Evaluation of the effect of high protein supply on diaphragm atrophy in critically ill patients receiving prolonged mechanical ventilation.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
Qian ZhangSuming Zhou

Abstract

Our aim was to evaluate the effect of high protein to the target of 2.0 g/kg/d on diaphragm atrophy and clinical prognosis of patients receiving prolonged mechanical ventilation (MV). This prospective, randomized, controlled, single-center study included 41 patients who were treated with ≥7 days' MV. The patients were randomly divided into a standard nutrition treatment (SNT) group and intensive nutrition treatment (INT) group, followed by evaluation of computer tomography-analyzed diaphragm volume, the level of butyrylcholinesterase (BChE) as a muscle mass indicator, and respiratory mechanics indices weekly to observe and compare the differences between the groups. In the INT group, the actual protein (1.70 ± 0.21 vs 1.06 ± 0.21 g/kg/d, P < .001) and calorie intake (33.46 ± 2.78 vs 25.75 ± 4.81 kcal/kg/d, P < .001) were significantly different from those of the SNT group. Compared with the SNT group, the INT group's diaphragm atrophy improved in the fourth and fifth weeks (all P < .05). The BChE after the third week was higher (all P < .05). No significant differences in respiratory mechanical indices and clinical outcomes were found in the surviving patients between the groups. INT improved the diaphragm atrophy and muscle ma...Continue Reading

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