZIC-RC TARGET Study Project Manager, Lorraine Little by email.