Charles Sternberg, Associate Editor07.31.23
Art Medical, an Israeli medical device company, has shared results on the performance of its smART+ Platform in a randomized comparative study published by the European Society for Clinical Nutrition and Metabolism's (ESPEN's) Clinical Nutrition.
The study demonstrated the smART+ Platform can maximize feeding efficiency, reaching nearly 90% of the targeted nutrition goal and improve patient outcomes by reducing both ICU length of stay and length of ventilation by 3.3 days. This study is a major step toward the commercialization of Art Medical's revolutionary technology.
"When patients do not receive adequate nutrition, it leads to life-threatening complications and a great economic burden," said professor Pierre Singer, study author, former ESPEN chair and author of the current ESPEN guidelines on clinical nutrition in the ICU. "These results, which demonstrate nearly 90% feeding efficiency, are unparalleled. With the smART+ Platform, we are now able to provide the prescribed and adequate enteral feeding to patients daily, which hasn't been possible before. I believe this breakthrough technology will profoundly impact the practice of critical care nutrition going forward."
Feeding is also frequently interrupted by routine medical procedures, but the necessary nutrition is not compensated. Most ICU patients do not reach 60%4 of nutrition adequacy. Current solutions on the market are not sufficient to address these complex and often linked complications.
Beyond its influence on patient outcomes, the current standard of care also impacts the hospitals' economic burden. The cost of a ventilated patient in a United States ICU can add up to $10,000 per day. However, U.S. hospitals are not reimbursed for these additional expenses incurred while treating ICU-acquired complications, highlighting the pressing need to find effective ways to mitigate these costs.
“Medical devices in critical care nutrition have had little to no innovation over the last several decades. Nutrition, while considered important, was never directly correlated to ICU length of stay,” said Liron Elia, founder and CEO of Art Medical. “The groundbreaking data of this study puts nutrition management front and center of critical care and proves that malnutrition and aspiration can only be treated holistically and in real time. Our evidence shows that by optimizing nutrition, we can dramatically improve patient outcomes. We are excited to introduce the smART+ Platform to the global market, providing clinicians with a powerful tool to elevate the standard of care in ICUs and help the sickest patients.”
References:
1 Zusman O, Kagan I, Bendavid I, Theilla M, Cohen J, Singer P. Predictive equations versus measured energy expenditure by indirect calorimetry: A retrospective validation. Clinical Nutrition. 2019;38(3):1206-1210. doi:10.1016/j.clnu.2018.04.020
2 Lew CCH, Yandell R, Fraser RJL, Chua AP, Chong MFF, Miller M. Association between malnutrition and clinical outcomes in the intensive care unit: a systematic review. JPEN J Parenter Enteral Nutr. 2017;41(5):744–58. doi: 10.1177/0148607115625638.
3 Bar-Lavie YP, Epstein D, Roimi M, Steinlauf S. Detection of gastroesophageal reflux by multichannel intraluminal impedance technology during mechanical ventilation: the first case series. Clinical Nutrition Open Science. 2022;44:118-125. doi:10.1016/j.nutos.2022.06.008
4 Nurkkala JP, Kaakinen TI, Vakkala MA, Ala-Kokko TI, Liisanantti JH. Nutrition deficit during intensive care stay: incidence, predisposing factors and outcomes. Minerva Anestesiol. 2020 May;86(5):527-536. doi: 10.23736/S0375-9393.20.14068-9
The study demonstrated the smART+ Platform can maximize feeding efficiency, reaching nearly 90% of the targeted nutrition goal and improve patient outcomes by reducing both ICU length of stay and length of ventilation by 3.3 days. This study is a major step toward the commercialization of Art Medical's revolutionary technology.
About the smART+ Platform
The smART+ Platform is designed to prevent delayed initiation of enteral feeding by assisting with tube positioning, continuously calculating an appropriate energy goal, supporting the physician in selecting the right feeding formula, detecting reflux events in real time and redirecting gastric content, which can cause aspiration, to an evacuation bag. To offset feeding interruptions, the system calculates the resulting deficit and delivers gradual compensation to better reach the prescribed 100% nutritional target."When patients do not receive adequate nutrition, it leads to life-threatening complications and a great economic burden," said professor Pierre Singer, study author, former ESPEN chair and author of the current ESPEN guidelines on clinical nutrition in the ICU. "These results, which demonstrate nearly 90% feeding efficiency, are unparalleled. With the smART+ Platform, we are now able to provide the prescribed and adequate enteral feeding to patients daily, which hasn't been possible before. I believe this breakthrough technology will profoundly impact the practice of critical care nutrition going forward."
Two-Year Results from the smART+ Platform Study
Over a two-year period, a clinical study was conducted to assess critically ill patients who were mechanically ventilated and enterally fed. The patients were randomized into two groups: a control group receiving nutrition according to ESPEN guidelines and standard (manual) practice, versus the treated group following the same guidelines but utilizing the smART+ Platform for two to 14 days. Overall, the data demonstrated significant benefits for patients in the group utilizing the smART+ Platform.Key Outcomes
- Achieved nearly 90% feeding efficiency (delivered nutrition/target nutrition): 89.5% versus 65% in the control group
- Reduced length of stay in the ICU by an average of 3.3 days: 10.4 days versus 13.7 days in the control group
- Reduced length of ventilation by an average of 3.3 days: 9.5 days versus 12.8 days in the control group
- Significantly improved the achievement of daily nutritional targets, with smART+ patients reaching 100% of their daily nutrition target 10 times more often than the control group
Putting Nutrition Management Front & Center
ICU-acquired complications related to nutrition pose significant challenges in critical care. The current standard of care relies on manual calculations to determine patient nutritional needs, which can be off by up to 50%.1 Patients are often underfed or overfed (with malnutrition of up to 78%2) — both correlate to increased mortality. In addition, uncontrolled reflux events present a great risk of aspiration and pneumonia.3Feeding is also frequently interrupted by routine medical procedures, but the necessary nutrition is not compensated. Most ICU patients do not reach 60%4 of nutrition adequacy. Current solutions on the market are not sufficient to address these complex and often linked complications.
Beyond its influence on patient outcomes, the current standard of care also impacts the hospitals' economic burden. The cost of a ventilated patient in a United States ICU can add up to $10,000 per day. However, U.S. hospitals are not reimbursed for these additional expenses incurred while treating ICU-acquired complications, highlighting the pressing need to find effective ways to mitigate these costs.
“Medical devices in critical care nutrition have had little to no innovation over the last several decades. Nutrition, while considered important, was never directly correlated to ICU length of stay,” said Liron Elia, founder and CEO of Art Medical. “The groundbreaking data of this study puts nutrition management front and center of critical care and proves that malnutrition and aspiration can only be treated holistically and in real time. Our evidence shows that by optimizing nutrition, we can dramatically improve patient outcomes. We are excited to introduce the smART+ Platform to the global market, providing clinicians with a powerful tool to elevate the standard of care in ICUs and help the sickest patients.”
References:
1 Zusman O, Kagan I, Bendavid I, Theilla M, Cohen J, Singer P. Predictive equations versus measured energy expenditure by indirect calorimetry: A retrospective validation. Clinical Nutrition. 2019;38(3):1206-1210. doi:10.1016/j.clnu.2018.04.020
2 Lew CCH, Yandell R, Fraser RJL, Chua AP, Chong MFF, Miller M. Association between malnutrition and clinical outcomes in the intensive care unit: a systematic review. JPEN J Parenter Enteral Nutr. 2017;41(5):744–58. doi: 10.1177/0148607115625638.
3 Bar-Lavie YP, Epstein D, Roimi M, Steinlauf S. Detection of gastroesophageal reflux by multichannel intraluminal impedance technology during mechanical ventilation: the first case series. Clinical Nutrition Open Science. 2022;44:118-125. doi:10.1016/j.nutos.2022.06.008
4 Nurkkala JP, Kaakinen TI, Vakkala MA, Ala-Kokko TI, Liisanantti JH. Nutrition deficit during intensive care stay: incidence, predisposing factors and outcomes. Minerva Anestesiol. 2020 May;86(5):527-536. doi: 10.23736/S0375-9393.20.14068-9