Increased protein supplementation could aid critically ill, suggests review

The research – published in the American Journal of Clinical Nutrition – assessed the effects of various wide ranging recommendations for the provision of protein or amino acid supplementation to critically ill patients in hospital.

Led by Professor John Hoffer of McGill University, Canada, the researchers revealed that whilst data comparing the effects of different levels of protein intake on clinically relevant outcomes is ‘limited’, the data that is present suggests that most critically ill patients are receiving approximately half of what should be considered the ‘optimal’ levels of protein supplementation.

Hoffer and his team said whilst the “limited amount and poor quality of the evidence”​ prevent solid conclusions or firm clinical recommendations, the available data does ‘strongly suggest’ that receiving between 2.0 and 2.5 grams of protein per kilogram (kg) per day “is safe and could be optimum for most critically ill patients.”​

“At the present time, most critically ill adults receive less than half of the most common current recommendation…for the first week or longer of their stay in an intensive care unit,”​ they said.

Comprehensive review​

“​We carried out a systematic review of clinical trials that compared the metabolic or clinical effects of different protein intakes in adult critical illness and comprehensively reviewed all of the available evidence pertinent to the safe upper limit of protein provision in this setting,”​ said the authors.

The analysis revealed that research has shown that supplementation with up to 2.5 grams of protein per kg per day  is note only safe, but “could be optimal.” However, many patients in an intensive care unit will only receive around 1.5 grams per kg per day – which is in line with current recommendations, they said.

As a result, Hoffer and his team argue that there is an ‘urgent need’ for well-designed clinical trials to properly identify the appropriate level of protein provision in critical illness.

Source: American Journal of Clinical Nutrition​
Volume 96, Number 3, Pages 591-600, doi: 10.3945/​ajcn.111.032078​
“Appropriate protein provision in critical illness: a systematic and narrative review”​
Authors: L John Hoffer, Bruce R Bistrian