Early High Protein in Critical Illness
Trial question
What is the effect of early high protein intake in patients with critical illness?
Study design
Single center
Single blinded
RCT
Population
Characteristics of study participants
36.0% female
64.0% male
N = 173
173 patients (62 female, 111 male).
Inclusion criteria: critically ill patients who stayed in the ICU/emergency ICU for at least 7 days.
Key exclusion criteria: burns; inability to initiate enteral nutrition within 48 hours of ICU admission; initiation of RRT within 24-48 hours admission; pregnancy/lactation.
Interventions
N=86 high protein intake (enteral nutrition provided 1.5 g/kg/day of protein and 20 kcal/kg/day of non-protein calories for the first 3 days).
N=87 low protein intake (enteral nutrition provided 0.8 g/kg/day of protein and 20 kcal/kg/day of non-protein calories for the first 3 days).
Primary outcome
Death at day 28
8.14%
19.54%
19.5 %
14.7 %
9.8 %
4.9 %
0.0 %
High protein
intake
Low protein
intake
Significant
decrease ▼
NNT = 8
Significant decrease in death at day 28 (8.14% vs. 19.54%; HR 0.406, 95% CI 0.17 to 0.98).
Secondary outcomes
No significant difference in refeeding syndrome incidence (25.58% vs. 19.54%; HR 0.784, 95% CI 0.42 to 1.48).
Significant decrease in mechanical ventilation duration (9 days vs. 10 days; AD -1 days, 95% CI -1.95 to -0.05).
Significant decrease in ICU days (10 days vs. 12 days; AD -2 days, 95% CI -3.75 to -0.25).
Conclusion
In critically ill patients who stayed in the ICU/emergency ICU for at least 7 days, high protein intake was superior to low protein intake with respect to death at day 28.
Reference
Yifei Wang, Yanyang Ye, Lusha Xuan et al. Impact of early high protein intake in critically ill patients: a randomized controlled trial. Nutr Metab (Lond). 2024 Jun 28;21(1):39.
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