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Nutrients 2019, 11(1), 106; https://doi.org/10.3390/nu11010106

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

1
Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, 49100 Petah Tikva, Israel
2
Sackler School of Medicine, Tel Aviv University, 39040 Tel Aviv, Israel
3
Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 49100 Petah Tikva, Israel
4
Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv University, 39040 Tel Aviv, Israel
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 4 December 2018 / Revised: 28 December 2018 / Accepted: 2 January 2019 / Published: 7 January 2019
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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. View Full-Text
Keywords: critically ill; nutrition; protein; early; mortality critically ill; nutrition; protein; early; mortality
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Bendavid, I.; Zusman, O.; Kagan, I.; Theilla, M.; Cohen, J.; Singer, P. Early Administration of Protein in Critically Ill Patients: A Retrospective Cohort Study. Nutrients 2019, 11, 106.

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