Objective To investigate the effects of protein intake in the early phase and later phase on the outcomes of critically ill patients. Methods A total of 326 critically ill patients admitted in intensive care unit of our hospital from September 2016 to March 2018 were enrolled in this prospective observational study. According to the 28-day prognosis of patients, they were divided into death group and survival group. Early protein target ( EPT) was defined as the daily protein intake≥0.8 g/( kg · d) on days 1 -3, and late protein target (LPT) was defined as the daily protein intake≥0.8 g/( k· d) on days 4-7. Results Daily protein intakes on day 1 and day 3 and cumulative protein intakes on days 1-3 were significantly higher in non-survivors than in the survivors (P<0.05), but daily protein intakes on day 2, 4, 5, 6 and 7 and cumulative protein intakes on days 4-7 and 1 -7 showed no significant difference between two groups (P>0.05). Hospital mortality was the lowest in the LPT group, the highest in the EPT, and in the middle in the EPT+LPT group and non-EPT+non-LPT group ( P<0.05 ). The survival curve analysis showed that the survival time of the EPT-only group was significantly lower than that of the LPT-only group (P<0.05). Multivariate analysis showed that age, sex, cumulative protein and caloric intakes on days 1 - 7 were the independent risk factors for mortality. Conclusion Early low protein intake is benefit for the outcomes of critically ill patients, and combined with adequate intake of protein in the later stage may further improve the outcomes.
Chinese Journal of Clinical Nutrition
Critically ill patients
通信作者:顾勤,E-mail: guqin6065@ 163.com.