High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes

Abstract Background We evaluated the efficacy of high protein intake and early exercise versus standard nutrition care and routine physiotherapy on the outcome of critically ill patients. Methods We randomized mechanically ventilated patients expected to stay in the intensive care unit (ICU) for 4 d...

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Autores principales:	José Raimundo Araujo de Azevedo, Hugo César Martins Lima, Pedro Henrique Dias Brasiliense Frota, Ivna Raquel Olimpio Moreira Nogueira, Suellen Christine de Souza, Erika Arana Arraes Fernandes, Adlyene Muniz Cruz
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Protein Resistance training Critical care Physical component summary Indirect calorimetry Outcome Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/1f285d71bf1f4be68eefcc5903a1d3b0
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spelling	oai:doaj.org-article:1f285d71bf1f4be68eefcc5903a1d3b02021-11-14T12:11:48ZHigh-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes10.1186/s12871-021-01492-61471-2253https://doaj.org/article/1f285d71bf1f4be68eefcc5903a1d3b02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01492-6https://doaj.org/toc/1471-2253Abstract Background We evaluated the efficacy of high protein intake and early exercise versus standard nutrition care and routine physiotherapy on the outcome of critically ill patients. Methods We randomized mechanically ventilated patients expected to stay in the intensive care unit (ICU) for 4 days. We used indirect calorimetry to determine energy expenditure and guide caloric provision to the patients randomized to the high protein and early exercise (HPE) group and the control group. Protein intakes were 1.48 g/kg/day and 1.19 g/kg/day medians respectively; while the former was submitted to two daily sessions of cycle ergometry exercise, the latter received routine physiotherapy. We evaluated the primary outcome physical component summary (PCS) score at 3 and 6 months) and the secondary outcomes (handgrip strength at ICU discharge and ICU and hospital mortality). Results We analyzed 181 patients in the HPE (87) and control (94) group. There was no significant difference between groups in relation to calories received. However, the amount of protein received by the HPE group was significantly higher than that received by the control group (p < 0.0001). The PCS score was significantly higher in the HPE group at 3 months (p = 0.01) and 6 months (p = 0.01). The mortality was expressively higher in the control group. We found an independent association between age and 3-month PCS and that between age and group and 6-month PCS. Conclusion This study showed that a high-protein intake and resistance exercise improved the physical quality of life and survival of critically ill patients. Trial registration Research Ethics Committee of Hospital São Domingos: Approval number 1.487.683, April 09, 2018. The study protocol was registered in ClinicalTrials.gov ( NCT03469882 , March 19,2018).José Raimundo Araujo de AzevedoHugo César Martins LimaPedro Henrique Dias Brasiliense FrotaIvna Raquel Olimpio Moreira NogueiraSuellen Christine de SouzaErika Arana Arraes FernandesAdlyene Muniz CruzBMCarticleProteinResistance trainingCritical carePhysical component summaryIndirect calorimetryOutcomeAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Protein Resistance training Critical care Physical component summary Indirect calorimetry Outcome Anesthesiology RD78.3-87.3
spellingShingle	Protein Resistance training Critical care Physical component summary Indirect calorimetry Outcome Anesthesiology RD78.3-87.3 José Raimundo Araujo de Azevedo Hugo César Martins Lima Pedro Henrique Dias Brasiliense Frota Ivna Raquel Olimpio Moreira Nogueira Suellen Christine de Souza Erika Arana Arraes Fernandes Adlyene Muniz Cruz High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
description	Abstract Background We evaluated the efficacy of high protein intake and early exercise versus standard nutrition care and routine physiotherapy on the outcome of critically ill patients. Methods We randomized mechanically ventilated patients expected to stay in the intensive care unit (ICU) for 4 days. We used indirect calorimetry to determine energy expenditure and guide caloric provision to the patients randomized to the high protein and early exercise (HPE) group and the control group. Protein intakes were 1.48 g/kg/day and 1.19 g/kg/day medians respectively; while the former was submitted to two daily sessions of cycle ergometry exercise, the latter received routine physiotherapy. We evaluated the primary outcome physical component summary (PCS) score at 3 and 6 months) and the secondary outcomes (handgrip strength at ICU discharge and ICU and hospital mortality). Results We analyzed 181 patients in the HPE (87) and control (94) group. There was no significant difference between groups in relation to calories received. However, the amount of protein received by the HPE group was significantly higher than that received by the control group (p < 0.0001). The PCS score was significantly higher in the HPE group at 3 months (p = 0.01) and 6 months (p = 0.01). The mortality was expressively higher in the control group. We found an independent association between age and 3-month PCS and that between age and group and 6-month PCS. Conclusion This study showed that a high-protein intake and resistance exercise improved the physical quality of life and survival of critically ill patients. Trial registration Research Ethics Committee of Hospital São Domingos: Approval number 1.487.683, April 09, 2018. The study protocol was registered in ClinicalTrials.gov ( NCT03469882 , March 19,2018).
format	article
author	José Raimundo Araujo de Azevedo Hugo César Martins Lima Pedro Henrique Dias Brasiliense Frota Ivna Raquel Olimpio Moreira Nogueira Suellen Christine de Souza Erika Arana Arraes Fernandes Adlyene Muniz Cruz
author_facet	José Raimundo Araujo de Azevedo Hugo César Martins Lima Pedro Henrique Dias Brasiliense Frota Ivna Raquel Olimpio Moreira Nogueira Suellen Christine de Souza Erika Arana Arraes Fernandes Adlyene Muniz Cruz
author_sort	José Raimundo Araujo de Azevedo
title	High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
title_short	High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
title_full	High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
title_fullStr	High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
title_full_unstemmed	High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
title_sort	high-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1f285d71bf1f4be68eefcc5903a1d3b0
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High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes

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