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Open AccessArticle

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

by Itai Bendavid 1,2,*,†, Oren Zusman 2,3,†, Ilya Kagan 1,2, Miriam Theilla 1,4, Jonathan Cohen 1,2 and Pierre Singer 1,2
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.
Nutrients 2019, 11(1), 106; https://doi.org/10.3390/nu11010106
Received: 4 December 2018 / Revised: 28 December 2018 / Accepted: 2 January 2019 / Published: 7 January 2019
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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