High Protein Intake in Critically Ill Malnourished Ventilated Patients

Abstract Background Intensive care unit (ICU) patients are at high risk of morbidity, mortality, and prolonged care that need implementing practical approaches to improve outcomes during the early phase of critical illness. When energy and protein are delivered efficiently, this risk is ameliorated...

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Main Authors: Farouk Mostafa Faris, Yasmin Nabil Ellithy, Mohamed Amr Matar, Alia Hassan Abd Elfattah
Format: Article
Language:English
Published: Springer 2023-04-01
Series:Egyptian Journal of Critical Care Medicine
Subjects:
Online Access:https://doi.org/10.1097/EJ9.0000000000000051
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author Farouk Mostafa Faris
Yasmin Nabil Ellithy
Mohamed Amr Matar
Alia Hassan Abd Elfattah
author_facet Farouk Mostafa Faris
Yasmin Nabil Ellithy
Mohamed Amr Matar
Alia Hassan Abd Elfattah
author_sort Farouk Mostafa Faris
collection DOAJ
description Abstract Background Intensive care unit (ICU) patients are at high risk of morbidity, mortality, and prolonged care that need implementing practical approaches to improve outcomes during the early phase of critical illness. When energy and protein are delivered efficiently, this risk is ameliorated and recovery potentially improved. Objective To compare the effect of higher protein intake (1.5 g/kg/day) with standard one (1 g/kg/day) in ICU settings using whey protein during the early phase of the patients’ critical illness and its impact on laboratory and clinical outcomes. Methods This prospective interventional nonrandomized control study was conducted on 40 patients with respiratory failure; all patients were intubated and mechanically ventilated for at least 3 days. Twenty malnourished patients according to the Nutrition Risk in Critically ill (NUTRIC) score received higher protein intake using whey protein, with daily follow-up of blood sugar level, serum electrolytes, and chemistry. ICU outcomes regarding food intolerance, 30-day mortality, length of mechanical ventilation (MV), and ICU stay were recorded. Results This study was conducted on two groups of patients with the same caloric intake and no significant difference regarding demographic and clinical data. High protein intake led to a significant reduction in blood sugar level during first 2 days of ICU stay (P-value = .035 and .048, respectively), with a significant reduction in MV duration (P = .045), reintubation rate (.03), and ICU stay (.02). Conclusion Unlike standard protein diet (1 g/kg/day), higher protein diet (1.5 g/kg/day) in previously malnourished patients was associated with improved glycemic control and serum electrolytes (sodium, potassium, calcium, phosphorus, and magnesium) during their ICU stay with a significant reduction in length of MV and ICU stay.
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spelling doaj-art-cc8d3c8f469f4310881061d86e72dc0e2025-08-20T02:16:48ZengSpringerEgyptian Journal of Critical Care Medicine2090-73032090-92092023-04-01102414710.1097/EJ9.0000000000000051High Protein Intake in Critically Ill Malnourished Ventilated PatientsFarouk Mostafa Faris0Yasmin Nabil Ellithy1Mohamed Amr Matar2Alia Hassan Abd Elfattah3Department of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityAbstract Background Intensive care unit (ICU) patients are at high risk of morbidity, mortality, and prolonged care that need implementing practical approaches to improve outcomes during the early phase of critical illness. When energy and protein are delivered efficiently, this risk is ameliorated and recovery potentially improved. Objective To compare the effect of higher protein intake (1.5 g/kg/day) with standard one (1 g/kg/day) in ICU settings using whey protein during the early phase of the patients’ critical illness and its impact on laboratory and clinical outcomes. Methods This prospective interventional nonrandomized control study was conducted on 40 patients with respiratory failure; all patients were intubated and mechanically ventilated for at least 3 days. Twenty malnourished patients according to the Nutrition Risk in Critically ill (NUTRIC) score received higher protein intake using whey protein, with daily follow-up of blood sugar level, serum electrolytes, and chemistry. ICU outcomes regarding food intolerance, 30-day mortality, length of mechanical ventilation (MV), and ICU stay were recorded. Results This study was conducted on two groups of patients with the same caloric intake and no significant difference regarding demographic and clinical data. High protein intake led to a significant reduction in blood sugar level during first 2 days of ICU stay (P-value = .035 and .048, respectively), with a significant reduction in MV duration (P = .045), reintubation rate (.03), and ICU stay (.02). Conclusion Unlike standard protein diet (1 g/kg/day), higher protein diet (1.5 g/kg/day) in previously malnourished patients was associated with improved glycemic control and serum electrolytes (sodium, potassium, calcium, phosphorus, and magnesium) during their ICU stay with a significant reduction in length of MV and ICU stay.https://doi.org/10.1097/EJ9.0000000000000051critical illnesselectrolytesglycemic controlintensive care unitmechanical ventilationwhey protein
spellingShingle Farouk Mostafa Faris
Yasmin Nabil Ellithy
Mohamed Amr Matar
Alia Hassan Abd Elfattah
High Protein Intake in Critically Ill Malnourished Ventilated Patients
Egyptian Journal of Critical Care Medicine
critical illness
electrolytes
glycemic control
intensive care unit
mechanical ventilation
whey protein
title High Protein Intake in Critically Ill Malnourished Ventilated Patients
title_full High Protein Intake in Critically Ill Malnourished Ventilated Patients
title_fullStr High Protein Intake in Critically Ill Malnourished Ventilated Patients
title_full_unstemmed High Protein Intake in Critically Ill Malnourished Ventilated Patients
title_short High Protein Intake in Critically Ill Malnourished Ventilated Patients
title_sort high protein intake in critically ill malnourished ventilated patients
topic critical illness
electrolytes
glycemic control
intensive care unit
mechanical ventilation
whey protein
url https://doi.org/10.1097/EJ9.0000000000000051
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