Automatic Critical Care Nutrition Clinical Information System

Critical Care Nutrition Clinical Information System implemented in ICU Gelderse Vallei Hospital, Ede, The Netherlands to improve patient outcome.

ICU RN and ICT-specialist Dick van Blokland and internist-intensivist Arthur van Zanten
Press Release: July 9, 2014

Early provision of the right amounts of proteins, energy (calories), and vitamins to critically ill patients, promotes their survival and recovery. 
The team at the Intensive Care Unit (ICU) of Gelderse Vallei Hospital developed a special nutrition program for ICU patients and achieves good results with it. On ICU admission precisely is calculated what amounts of tube feeding or parenteral nutrition (intravenous) are the targets for this specific patient. Faster and more accurate feeding results in better outcomes. That is the benefit of this research and development project at Gelderse Vallei hospital in Ede. The hospital that is dedicated to nutrition and exercise interventions to their patients to improve outcome and recovery.

Nutrition ICT program

On admission weight, height and the (nutritional) status of the patient is recorded in the electronic medical record of the ICU. Combining thes data accurately and automatically the quantity of nutritional support is calculated that has to be provided to the patient, by oral intake, enteral nutrition, protein additives, parenteral nutrition, or any combination thereof. Subsequently, every hour, the values of calculated intake are compared to the administration, the so-called nutrition balance. Nurses and doctors can now adjust the nutrition support to give the patient the best chance of recovery.


The calculations are complex because ICU patients receive many medications (sedative based on lipid emulsions), infusions (dextrose, glucose) and for example anticoagulants like citrate that affect the energy intake. These enormous real-time calculations are performed by the computer, taking all factors into account. The nutrition program is the result of research by ICT-specialist/ICU RN Dick van Blokland and internist-intensivist Arthur van Zanten. The Task Force Critical Care Nutrition comprising team members of the ICU and dieticians have co-developed this comprehensive nutrition program.

Global Interest

Intensivist Arthur van Zanten, “What the group has achieved is unique in the world! I’ve not yet encountered such a sophisticated system. It will continue to improve the care of ICU patients. In addition, it contributes to the (inter) national position of Gelderse Vallei Hospital as hospital dedicated to clinical nutrition. “Our ICU nutrition protocol is now used in hospitals in the Netherlands and Europe, but also in Asia and in the Middle East. Arthur van Zanten frequently lectures at international venues and has published relevant scientific publications. Annually many international physicians and scientists visit the ICU at Gelderse Vallei Hospital to learn from the accumulated expertise and ICT solutions in the field of nutrition for critically ill patients.

Prof. dr. Arthur R.H. van Zanten

Netherlands Institute for Acute Care
INCA Foundation

Gelderse Vallei Hospital
Willy Brandtlaan 10
6716 RP Ede, The Netherlands