• Nutr Clin Pract · Jun 2020

    Do We Have Clinical Equipoise (or Uncertainty) About How Much Protein to Provide to Critically Ill Patients?

    • Jayshil J Patel, Todd Rice, Charlene Compher, and Daren K Heyland.
    • Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
    • Nutr Clin Pract. 2020 Jun 1; 35 (3): 499-505.

    AbstractThe current recommendation for protein dose in critically ill patients is 1.2-2.0 g/kg/d. Despite this recommendation, there is significant variation in the amount of protein prescribed and delivered worldwide. We contend clinical equipoise, or a state of genuine uncertainty about 2 (dosing) strategies, exists because guideline-based recommendations for protein dose in critically ill patients are rooted in a weak evidentiary base, leaving the clinician with no good basis for choosing a lower or higher protein dose. We outline evidence for and against high protein dose and introduce a pragmatic, registry-based, multicenter, randomized controlled trial, known as EFFORT, which aims to resolve the high vs low protein dose controversy.© 2019 American Society for Parenteral and Enteral Nutrition.

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