A burning question in today’s clinical practice with critically ill patients is how much protein is required to optimize patient outcomes. Our recent clinical guidelines for critical illness in adults recommend protein doses of 1.2-2.0 g/kg body weight daily. Large observational studies generally support lower mortality with greater protein intake; the few randomized clinical trials are small and inconclusive; but post hoc analyses of randomized trials suggest that more protein may be associated with harm. Hence, there is confusion about the most efficacious dose of protein for these vulnerable patients.
ASPEN’s mission is to improve patient care by advancing the science and practice of clinical nutrition and metabolism. Clearly, answering the question of how much protein is best for critically ill patients is consistent with that mission. On that basis, ASPEN has joined Principal Investigator Dr. Daren Heyland in promoting the EFFORT trial to interested members and colleagues.
Dr. Heyland is a recognized leader in critical care nutrition research who has launched the EFFORT trial to answer the question of appropriate protein dose. Site participation in the EFFORT trial requires local ethics body approval and data entry by volunteers in global ICUs. Sites in the US may be eligible for waiver of consent (See figure for procedures). Sites will receive a benchmarking report once the trial has ended and steady feedback about their success in attaining goal protein intake. The EFFORT trial includes randomization of individual patients to a protein target of either ≤1.2 g/kg/day or ≥2.2 g/kg/day. Over a period of 3 years, the trial will enroll approximately 4,000 adult patients to answer the question of which of these two common protein doses yields lower 60-day mortality, and secondarily shorter time to discharge alive.
By the 2022 ASPEN Nutrition Science & Practice Conference, we hope that the answer to the important question about the optimal protein dose in critically ill patients will be clear. We need your support and participation to make this dream come true. Please check the www.criticalcarenutrition.com website for details. Get involved in enrolling ICU patients to this important trial. Dr. Charlene Compher ([email protected]) and Dr. Jayshil Patel ([email protected]) will be glad to answer your questions.
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