High protein provision of more than 1.2 g/kg improves muscle mass preservation and mortality in ICU patients: A systematic review and meta-analyses

被引：9

作者：

van Ruijven, Isabel M. ^{[1
,2
,3
,9
]}

Abma, Jose ^{[4
]}

Brunsveld-Reinders, Anja H. ^{[4
,5
]}

Stapel, Sandra N. ^{[2
]}

van Etten-Jamaludin, Faridi ^{[6
]}

Boirie, Yves ^{[7
]}

Barazzoni, Rocco ^{[8
]}

Weijs, Peter J. M. ^{[1
,2
,3
]}

机构：

[1] Amsterdam Univ Appl Sci, Fac Sports & Nutr, Ctr Expertise Urban Vital, Dept Nutr & Dietet, NL-1067 SM Amsterdam, Netherlands

[2] Vrije Univ, Amsterdam Univ Med Ctr, Dept Adult Intens Care Med, Amsterdam, Netherlands

[3] Vrije Univ, Amsterdam Univ Med Ctr, Amsterdam Movement Sci, Dept Nutr & Dietet, Amsterdam, Netherlands

[4] Amsterdam UMC Locat Univ Amsterdam, Epidemiol & Data Sci, Meibergdreef 9, Amsterdam, Netherlands

[5] Leiden Univ, Med Ctr, Dept Qual & Patient Safety, Leiden, Netherlands

[6] Amsterdam UMC Locat Univ Amsterdam, Med Lib AMC, Meibergdreef 9, Amsterdam, Netherlands

[7] Univ Clermont Auvergne, Clin Nutr Dept, INRAE, CRNH,CHU Clermont Ferrand, Clermont Ferrand, France

[8] Univ Trieste, Dept Med Surg & Hlth Sci, Trieste, Italy

[9] Amsterdam Univ Med Ctr, Dept Nutr & Dietet, POB 7057, NL-1007 MB Amsterdam, Netherlands

来源：

CLINICAL NUTRITION | 2023年 / 42卷 / 12期

关键词：

Protein; ICU; Nitrogen balance; Mortality; Muscle mass; CRITICALLY-ILL PATIENTS; INTENSIVE-CARE; ENTERAL NUTRITION; CLINICAL-OUTCOMES; THERAPY; ENERGY; PHASE;

D O I：

10.1016/j.clnu.2023.09.026

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Background: ICU patients lose muscle mass rapidly and maintenance of muscle mass may contribute to improved survival rates and quality of life. Protein provision may be beneficial for preservation of muscle mass and other clinical outcomes, including survival. Current protein recommendations are expert-based and range from 1.2 to 2.0 g/kg. Thus, we performed a systematic review and meta-analysis on protein provision and all clinically relevant outcomes recorded in the available literature.Methods: We conducted a systematic review and meta-analyses, including studies of all designs except case control and case studies, with patients aged >= 18 years with an ICU stay of >= 2 days and a mean protein provision group of >= 1.2 g/kg as compared to <1.2 g/kg with a difference of >= 0.2 g/kg between protein provision groups. All clinically relevant outcomes were studied. Meta-analyses were performed for all clinically relevant outcomes that were recorded in >= 3 included studies.Results: A total of 29 studies published between 2012 and 2022 were included. Outcomes reported in the included studies were ICU, hospital, 28-day, 30-day, 42-day, 60-day, 90-day and 6-month mortality, ICU and hospital length of stay, duration of mechanical ventilation, vomiting, diarrhea, gastric residual volume, pneumonia, overall infections, nitrogen balance, changes in muscle mass, destination at hospital discharge, physical performance and psychological status. Meta-analyses showed differences between groups in favour of high protein provision for 60-day mortality, nitrogen balance and changes in muscle mass.Conclusion: High protein provision of more than 1.2 g/kg in critically ill patients seemed to improve nitrogen balance and changes in muscle mass on the short-term and likely 60-day mortality. Data on long-term effects on quality of life are urgently needed.(c) 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license(http://creativecommons.org/licenses/by/4.0/).

引用

页码：2395 / 2403

页数：9