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Cited by 73Clinical Nutrition and GastroenterologySepsis Diagnosis and TreatmentHyperglycemia and glycemic control in critically ill and hospitalized patients

Early Administration of Protein in Critically Ill Patients: A Retrospective Cohort Study

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Bendavid, Itai, Zusman, Oren, Kagan, Ilya, Theilla, Miriam, Cohen, Jonathan, Singer, Pierre·2019·Nutrients
DOI 10.3390/nu11010106PMC PMC6356518
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Abstract

It is currently uncertain whether early administration of protein improves patient outcomes. We examined mortality rates of critically ill patients receiving early compared to late protein administration. This was a retrospective cohort study of mixed ICU patients receiving enteral or parenteral nutritional support. Patients receiving >0.7 g/kg/d protein within the first 3 days were considered the early protein group and those receiving less were considered the late protein group. The latter were subdivided into late-low group (LL) who received a low protein intake (<0.7 g/kg/d) throughout their stay and the late-high group (LH) who received higher doses (>0.7 g/kg/d) of protein following their first 3 days of admission. The outcome measure was all-cause mortality 60 days after admission. Of the 2253 patients included in the study, 371 (36%) in the early group, and 517 (43%) in the late-high group had died (p < 0.001 for difference). In multivariable Cox regression analysis, while controlling for confounders, early protein administration was associated with increased survival (HR 0.83, 95% CI 0.71–0.97, p = 0.017). Administration of protein early in the course of critical illness appears to be associated with improved survival in a mixed ICU population, even after adjusting for confounding variables.

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  • More recent studies in medical ICU patients reported a positive correlation between early or high protein intake and decreased odds of mortality.

    “More recent studies in medical ICU patients reported a positive correlation between early [25] or high [26] protein intake and decreased odds of mortality.”

    From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [25]

    The Conclusions report higher 60-day survival among patients receiving >0.7 g/kg/day of protein in the first three ICU days, supporting the association with early intake. But Methods §2.1 describes a mixed medical-surgical ICU, not a medical-only ICU; the Discussion also cautions that this retrospective result shows association, not causation. Page numbers are unavailable in our copy. (LLM, conf=0.87)

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Cited by

Sorted by citations

Authors
Bendavid, I., Zusman, O., Kagan, I., Theilla, M., Cohen, J., & Singer, P.
Affiliations
Tel Aviv University (IL)
Corresponding author
Bendavid, Itai
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2019-01-07
Volume
11
Issue
1
Pages
106
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu11010106
PMC
PMC6356518
OpenAlex
W2907755131
Cited by
73
References
9
Citations by year
2026: 1 · 2025: 8 · 2024: 15 · 2023: 11 · 2022: 14 · 2021: 7 · 2020: 8 · 2019: 8 · 2018: 1
FWCI
7.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
critically ill patients, protein intake, enteral nutrition, parenteral nutrition, all-cause mortality, intensive care unit, nutritional support
MeSH terms
Adult, Aged, Energy Intake, Calorimetry, Indirect, Critical Care, Female, Hospitals, University, Humans, Male, Middle Aged, Nutritional Requirements, Parenteral Nutrition, Proteins, Retrospective Studies, Time Factors, Cohort Studies, Critical Illness, Treatment Outcome, Nutritional Support

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