Early high protein intake and mortality in critically ill ICU patients with low skeletal muscle area and -density
| Autor: | Peter J.M. Weijs, Armand R. J. Girbes, Wilhelmus G. P. M. Looijaard, Heleen M. Oudemans-van Straaten, Ingeborg M. Dekker, Albertus Beishuizen |
|---|---|
| Přispěvatelé: | Faculteit Bewegen, Sport en Voeding, Intensive care medicine, Internal medicine, ACS - Diabetes & metabolism, APH - Aging & Later Life, Amsterdam Movement Sciences - Restoration and Development, Amsterdam Movement Sciences - Rehabilitation & Development, AGEM - Endocrinology, metabolism and nutrition, AMS - Ageing & Vitality |
| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Icu patients medicine.medical_specialty Time Factors Databases Factual Critical Illness Nutritional Status 030209 endocrinology & metabolism Lumbar vertebrae Critical Care and Intensive Care Medicine Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors law Internal medicine Intensive care medicine Humans Hospital Mortality Muscle Skeletal Retrospective Studies 030109 nutrition & dietetics Nutrition and Dietetics Critically ill business.industry High protein Malnutrition Hazard ratio Skeletal muscle Middle Aged Prognosis Respiration Artificial Intensive care unit Intensive Care Units medicine.anatomical_structure Body Composition Diet High-Protein Female Tomography X-Ray Computed business |
| Zdroj: | Clinical Nutrition, 39(7), 2192-2201. Elsevier Ltd. Looijaard, W G P M, Dekker, I M, Beishuizen, A, Girbes, A R J, Oudemans-van Straaten, H M & Weijs, P J M 2020, ' Early high protein intake and mortality in critically ill ICU patients with low skeletal muscle area and-density ', Clinical Nutrition, vol. 39, no. 7, pp. 2192-2201 . https://doi.org/10.1016/j.clnu.2019.09.007 Clinical Nutrition, 39(7), 2192-2201. Churchill Livingstone |
| ISSN: | 0261-5614 |
| Popis: | Summary Background & aims Optimal nutritional support during the acute phase of critical illness remains controversial. We hypothesized that patients with low skeletal muscle area and -density may specifically benefit from early high protein intake. Aim of the present study was to determine the association between early protein intake (day 2–4) and mortality in critically ill intensive care unit (ICU) patients with normal skeletal muscle area, low skeletal muscle area, or combined low skeletal muscle area and -density. Methods Retrospective database study in mechanically ventilated, adult critically ill patients with an abdominal CT-scan suitable for skeletal muscle assessment around ICU admission, admitted from January 2004 to January 2016 (n = 739). Patients received protocolized nutrition with protein target 1.2–1.5 g/kg/day. Skeletal muscle area and -density were assessed on abdominal CT-scans at the 3rd lumbar vertebra level using previously defined cut-offs. Results Of 739 included patients (mean age 58 years, 483 male (65%), APACHE II score 23), 294 (40%) were admitted with normal skeletal muscle area and 445 (60%) with low skeletal muscle area. Two hundred (45% of the low skeletal muscle area group) had combined low skeletal muscle area and -density. In the normal skeletal muscle area group, no significant associations were found. In the low skeletal muscle area group, higher early protein intake was associated with lower 60-day mortality (adjusted hazard ratio (HR) per 0.1 g/kg/day 0.82, 95%CI 0.73–0.94) and lower 6-month mortality (HR 0.88, 95%CI 0.79–0.98). Similar associations were found in the combined low skeletal muscle area and -density subgroup (HR 0.76, 95%CI 0.64–0.90 for 60-day mortality and HR 0.80, 95%CI 0.68–0.93 for 6-month mortality). Conclusions Early high protein intake is associated with lower mortality in critically ill patients with low skeletal muscle area and -density, but not in patients with normal skeletal muscle area on admission. These findings may be a further step to personalized nutrition, although randomized studies are needed to assess causality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect