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Updated: Jun 24, 2026

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
04:53

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Published on: September 20, 2019

Body composition-guided protein dosing in critically ill patients: a before-and-after study (PROGRESS-ICU).

Michelle C Paulus1,2, Fatima Hajeer1,2, Arthur R H van Zanten3,4

  • 1Department of Intensive Care Medicine & Research, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands.

Critical Care (London, England)
|June 23, 2026
PubMed
Summary
This summary is machine-generated.

Fat-free mass (FFM)-adjusted protein dosing in critically ill patients did not significantly impact 90-day mortality compared to total body weight (TBW)-based dosing. However, FFM-based dosing showed potential benefits in reducing ICU stay and mechanical ventilation duration.

Keywords:
BIABody compositionCritical illnessFat-free massProtein dosing

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Last Updated: Jun 24, 2026

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
04:53

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

Area of Science:

  • Critical Care Medicine
  • Nutritional Support
  • Clinical Nutrition

Background:

  • Critically ill patients in the intensive care unit (ICU) require precise nutritional support.
  • Protein dosing strategies, based on total body weight (TBW) or fat-free mass (FFM), are debated for their clinical impact.
  • Optimizing protein delivery is crucial for patient recovery and metabolic balance.

Purpose of the Study:

  • To compare clinical and metabolic outcomes between FFM-adjusted and TBW-based protein dosing in ICU patients.
  • To evaluate the association of different protein dosing strategies with mortality, length of stay, and metabolic markers.
  • To investigate the efficacy of FFM-based protein dosing in improving patient outcomes.

Main Methods:

  • An observational cohort study (PROGRESS-ICU) included adult ICU patients from April 2020 to October 2025.
  • Patients received either TBW-based (1.5 g/kg/day) or FFM-based (1.85 g/kg/day dry FFM) protein dosing.
  • Outcomes assessed included 90-day mortality, ICU/hospital length of stay, mechanical ventilation duration, and changes in FFM and urea-to-creatinine ratio (UCR).

Main Results:

  • No significant difference in 90-day all-cause mortality was observed between FFM-based and TBW-based protein dosing groups (aHR 0.78).
  • FFM-based dosing was associated with a shorter ICU length of stay (HR 0.79) and fewer days on invasive mechanical ventilation (IMV) (HR 0.79).
  • TBW-based dosing was linked to higher UCR trajectories and greater FFM loss, though findings require cautious interpretation due to observational design.

Conclusions:

  • FFM-based protein dosing did not show a significant difference in mortality compared to TBW-based dosing in this observational study.
  • Observed associations with reduced ICU stay and IMV duration for FFM-based dosing may be influenced by residual confounding and temporal changes.
  • The study was underpowered for mortality differences; findings are exploratory and necessitate confirmation via adequately powered randomized controlled trials.