Do We Have Clinical Equipoise (or Uncertainty) About How Much Protein to Provide to Critically Ill Patients?

被引：6

作者：

Patel, Jayshil J. ^{[1
]}

Rice, Todd ^{[2
]}

Compher, Charlene ^{[3
]}

Heyland, Daren K. ^{[4
,5
,6
]}

机构：

[1] Med Coll Wisconsin, Div Pulm & Crit Care Med, Milwaukee, WI 53226 USA

[2] Vanderbilt Univ, Sch Med, Div Allergy Pulm & Crit Care Med, Nashville, TN 37212 USA

[3] Univ Penn, Sch Nursing, Biobehav Hlth Sci Dept, Philadelphia, PA 19104 USA

[4] Kingston Gen Hosp, Dept Crit Care Med, Kingston, ON, Canada

[5] Queens Univ, Dept Publ Hlth Sci, Kingston, ON, Canada

[6] Kingston Gen Hosp, Clin Evaluat Res Unit, Kingston, ON, Canada

来源：

NUTRITION IN CLINICAL PRACTICE | 2020年 / 35卷 / 03期

关键词：

critical care; critical illness; equipoise; nutrition support; outcomes; protein; renal failure; ACUTE-RENAL-FAILURE; ACUTE LUNG INJURY; ENTERAL NUTRITION; PARENTERAL-NUTRITION; NITROGEN-BALANCE; CRITICAL ILLNESS; AMINO-ACIDS; REQUIREMENTS; PROVISION; ENERGY;

D O I：

10.1002/ncp.10320

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：

The current recommendation for protein dose in critically ill patients is 1.2-2.0 g/kg/d. Despite this recommendation, there is significant variation in the amount of protein prescribed and delivered worldwide. We contend clinical equipoise, or a state of genuine uncertainty about 2 (dosing) strategies, exists because guideline-based recommendations for protein dose in critically ill patients are rooted in a weak evidentiary base, leaving the clinician with no good basis for choosing a lower or higher protein dose. We outline evidence for and against high protein dose and introduce a pragmatic, registry-based, multicenter, randomized controlled trial, known as EFFORT, which aims to resolve the high vs low protein dose controversy.

引用

页码：499 / 505

页数：7

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