Dados do Trabalho

Título

The effect of protein supplementation in critical ill patientes

Objetivo

Verify whether an increased protein intake compared to a conservative protein intake did not cause kidney damage and can also provide benefits such as less days on mechanical ventilation and hospital mortality.

Métodos

Multicenter, randomized, and controlled study. Patients admitted to ICU who used enteral and/or parenteral nutritional therapy were enrolled. Data was collected regarding nutritional therapy, kidney function and hospital outcomes. Eligible patients were randomized into two groups: group 1 (G1) <1.5 grams of protein/kg/day and group 2 (G2) >1.8 grams/kg/day.

Resultados

: It was involved 125 patients, 60 G2 patients and 65 G1. The median age was 78.0(59.5-87) years, 51.2% female, BMI was 23.7(20.2-27) kg/m2, NRS 2002 median 3.0(2.0-4.0), NUTRIC median 4.0(2.0-5.0) and SAPS 3 was 57.0(36.0-67). There was no difference statistically significant between groups in relation to baseline characteristic. The groups presented the same creatinine serum level [0.74(0.59-0.91) vs 0.77(0.57-1.02),P= 0.913], Urea [60.7(41.3-80.2) vs 63.1(38.6-95.7),P=0.83], length of hospital stay [19.0(15.0-31.5) vs 19.0(11.7-30.0) days,P= 0.617], length of mechanical ventilation stay [7.0(3.5-11.5) vs 8.5(6.0-13.0) days,P= 0.405]. However, higher protein intake target group-G2 presented lower length of ICU stay [10.0(7.0-17.2) vs 13.5(10-21) days,P= 0.017] than standard protein intake target group-G1. As expected, G2 presented higher protein intake [1.36(0.97-1.7) vs 1.18(1.02-1.4) g/kg/day,P= 0.023] than G1. In addition, there was no statistic significant difference about hospital mortality rate (P= 0.627) and dialysis (P= 0.37).

Conclusão

Higher protein intake target has been shown to be safe regarding preservation of renal function and may be associated with shorter ICU stay.