title: The influence of protein provision in the early phase of intensive care on clinical outcomes for critically ill patients on mechanical ventilation.
abstract: OBJECTIVE
  Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support.
  
  
  METHODS
  Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included. Three groups, based on nutrition intake, were examined: adequate protein intake (aPI), n=34; insufficient protein intake/ adequate energy intake (iPI/aEI), n=25; insufficient protein and energy intake (iPI/iEI), n=152.
  
  
  RESULTS
  Patients' mean age was 65±14 years; body mass index, 22±4; Acute Physiology and Chronic Health Evaluation II score, 24±7. The aPI group had significantly lower rates of in-ICU (14.7%) and in-hospital (23.5%) mortality than patients with insufficient protein intake: in-ICU mortality, iPI/aEI, 36%; iPI/iEI, 44.1% (p=0.006); in-hospital mortality, iPI/aEI, 56.0%; iPI/iEI, 52.0% (p=0.008). In the multivariate analysis, the hazard ratios (95% confidence intervals) for 60-day survival were 2.59 (1.02-6.59; p=0.046) and 2.88 (1.33-6.26; p=0.008) for the iPI/aEI and iPI/iEI groups, respectively.
  
  
  CONCLUSIONS
  Despite possible selection bias owing to the retrospective nature of the study, achievement of >90% of target protein intake was associated with improved ICU outcomes in mechanically ventilated critically ill patients, based on real-world clinical circumstances.
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Song
authors.affiliation: Department of Nutrition and Dietetics, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Ho Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Song Yee
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jie Ye
authors.initials: JY
authors.lastname: Jung
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Ae
authors.initials: YA
authors.lastname: Kang
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Moo Suk
authors.initials: MS
authors.lastname: Park
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Sam
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Se Kyu
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Joon
authors.initials: J
authors.lastname: Chang
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Email: chungks@yuhs.ac.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Chung
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D016896:Treatment Outcome
chemical_list: D004044:Dietary Proteins