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Provision of protein and energy in relation to measured requirements in intensive care patients
Abstract
Background & aims Adequacy of nutritional support in intensive care patients is still a matter of investigation. This study aimed to relate mortality to provision, measured requirements and balances for energy and protein in ICU patients. Design Prospective observational cohort study of 113 ICU patients in a tertiary referral hospital. Results Death occurred earlier in the tertile of patients with the lowest provision of protein and amino acids. The results were confirmed in Cox regression analyses which showed a significantly decreased hazard ratio of death with increased protein provision, also when adjusted for baseline prognostic variables (APACHE II, SOFA scores and age). Provision of energy, measured resting energy expenditure or energy and nitrogen balance was not related to mortality. The possible cause-effect relationship is discussed after a more detailed analysis of the initial part of the admission. Conclusion In these severely ill ICU patients, a higher provision of protein and amino acids was associated with a lower mortality. This was not the case for provision of energy or measured resting energy expenditure or energy or nitrogen balances. The hypothesis that higher provision of protein improves outcome should be tested in a randomised trial.
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“Weijs et al. (162) studying 886 patients showed that ICU patients with 1.2 to 1.5 g/kg/d delivered protein had reduced 28-day mortality.”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [162]
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Metadata
- Authors
- Allingstrup, M. J., Esmailzadeh, N., Wilkens Knudsen, A., Espersen, K., Hartvig Jensen, T., Wiis, J., Perner, A., & Kondrup, J.
- Affiliations
- Copenhagen University Hospital (DK)
- University of Copenhagen (DK)
- Corresponding author
- Allingstrup, Matilde Jo
- ORCID
- Perner, Anders
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 31
- Issue
- 4
- Pages
- 462-468
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2054596359
- Cited by
- 381
- References
- 27
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 24 · 2023: 19 · 2022: 23 · 2021: 33 · 2020: 37 · 2019: 41 · 2018: 31 · 2017: 42 · 2016: 23 · 2015: 28 · 2014: 30 · 2013: 23 · 2012: 3
- FWCI
- 16.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Keywords
- amino acids, energy supply, intensive care unit patients, nutritional support, mortality, resting energy expenditure, nitrogen balance, energy balance, critically ill patients
- MeSH terms
- Adult, Aged, Energy Intake, Critical Care, Dietary Proteins, Humans, Intensive Care Units, Length of Stay, Middle Aged, Nutritional Requirements, Prospective Studies, Proportional Hazards Models, Treatment Outcome, Hospital Mortality, Nutritional Support, APACHE, Tertiary Care Centers
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