Protein requirement in critical illness

Abstract

How much protein do critically ill patients require? For the many decades that nutritional support has been used there was a broad consensus that critically ill patients need much more protein than required for normal health. Now, however, some clinical investigators recommend limiting all macronutrient provision during the early phase of critical illness. How did these conflicting recommendations emerge? Which of them is correct? This review explains the longstanding recommendation for generous protein provision in critical illness, analyzes the clinical trials now being claimed to refute it, and concludes with suggestions for clinical investigation and practice.

Keywords: besoins nutritifs; besoins protéiques; biais; bias; calories; critical care; critical illness; energy; enteral nutrition; maladie grave; nutrition entérale; nutrition parentérale; nutrition requirements; nutritional support; parenteral nutrition; protein requirements; soins intensifs; soutien nutritif; énergie.