TY - JOUR
T1 - Protein delivery in mechanically ventilated adults in Australia and New Zealand
T2 - current practice
AU - Murthy, Tejaswini Arunachala
AU - Bellomo, Rinaldo
AU - Chapman, Marianne J.
AU - Deane, Adam M.
AU - Ferrie, Suzie
AU - Finnis, Mark E.
AU - Hurford, Sally
AU - O’Connor, Stephanie N.
AU - Peake, Sandra L.
AU - Summers, Matthew J.
AU - Williams, Patricia J.
AU - Young, Paul J.
AU - Chapple, Lee Anne S.
AU - for the TARGET Protein Management Committee
N1 - Funding Information:
Acknowledgements: Marianne Chapman is the recipient of a National Health and Medical Research Council (NHMRC) Project grant (APP1144496). The Royal Adelaide Hospital provided
Funding Information:
The strengths of our study are that it was investigator-led, supported by independent funding, and sponsored by a university-affiliated hospital. A heterogeneous critically ill mechanically ventilated population was studied, excluding specific cohorts of patients believed to require higher protein doses (ie, burns), which improves generalisability across Australia and New Zealand. Illness severity and clinical outcome data were similar to that previously reported in ICU nutrition studies,17 suggesting a cohort of patients representative of the general Australian and New Zealand ICU population. Limitations include that data were collected from only five metropolitan ICUs in Australia and New Zealand, which may limit generalisability.
Publisher Copyright:
© 2021, College of Intensive Care Medicine. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Objective: To quantify current protein prescription and delivery in critically ill adults in Australia and New Zealand and compare it with international guidelines. Design: Prospective, multicentre, observational study. Setting: Five intensive care units (ICUs) across Australia and New Zealand. Participants: Mechanically ventilated adults who were anticipated to receive enteral nutrition for ≥ 24 hours. Main outcome measures: Baseline demographic and nutrition data in ICU, including assessment of requirements, prescription and delivery of enteral nutrition, parenteral nutrition and protein supplementation, were collected. The primary outcome was enteral nutrition protein delivery (g/ kg ideal body weight [IBW] per day). Data are reported as mean ± standard deviation or n (%). Results: 120 patients were studied (sex, 60% male; mean age, 59 ± 16 years; mean admission APACHE II score, 20 ± 8). Enteral nutrition was delivered on 88%, parenteral nutrition on 6.8%, and protein supplements on 0.3% of 1156 study days. For the 73% (88/120) of patients who had a nutritional assessment, the mean estimated protein requirements were 99 ± 22 g/day (1.46 ± 0.55 g/kg IBW per day). The mean daily protein delivery was 54 ± 23 g (0.85 ± 0.35 g/kg IBW per day) from enteral nutrition and 56 ± 23 g (0.88 ± 0.35 g/kg IBW per day) from all sources (enteral nutrition, parenteral nutrition, protein supplements). Protein delivery was ≥ 1.2 g/kg IBW per day on 29% of the total study days per patient. Conclusions: Protein delivery as a part of current usual care to critically ill adults in Australia and New Zealand remains below that recommended in international guidelines.
AB - Objective: To quantify current protein prescription and delivery in critically ill adults in Australia and New Zealand and compare it with international guidelines. Design: Prospective, multicentre, observational study. Setting: Five intensive care units (ICUs) across Australia and New Zealand. Participants: Mechanically ventilated adults who were anticipated to receive enteral nutrition for ≥ 24 hours. Main outcome measures: Baseline demographic and nutrition data in ICU, including assessment of requirements, prescription and delivery of enteral nutrition, parenteral nutrition and protein supplementation, were collected. The primary outcome was enteral nutrition protein delivery (g/ kg ideal body weight [IBW] per day). Data are reported as mean ± standard deviation or n (%). Results: 120 patients were studied (sex, 60% male; mean age, 59 ± 16 years; mean admission APACHE II score, 20 ± 8). Enteral nutrition was delivered on 88%, parenteral nutrition on 6.8%, and protein supplements on 0.3% of 1156 study days. For the 73% (88/120) of patients who had a nutritional assessment, the mean estimated protein requirements were 99 ± 22 g/day (1.46 ± 0.55 g/kg IBW per day). The mean daily protein delivery was 54 ± 23 g (0.85 ± 0.35 g/kg IBW per day) from enteral nutrition and 56 ± 23 g (0.88 ± 0.35 g/kg IBW per day) from all sources (enteral nutrition, parenteral nutrition, protein supplements). Protein delivery was ≥ 1.2 g/kg IBW per day on 29% of the total study days per patient. Conclusions: Protein delivery as a part of current usual care to critically ill adults in Australia and New Zealand remains below that recommended in international guidelines.
UR - http://www.scopus.com/inward/record.url?scp=85126609323&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:85126609323
SN - 1441-2772
VL - 23
SP - 386
EP - 393
JO - Critical Care and Resuscitation
JF - Critical Care and Resuscitation
IS - 4
ER -