Early high protein intake may decrease mortality in ICU patients with low muscle mass

By Rob Goodier

NEW YORK (Reuters Health) – Delivering high protein nutrition shortly after admission to intensive care may reduce the mortality risk for patients with low muscle mass, a retrospective study suggests.

“We found protein intake over days 2 to 4 to be significantly associated with 28-day and hospital mortality in patients admitted with low muscle mass (e.g. low protein reserves) who could be adequately fed, but not in patients admitted with normal muscle mass,” said the study’s lead author Dr. Willem Looijaard at VU University Medical Center in Amsterdam.

Dr. Looijaard presented the findings in Orlando, Florida February 20 during Clinical Nutrition Week 2017, where the study was nominated for a Harry M. Vars Award.

He and his colleagues reviewed data on 221 ICU patients who were well fed at 80-120% of their estimated required energy.

Sixty-three percent of the patients had low muscle mass, defined as a muscle area at the third lumbar vertebra of less than 110 cm2 for women and less than 170 cm2 for men. Those patients had a six-month mortality rate of 45.3%, compared to 18.5% in patients with normal muscle mass.

Patients with low muscle mass who had a high protein diet of 1.2g/kg or more after admission appear to have been less likely to die at six months (hazard ratio 0.49; P= 0.011).

The same did not hold for patients with normal muscle mass, however.

“The finding that the provision of protein was associated with mortality in patients admitted with low muscle mass, but not in patients with normal muscle mass, really shows us that one size does not fit all and we really need to look at our patients and try to figure out their personalized nutritional needs,” Dr. Looijaard told Reuters Health.

SOURCE: http://bit.ly/2lrguRj

Clinical Nutrition Week 2017.

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