The influence of protein provision in the early phase of intensive care on clinical outcomes for critically ill patients on mechanical ventilation

Joo Han Song, Ho Sun Lee, Song Yee Kim, Eun Young Kim, Jie Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and Objectives: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. Methods and Study Design: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included. Three groups, based on nutrition intake, were examined: adequate protein intake (aPI), n=34; insufficient protein intake/ adequate energy intake (iPI/aEI), n=25; insufficient protein and energy intake (iPI/iEI), n=152. Results: Patients' mean age was 65±14 years; body mass index, 22±4; Acute Physiology and Chronic Health Evaluation II score, 24±7. The aPI group had significantly lower rates of in-ICU (14.7%) and in-hospital (23.5%) mortality than patients with insufficient protein intake: in-ICU mortality, iPI/aEI, 36%; iPI/iEI, 44.1% (p=0.006); in-hospital mortality, iPI/aEI, 56.0%; iPI/iEI, 52.0% (p=0.008). In the multivariate analysis, the hazard ratios (95% confidence intervals) for 60-day survival were 2.59 (1.02-6.59; p=0.046) and 2.88 (1.33-6.26; p=0.008) for the iPI/aEI and iPI/iEI groups, respectively. Conclusions: Despite possible selection bias owing to the retrospective nature of the study, achievement of > 90% of target protein intake was associated with improved ICU outcomes in mechanically ventilated critically ill patients, based on real-world clinical circumstances.

Original languageEnglish
Pages (from-to)234-240
Number of pages7
JournalAsia Pacific Journal of Clinical Nutrition
Volume26
Issue number2
DOIs
Publication statusPublished - 2017 Jan 1

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Critical Care
Artificial Respiration
Critical Illness
Energy Intake
Proteins
Intensive Care Units
Hospital Mortality
APACHE
Selection Bias
Body Mass Index
Multivariate Analysis
Retrospective Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Song, Joo Han ; Lee, Ho Sun ; Kim, Song Yee ; Kim, Eun Young ; Jung, Jie Ye ; Kang, Young Ae ; Park, Moo Suk ; Kim, Young Sam ; Kim, Se Kyu ; Chang, Joon ; Chung, Kyung Soo. / The influence of protein provision in the early phase of intensive care on clinical outcomes for critically ill patients on mechanical ventilation. In: Asia Pacific Journal of Clinical Nutrition. 2017 ; Vol. 26, No. 2. pp. 234-240.
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title = "The influence of protein provision in the early phase of intensive care on clinical outcomes for critically ill patients on mechanical ventilation",
abstract = "Background and Objectives: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. Methods and Study Design: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included. Three groups, based on nutrition intake, were examined: adequate protein intake (aPI), n=34; insufficient protein intake/ adequate energy intake (iPI/aEI), n=25; insufficient protein and energy intake (iPI/iEI), n=152. Results: Patients' mean age was 65±14 years; body mass index, 22±4; Acute Physiology and Chronic Health Evaluation II score, 24±7. The aPI group had significantly lower rates of in-ICU (14.7{\%}) and in-hospital (23.5{\%}) mortality than patients with insufficient protein intake: in-ICU mortality, iPI/aEI, 36{\%}; iPI/iEI, 44.1{\%} (p=0.006); in-hospital mortality, iPI/aEI, 56.0{\%}; iPI/iEI, 52.0{\%} (p=0.008). In the multivariate analysis, the hazard ratios (95{\%} confidence intervals) for 60-day survival were 2.59 (1.02-6.59; p=0.046) and 2.88 (1.33-6.26; p=0.008) for the iPI/aEI and iPI/iEI groups, respectively. Conclusions: Despite possible selection bias owing to the retrospective nature of the study, achievement of > 90{\%} of target protein intake was associated with improved ICU outcomes in mechanically ventilated critically ill patients, based on real-world clinical circumstances.",
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The influence of protein provision in the early phase of intensive care on clinical outcomes for critically ill patients on mechanical ventilation. / Song, Joo Han; Lee, Ho Sun; Kim, Song Yee; Kim, Eun Young; Jung, Jie Ye; Kang, Young Ae; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Chung, Kyung Soo.

In: Asia Pacific Journal of Clinical Nutrition, Vol. 26, No. 2, 01.01.2017, p. 234-240.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The influence of protein provision in the early phase of intensive care on clinical outcomes for critically ill patients on mechanical ventilation

AU - Song, Joo Han

AU - Lee, Ho Sun

AU - Kim, Song Yee

AU - Kim, Eun Young

AU - Jung, Jie Ye

AU - Kang, Young Ae

AU - Park, Moo Suk

AU - Kim, Young Sam

AU - Kim, Se Kyu

AU - Chang, Joon

AU - Chung, Kyung Soo

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background and Objectives: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. Methods and Study Design: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included. Three groups, based on nutrition intake, were examined: adequate protein intake (aPI), n=34; insufficient protein intake/ adequate energy intake (iPI/aEI), n=25; insufficient protein and energy intake (iPI/iEI), n=152. Results: Patients' mean age was 65±14 years; body mass index, 22±4; Acute Physiology and Chronic Health Evaluation II score, 24±7. The aPI group had significantly lower rates of in-ICU (14.7%) and in-hospital (23.5%) mortality than patients with insufficient protein intake: in-ICU mortality, iPI/aEI, 36%; iPI/iEI, 44.1% (p=0.006); in-hospital mortality, iPI/aEI, 56.0%; iPI/iEI, 52.0% (p=0.008). In the multivariate analysis, the hazard ratios (95% confidence intervals) for 60-day survival were 2.59 (1.02-6.59; p=0.046) and 2.88 (1.33-6.26; p=0.008) for the iPI/aEI and iPI/iEI groups, respectively. Conclusions: Despite possible selection bias owing to the retrospective nature of the study, achievement of > 90% of target protein intake was associated with improved ICU outcomes in mechanically ventilated critically ill patients, based on real-world clinical circumstances.

AB - Background and Objectives: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. Methods and Study Design: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included. Three groups, based on nutrition intake, were examined: adequate protein intake (aPI), n=34; insufficient protein intake/ adequate energy intake (iPI/aEI), n=25; insufficient protein and energy intake (iPI/iEI), n=152. Results: Patients' mean age was 65±14 years; body mass index, 22±4; Acute Physiology and Chronic Health Evaluation II score, 24±7. The aPI group had significantly lower rates of in-ICU (14.7%) and in-hospital (23.5%) mortality than patients with insufficient protein intake: in-ICU mortality, iPI/aEI, 36%; iPI/iEI, 44.1% (p=0.006); in-hospital mortality, iPI/aEI, 56.0%; iPI/iEI, 52.0% (p=0.008). In the multivariate analysis, the hazard ratios (95% confidence intervals) for 60-day survival were 2.59 (1.02-6.59; p=0.046) and 2.88 (1.33-6.26; p=0.008) for the iPI/aEI and iPI/iEI groups, respectively. Conclusions: Despite possible selection bias owing to the retrospective nature of the study, achievement of > 90% of target protein intake was associated with improved ICU outcomes in mechanically ventilated critically ill patients, based on real-world clinical circumstances.

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