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Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study
BACKGROUND: The optimal nutritional support for critically ill septic patients remains unknown. This study evaluates the associations of macronutrient intake during the first week of intensive care unit (ICU) admission and long‐term clinical outcomes in septic and non‐septic patients. METHODS: Prolo...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078979/ https://www.ncbi.nlm.nih.gov/pubmed/31172544 http://dx.doi.org/10.1002/jpen.1663 |
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author | de Koning, Marie‐Sophie Louise Yvonne Koekkoek, Wilhelmina Aria Christina (Kristine) Kars, Johannes Cornelis Nicolaas (Hans) van Zanten, Arthur Raymond Hubert |
author_facet | de Koning, Marie‐Sophie Louise Yvonne Koekkoek, Wilhelmina Aria Christina (Kristine) Kars, Johannes Cornelis Nicolaas (Hans) van Zanten, Arthur Raymond Hubert |
author_sort | de Koning, Marie‐Sophie Louise Yvonne |
collection | PubMed |
description | BACKGROUND: The optimal nutritional support for critically ill septic patients remains unknown. This study evaluates the associations of macronutrient intake during the first week of intensive care unit (ICU) admission and long‐term clinical outcomes in septic and non‐septic patients. METHODS: Prolonged mechanically ventilated patients were retrospectively studied. The association of protein (low: <0.8 g/kg/d, medium: 0.8–1.2 g/kg/d, high >1.2 g/kg/d) and energy intake (<80%, 80%–110%, 110% of target) during days 1–3 and 4–7 after ICU admission and 6‐month mortality was analyzed for septic and non‐septic patients separately. RESULTS: A total of 423 patients were investigated. Of these, 297 had sepsis. In the sepsis group, medium protein intake at days 4–7 was associated with lower 6‐month mortality (hazard ratio [HR]: 0.646, 95% confidence interval [CI]: 0.418‐0.996, P=0.048) compared with high intake. In the non‐sepsis group, early high and late low protein intake were associated with higher 6‐month mortality (HR: 3.902, 95% CI: 1.505‐10.115, P=0.005; HR: 2.642, 95% CI: 1.128‐6.189, P=0.025) compared with low and high protein intake, respectively. For energy intake, late energy intake of >110% was associated with decreased mortality in septic patients (HR: 0.400, 95% CI: 0.222‐0.721, P=0.002), whereas in non‐septic patients, late medium energy intake (80%–110%) was associated with better survival (HR: 0.379, 95% CI: 0.175‐0.820, P=0.014), both compared with low energy intake. CONCLUSION: Divergent associations of macronutrient intake were found; early high protein intake in non‐septic patients, but not in septic patients, was found to be associated with higher 6‐month mortality. |
format | Online Article Text |
id | pubmed-7078979 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-70789792020-03-19 Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study de Koning, Marie‐Sophie Louise Yvonne Koekkoek, Wilhelmina Aria Christina (Kristine) Kars, Johannes Cornelis Nicolaas (Hans) van Zanten, Arthur Raymond Hubert JPEN J Parenter Enteral Nutr Original Communications BACKGROUND: The optimal nutritional support for critically ill septic patients remains unknown. This study evaluates the associations of macronutrient intake during the first week of intensive care unit (ICU) admission and long‐term clinical outcomes in septic and non‐septic patients. METHODS: Prolonged mechanically ventilated patients were retrospectively studied. The association of protein (low: <0.8 g/kg/d, medium: 0.8–1.2 g/kg/d, high >1.2 g/kg/d) and energy intake (<80%, 80%–110%, 110% of target) during days 1–3 and 4–7 after ICU admission and 6‐month mortality was analyzed for septic and non‐septic patients separately. RESULTS: A total of 423 patients were investigated. Of these, 297 had sepsis. In the sepsis group, medium protein intake at days 4–7 was associated with lower 6‐month mortality (hazard ratio [HR]: 0.646, 95% confidence interval [CI]: 0.418‐0.996, P=0.048) compared with high intake. In the non‐sepsis group, early high and late low protein intake were associated with higher 6‐month mortality (HR: 3.902, 95% CI: 1.505‐10.115, P=0.005; HR: 2.642, 95% CI: 1.128‐6.189, P=0.025) compared with low and high protein intake, respectively. For energy intake, late energy intake of >110% was associated with decreased mortality in septic patients (HR: 0.400, 95% CI: 0.222‐0.721, P=0.002), whereas in non‐septic patients, late medium energy intake (80%–110%) was associated with better survival (HR: 0.379, 95% CI: 0.175‐0.820, P=0.014), both compared with low energy intake. CONCLUSION: Divergent associations of macronutrient intake were found; early high protein intake in non‐septic patients, but not in septic patients, was found to be associated with higher 6‐month mortality. John Wiley and Sons Inc. 2019-06-06 2020-03 /pmc/articles/PMC7078979/ /pubmed/31172544 http://dx.doi.org/10.1002/jpen.1663 Text en © 2019 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Communications de Koning, Marie‐Sophie Louise Yvonne Koekkoek, Wilhelmina Aria Christina (Kristine) Kars, Johannes Cornelis Nicolaas (Hans) van Zanten, Arthur Raymond Hubert Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study |
title | Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study |
title_full | Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study |
title_fullStr | Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study |
title_full_unstemmed | Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study |
title_short | Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non‐Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study |
title_sort | association of protein and caloric intake and clinical outcomes in adult septic and non‐septic icu patients on prolonged mechanical ventilation: the procasept retrospective study |
topic | Original Communications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078979/ https://www.ncbi.nlm.nih.gov/pubmed/31172544 http://dx.doi.org/10.1002/jpen.1663 |
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