Comment on high protein intake after subarachnoid hemorrhage improves oral intake and temporal muscle volume

Author(s):  
Noaki Matsumoto ◽  
Hayato Inuma ◽  
Hidetaka Wakabayashi ◽  
Shingo Kakehi
Author(s):  
Hidetaka Onodera ◽  
Takuma Mogamiya ◽  
Shinya Matsushima ◽  
Taigen Sase ◽  
Kimiyuki Kawaguchi ◽  
...  

2020 ◽  
Vol 40 ◽  
pp. 595
Author(s):  
H. Onodera ◽  
T. Mogamiya ◽  
M. Mori ◽  
S. Matsushima ◽  
T. Sase ◽  
...  

Critical Care ◽  
2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Olav Rooyackers ◽  
Martin Sundström Rehal ◽  
Felix Liebau ◽  
Åke Norberg ◽  
Jan Wernerman

2009 ◽  
Vol 20 (8) ◽  
pp. 1797-1804 ◽  
Author(s):  
Nynke Halbesma ◽  
Stephan J.L. Bakker ◽  
Desiree F. Jansen ◽  
Ronald P. Stolk ◽  
Dick De Zeeuw ◽  
...  

Critical Care ◽  
2022 ◽  
Vol 26 (1) ◽  
Author(s):  
Wolfgang H. Hartl ◽  
Philipp Kopper ◽  
Andreas Bender ◽  
Fabian Scheipl ◽  
Andrew G. Day ◽  
...  

Abstract Background Proteins are an essential part of medical nutrition therapy in critically ill patients. Guidelines almost universally recommend a high protein intake without robust evidence supporting its use. Methods Using a large international database, we modelled associations between the hazard rate of in-hospital death and live hospital discharge (competing risks) and three categories of protein intake (low: < 0.8 g/kg per day, standard: 0.8–1.2 g/kg per day, high: > 1.2 g/kg per day) during the first 11 days after ICU admission (acute phase). Time-varying cause-specific hazard ratios (HR) were calculated from piece-wise exponential additive mixed models. We used the estimated model to compare five different hypothetical protein diets (an exclusively low protein diet, a standard protein diet administered early (day 1 to 4) or late (day 5 to 11) after ICU admission, and an early or late high protein diet). Results Of 21,100 critically ill patients in the database, 16,489 fulfilled inclusion criteria for the analysis. By day 60, 11,360 (68.9%) patients had been discharged from hospital, 4,192 patients (25.4%) had died in hospital, and 937 patients (5.7%) were still hospitalized. Median daily low protein intake was 0.49 g/kg [IQR 0.27–0.66], standard intake 0.99 g/kg [IQR 0.89– 1.09], and high intake 1.41 g/kg [IQR 1.29–1.60]. In comparison with an exclusively low protein diet, a late standard protein diet was associated with a lower hazard of in-hospital death: minimum 0.75 (95% CI 0.64, 0.87), and a higher hazard of live hospital discharge: maximum HR 1.98 (95% CI 1.72, 2.28). Results on hospital discharge, however, were qualitatively changed by a sensitivity analysis. There was no evidence that an early standard or a high protein intake during the acute phase was associated with a further improvement of outcome. Conclusions Provision of a standard protein intake during the late acute phase may improve outcome compared to an exclusively low protein diet. In unselected critically ill patients, clinical outcome may not be improved by a high protein intake during the acute phase. Study registration ID number ISRCTN17829198


2002 ◽  
Vol 25 (4) ◽  
pp. 261-268 ◽  
Author(s):  
R. Bellomo ◽  
H. K. Tan ◽  
S. Bhonagiri ◽  
I. Gopal ◽  
J. Seacombe ◽  
...  

Aims To study the effect of combined continuous veno-venous hemodiafiltration (CVVHDF) and high (2.5 g/kg/day) parenteral amino acid supplementation on nitrogen balance, amino acid losses and azotemic control in a cohort of patients with severe acute renal failure (ARF). Methods We administered 2.5 grams/kg/day of amino acids intravenously to seven critically ill patients with ARF. We obtained paired blood and ultrafiltrate (UF) samples (n=20) and calculated amino acid clearances and losses, nitrogen balance, protein catabolic rate and total nitrogen losses. Results The median total serum amino acid concentration was high at 5.2 mmol/L with particularly high concentrations of ornithine, lysine, and phenylalanine, but a low level of histidine. The median overall amino acid clearance was 18.6 ml/min (range: 12 to 29 ml/min). UF losses as percentage of administered dose were high for tyrosine (53.6 %) but low for methionine (3.0 %) and arginine (2.3 %). A positive nitrogen balance was achieved in 7 (35%) of the 20 study days with an overall median nitrogen balance of -1.8 g/day. Urea levels were maintained at a median of 26.6 mmol/L. Conclusions High protein intake increases the serum concentrations of most amino acids. Such protein supplementation, when coupled with CVVHDF, achieves a slightly negative overall nitrogen balance in extremely catabolic patients while still allowing adequate azotemic control.


2020 ◽  
Vol 39 (7) ◽  
pp. 2192-2201 ◽  
Author(s):  
Wilhelmus G.P.M. Looijaard ◽  
Ingeborg M. Dekker ◽  
Albertus Beishuizen ◽  
Armand R.J. Girbes ◽  
Heleen M. Oudemans-van Straaten ◽  
...  

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