Related Experiment Video

Updated: Oct 1, 2025

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
10:38

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Published on: January 16, 2019

20.4K

Early high protein provision and mortality in ICU patients including those receiving continuous renal replacement

Isabel M van Ruijven1,2,3,4, Sandra N Stapel1, Armand R J Girbes1

  • 1Department of Adult Intensive Care Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.

European Journal of Clinical Nutrition
|March 5, 2022
PubMed

Insights

Early high protein intake in intensive care unit (ICU) patients is linked to reduced hospital and ICU mortality. This benefit was observed even in patients receiving continuous renal replacement therapy (CRRT), but not in septic patients.

Area of Science:

  • Critical Care Medicine
  • Nutritional Support
  • Clinical Nutrition

Background:

  • Inconsistent findings exist regarding early high protein provision and mortality in ICU patients.
  • The specific impact on patients undergoing continuous renal replacement therapy (CRRT) remains unclear.

Purpose of the Study:

  • To investigate the association between early high protein provision and hospital and ICU mortality.
  • To examine this association in subgroups, including CRRT patients, and non-septic and septic patients.

Main Methods:

  • A retrospective cohort study of 2618 mechanically ventilated ICU patients (2003-2016) with feeding tubes.
  • Cox proportional hazards analysis assessed early high protein provision (≥1.2 g/kg/day at day 4) versus lower provision.
  • Adjustments were made for APACHE II score, energy intake, BMI, and age.

Main Results:

  • Early high protein provision was associated with significantly lower hospital mortality in the overall cohort, CRRT patients, and non-septic patients.
  • No significant association was found between early high protein provision and mortality in septic patients.
  • Similar trends were observed for ICU mortality, with robust results in sensitivity analyses for energy provision.

Conclusions:

  • Early high protein provision is associated with reduced hospital and ICU mortality in critically ill patients, including those on CRRT.
  • The survival benefit of early high protein provision was not evident in septic patients.
  • Nutritional strategies should consider patient-specific factors like sepsis.
Abstract

More Related Videos

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin07:38

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Published on: May 6, 2018

8.5K
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

4.6K

Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
162
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
95
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
64
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
70
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
118
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
91