RESTORE Study

Study Overview

The RESTORE Study was an observational longitudinal cohort study designed to evaluate the real-world implementation of the Nutrition Care Process among critically ill adults with COVID-19 admitted to intensive care units across the United States. RESTORE stands for Nutritional Care Practices and Status of SARS-CoV-2 Patients.

The study examined the role of RDNs in identifying, documenting and addressing nutrition-related concerns for patients in the intensive care unit (ICU). Hospitalized patients with COVID-19, particularly those requiring intensive care, often experienced significant metabolic and inflammatory stress.

These patients were at increased risk for elevated nutrition needs, delayed or inadequate nutrition support, and malnutrition, all of which could affect recovery and clinical outcomes. The RESTORE Study was developed to better understand how standardized nutrition care was delivered to this high-risk patient population.

Data was collected through the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII), a web-based registry platform. The study included de-identified data from adult patients with COVID-19 admitted to eight ICUs between April 2021 and April 2022. Participating registered dietitian nutritionists documented their usual care practices using standardized Nutrition Care Process Terminology.

The Nutrition Care Process consists of four interconnected steps: nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation. Using this framework; dietitians documented nutrition-related problems, contributing causes, signs and symptoms, interventions, and follow-up status throughout the course of ICU care. Key areas of focus included energy intake, protein intake, enteral nutrition support, and the monitoring of nutrition-related indicators.

Overall, the RESTORE Study generated practical evidence on how dietitian-led nutrition care was implemented in ICU settings during the COVID-19 pandemic. By using real-world registry data, the study characterized nutrition care patterns and emphasized the value of systematically standardized nutrition documentation in critical care.

Its findings may help inform future registry studies, clinical trials, and initiatives aimed at strengthening nutrition care as an essential component of ICU patient management.

Publications

• Implementation of the Nutrition Care Process on Mortality Risk in Critically Ill COVID-19 Patients – A Registry Longitudinal Cohort Study (Annals of Medicine)
• Nutrition Care Practice Patterns for Patients with COVID-19 – A Preliminary Report (Journal of Parenteral and Enteral Nutrition)

Additional Resources

• Introductory video
• Recruitment Flyer
  

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