Protein Requirements in Critical Illness
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There is strong, consistent physiological evidence that generous protein provision could greatly improve clinical outcomes in critical illness. Surprisingly, however, no high quality randomized clinical trials (RCTs) have been published that formally tested this important possibility. Instead, numerous published RCTs have focused narrowly on high calorie provision. These internally well-designed but physiologically naive RCTs have confirmed what was predictable in advance, namely, that high-calorie, protein-deficient nutritional support does not benefit the overweight and obese patients who populate modern intensive care units.
Regrettably, recent authoritative reviews have extrapolated the results of these well-conducted but improperly designed RCTs to conclude that early nutritional intervention of any kind is useless in critical illness. My presentation will (1) address the practical issues and cognitive frailties that could explain why clinical trial experts have so long ignored the question of appropriate protein provision in critical illness, and (2) suggest a way forward.
Speaker:
Dr. John Hoffer, McGill University
*** Original Source: CNS Regional Conference - Advances in Protein Nutrition Across the Lifespan - January 10, 2015
Please note: The slide deck that is associated with Dr. John Hoffer's presentation is a shortened version of the one presented in January. As a result, it will not match the audio presentation directly.
Length: 34:09
Type: Audio
Last Updated: April 30, 2015
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