Experimental and Outcome-Based Approaches to Protein Requirements in the Intensive Care Unit

Insight into protein requirements of intensive care unit (ICU) patients is urgently needed, but at present, it is unrealistic to define protein requirements for different diagnostic groups of critical illness or at different stages of illness. No large randomized controlled trials have randomized pr...

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Bibliographic Details
Published in:Nutrition in Clinical Practice 2017-04, Vol.32 (1_suppl), p.77S-85S
Main Authors: Weijs, Peter J. M., Dickerson, Roland N., Heyland, Daren K., Moore, Frederick A., Rugeles, Saúl J., McClave, Stephen A.
Format: Article
Language:English
Subjects:
Critical Illness
Dietary Proteins
energy
Energy Intake
Enteral Nutrition
Humans
intensive care unit
Intensive Care Units
nitrogen
Nursing
Nutritional Requirements
Parenteral Nutrition
protein
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Summary:Insight into protein requirements of intensive care unit (ICU) patients is urgently needed, but at present, it is unrealistic to define protein requirements for different diagnostic groups of critical illness or at different stages of illness. No large randomized controlled trials have randomized protein delivery, adequately addressed energy intake, and evaluated relevant clinical outcomes. As a pragmatic approach, experimental studies have focused on protein requirements of heterogeneous ICU patients. Data are scarce and the absolute value of protein requirements therefore is an approximation. Experimental studies indicate a protein requirement of >1.2 g/kg protein, which is supported by several outcome-based observational studies. Protein intake levels of up to 2.0–2.5 g/kg appear to be safe. A higher level of personalized treatment, within 1.2 and 2.5 g/kg, must involve identification of patients with low muscle protein mass that might benefit most from adequate protein nutrition in the ICU.
ISSN:0884-5336
1941-2452
DOI:10.1177/0884533617692774