High Protein Intake in Critically Ill Ventilated Patients

Study Overview
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Brief Summary
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This prospective interventional randomized control study was conducted on forty patients with respiratory failure; all patients were intubated and mechanically ventilated for at least three days. Twenty patients received high protein intake using whey protein, with daily follow-up of the blood sugar level, serum electrolytes, and chemistry. ICU outcome regarding food intolerance, 30-day mortality, length of MV and ICU-stay was recorded

Official Title
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High Protein Intake During the Early Phase of Critical Illness Compared With Normal Protein Intake

Conditions
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Intensive Care Unit Syndrome

Intervention / Treatment
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* Dietary Supplement: Whey protein


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >18 years Mechanically ventilated patients (for three days or more ) Exclusion Criteria: Age < 18 years old Contraindication for enteral nutrition (gut ischemia, obstruction, or perforation) Expected intolerance for enteral nutrition (paralytic ileus) Inability to start enteral nutrition within 24-hours(i.e. surgery or other interventions) Short bowel syndrome Hemodynamic instability ( i.e shock state, need for vasopressors ) Child C liver cirrhosis or acute liver failure Dialysis dependency

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| standard protein<br> | |
| high protein<br> | Dietary Supplement: Whey protein<br>* Patients were randomly divided into two groups: Group (A): Enteral feeding with normal protein intake ( 1.0 gm pin /kg/day ) Group (B): Enteral feeding with high protein intake ( 1.5- gm open /kg/day ) -Patient's- nonprotein- caloric intake was calculated according to REE :(25xactual body weight in kg ) and received it as follow : 1/2 the calculated amount of caloric intake in DAY 1 3/4 of the calculated amount of caloric intake in DAY 2 -Full calculated caloric amount in DAY 3 This regimen was followed long as the patient was tolerating the amount of feeding, and in case of intolerance: The volume of feeding boluses was decreased or Increase the time interval between boluses or IV metoclopramide or erythromycin was given<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of high protein intake on glycemic control | measurements of blood glucose levels regularly after high protein intake | up to 7 days | 
| Effect of high protein intake on serum electrolytes | measurements of Na, K, Mg, phosphorous and calcium levels regularly after high protein intake | up to 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of high protein intake on ICU outcome | ICU outcome includes ICU survival , mechanical ventilation , food intolerance | up to 7 days |