Timing of PROTein INtake and clinical outcomes of adult critically ill patients on prolonged mechanical VENTilation: The PROTINVENT retrospective study

Koekkoek, W.A.C.; Setten, C.H. van; Olthof, Laura E.; Kars, Johannes Cornelis Nicolaas Hans; Zanten, Arthur R. H. van

doi:10.1016/j.clnu.2018.02.012

Cited by 140 publications

(122 citation statements)

References 26 publications

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“…16,17 Presumably, timing of nutrition interventions 18 might play an important role, and especially early (ࣘ3 days) high protein intake may relate to negative effects. 19 Suggestions have been made that early protein intake inhibits autophagy. 20 Autophagy is essential to clear cell debris and intracellular bacteria in order to provide metabolic precursors.…”

Section: Protein Intakementioning

confidence: 99%

“…However, this is not supported by few randomized controlled trials (RCTs) that have been performed in general ICU patients and other evidence from septic patients . Presumably, timing of nutrition interventions might play an important role, and especially early (≤3 days) high protein intake may relate to negative effects . Suggestions have been made that early protein intake inhibits autophagy .…”

Section: Introductionmentioning

confidence: 99%

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Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study

Koning

Koekkoek

Kars

et al. 2019

J Parenter Enteral Nutr

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Background The optimal nutritional support for critically ill septic patients remains unknown. This study evaluates the associations of macronutrient intake during the first week of intensive care unit (ICU) admission and long‐term clinical outcomes in septic and non‐septic patients. Methods Prolonged mechanically ventilated patients were retrospectively studied. The association of protein (low: <0.8 g/kg/d, medium: 0.8–1.2 g/kg/d, high >1.2 g/kg/d) and energy intake (<80%, 80%–110%, 110% of target) during days 1–3 and 4–7 after ICU admission and 6‐month mortality was analyzed for septic and non‐septic patients separately. Results A total of 423 patients were investigated. Of these, 297 had sepsis. In the sepsis group, medium protein intake at days 4–7 was associated with lower 6‐month mortality (hazard ratio [HR]: 0.646, 95% confidence interval [CI]: 0.418‐0.996, P=0.048) compared with high intake. In the non‐sepsis group, early high and late low protein intake were associated with higher 6‐month mortality (HR: 3.902, 95% CI: 1.505‐10.115, P=0.005; HR: 2.642, 95% CI: 1.128‐6.189, P=0.025) compared with low and high protein intake, respectively. For energy intake, late energy intake of >110% was associated with decreased mortality in septic patients (HR: 0.400, 95% CI: 0.222‐0.721, P=0.002), whereas in non‐septic patients, late medium energy intake (80%–110%) was associated with better survival (HR: 0.379, 95% CI: 0.175‐0.820, P=0.014), both compared with low energy intake. Conclusion Divergent associations of macronutrient intake were found; early high protein intake in non‐septic patients, but not in septic patients, was found to be associated with higher 6‐month mortality.

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Section: Protein Intakementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study

Koning

Koekkoek

Kars

et al. 2019

J Parenter Enteral Nutr

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“…Contrary to these findings, in a post hoc secondary analysis of the EPaNIC trial, a cumulative protein dose, rather than the cumulative glucose dose, early during ICU stay was associated with delayed ICU discharge [41]. Further, a single-centre retrospective cohort study (n = 455) reported a lower protein intake (< 0.8 g/kg/day) before day 3 and high protein intake (> 0.8 g/kg/day) after day 3 was associated with lower 6-month mortality (adjusted HR 0.609; 95% CI 0.480-0.772, p < 0.001) compared to patients with overall high protein intake [42]. Prospective, randomised data is required to inform the most appropriate amount and timing of protein to deliver to critically ill patients.…”

Section: Protein Delivery and Clinical Outcomesmentioning

confidence: 98%

Nutrition therapy in critical illness: a review of the literature for clinicians

et al. 2020

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Nutrition therapy during critical illness has been a focus of recent research, with a rapid increase in publications accompanied by two updated international clinical guidelines. However, the translation of evidence into practice is challenging due to the continually evolving, often conflicting trial findings and guideline recommendations. This narrative review aims to provide a comprehensive synthesis and interpretation of the adult critical care nutrition literature, with a particular focus on continuing practice gaps and areas with new data, to assist clinicians in making practical, yet evidence-based decisions regarding nutrition management during the different stages of critical illness.

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“…Bendavid et al concluded in a retrospective study that administrating protein during the early course of the disease (i.e., the first three days) was associated with better survival [85]. On the other hand, the PROTEINVENT retrospective study concluded that high protein intake during the first three to five days of admission to ICU was associated with increased mortality [86]. Until recently, suppling high levels of protein at such an early phase of the illness was only possible by using parenteral nutrition [87].…”

Section: Improved Protein Intakementioning

confidence: 99%

Advances in Medical Nutrition Therapy: Parenteral Nutrition

Itzhaki

Singer

2020

Nutrients

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Parenteral nutrition has evolved tremendously, with parenteral formulas now safer and more accessible than ever. "All-in-one" admixtures are now available, which simplify parenteral nutrition usage and decrease line infection rates alongside other methods of infectious control. Recently published data on the benefits of parenteral nutrition versus enteral nutrition together with the widespread use of indirect calorimetry solve many safety issues that have emerged over the years. All these advances, alongside a better understanding of glycemic control and lipid and protein formulation improvements, make parenteral nutrition a safe alternative to enteral nutrition.

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Timing of PROTein INtake and clinical outcomes of adult critically ill patients on prolonged mechanical VENTilation: The PROTINVENT retrospective study

Cited by 140 publications

References 26 publications

Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study

Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study

Nutrition therapy in critical illness: a review of the literature for clinicians

Advances in Medical Nutrition Therapy: Parenteral Nutrition

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