Effect of High-Dose Protein in Critically Ill Patients

Study design

International, investigator-initiated, pragmatic, registry-based, single-blinded, randomised trial

Population

• Number of patients studied: 1301 (97·9% of randomized patients)
• Inclusion criteria: Nutritionally high-risk adults (≥18 years) undergoing mechanical ventilation
• Exclusion criteria: Patients who dropped out of the study before receiving the study intervention

Interventions

• Experimental group: High-dose protein (≥2.2 g/kg per day)
• Control group: Usual dose protein (≥1.2 g/kg per day)

Primary outcome: Time-to-discharge-alive from hospital up to 60 days after ICU admission

High-Dose Protein Study Results

Secondary outcomes

60-day mortality rate: 34.6% (222 of 642) in the high-dose protein group and 32.1% (208 of 648) in the usual dose protein group

Safety outcomes or Adverse Events

Higher protein provision might have worsened outcomes for patients with acute kidney injury and high organ failure scores

Conclusion

Delivery of higher doses of protein to mechanically ventilated critically ill patients did not improve the time-to-discharge-alive from hospital and might have worsened outcomes for patients with acute kidney injury and high organ failure scores.