Relationship between nutrition support and clinical outcomes in post-lung transplant patients in intensive care unit...

Nutrition status significantly influences outcomes after solid organ transplantation, yet data on energy and protein intake in lung transplantation (LTx) patients in the intensive care unit (ICU) are scarce. The objective is to examine the medical nutrition therapy and clinical outcomes in mechanically ventilated post-LTx adults.

This retrospective study (2022-2023) included adults post-LTx receiving mechanical ventilation admitted to the ICU. Clinical and nutrition parameters were recorded for the first 14 days of ICU stay. The Wilcoxon rank sum test or Fisher exact test were used to compare variables followed by a multivariate analysis to determine predictors of ICU length of stay (LOS).

One hundred patients were included in this study: 65 (65%) were male with a median age of 65 years and body mass index of 26.3 kg/m². Both ICU and total hospital LOS were prolonged in patients who received >1.2 g/kg/day of protein, but LOS was not affected by energy intake or nutrition status. There were no associations with mortality or infection rate. In a multivariate analysis, no individual main effect variable was significantly associated with ICU LOS. However, a significant interaction between protein intake and Acute Physiology and Chronic Health Evaluation Score (β = 0.0216; p = 0.0092) indicted that the effect of protein intake on ICU LOS is modified by illness severity.

In critically ill post-LTx patients, higher protein intake was associated with a longer ICU and hospital LOS. This relationship appears to be influenced by illness severity, emphasizing the importance of individualized nutrition strategies in this high-risk population.