Towards optimised nutrition therapy after critical illness: a position statement and research framework by the global research initiative on post-intensive care nutrition (GRIP) consortium

BACKGROUND: While mortality for critically ill patients has decreased, many survivors face persistent physical, cognitive, and psychological impairments, collectively known as post-intensive care syndrome, which significantly reduce health-related quality of life (HRQoL). Nutrition is a crucial component of recovery, yet evidence-based strategies for post-intensive care unit (ICU) nutritional management remain underdeveloped. METHODS: The Global Research Initiative on Post-ICU Nutrition (GRIP) was established to address this gap by advancing research, education, and clinical practice in post-ICU nutrition. International experts in the field of critical care nutrition were invited to a diagnostic matrix meeting, to develop a definition of post-ICU patients relevant to GRIP, discuss emerging evidence regarding post-ICU nutritional management, and identify core research domains to guide future research. RESULTS: The consortium consensus was achieved. A post-ICU patient is defined as any adult patient who has been admitted to an ICU for more than 48 h and is in the post-ICU recovery phase, which begins after the first ICU discharge and continues for up to one year, regardless of hospital length of stay, readmissions, or discharge destination. Ten core nutrition research domains were identified, including: (1) pathophysiology of post-ICU recovery, (2) phenotyping and personalised nutrition strategies, (3) timing and delivery of nutrition, (4) nutritional intake monitoring and optimisation, (5) nutrition interventions and effectiveness, (6) long-term functional and health-related quality of life outcomes, (7) digital tools and remote monitoring, (8) education and healthcare professional engagement, (9) implementation science and system integration, and (10) patient and family involvement. CONCLUSION: GRIP envisions a future in which patients post-ICU receive personalised, timely, and effective nutritional care to enhance recovery, reduce complications, and improve long-term HRQoL. By identifying knowledge gaps, initiating targeted research projects, and supporting global educational efforts, GRIP aims to generate robust evidence, foster international collaboration, and strengthen clinical capacity to improve global post-ICU nutritional care.