Protein requirements, morbidity and mortality in critically ill patients: fundamentals and applications
Recent evidence suggests that a negative protein balance secondary to severe disease is associated with increased morbidity. A loss of total body protein is inevitable in this scenario, even with an aggressive nutritional approach, primarily due to the catabolism of skeletal muscle fibers. The ubiqu...
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Associação Brasileira de Medicina intensiva
2013
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031858/ |
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pubmed-40318582014-06-02 Protein requirements, morbidity and mortality in critically ill patients: fundamentals and applications da Cunha, Haroldo Falcão Ramos da Rocha, Eduardo Eiras Moreira Hissa, Monica Review Article Recent evidence suggests that a negative protein balance secondary to severe disease is associated with increased morbidity. A loss of total body protein is inevitable in this scenario, even with an aggressive nutritional approach, primarily due to the catabolism of skeletal muscle fibers. The ubiquitin-proteasome system is the primary metabolic and biochemical mechanism involved in this process; paradoxically, this system consumes adenosine triphosphate as its energy source. It is possible that a neutral protein balance in these clinical situations is important for improving outcomes and achieving the caloric goals estimated or measured by indirect calorimetry. Recent studies have suggested that the use of higher protein concentrations in nutritional therapy for critically ill patients may help to reduce mortality. The purpose of this study was to review some of the nutrition therapy principles related to protein metabolism, evaluate the main assertions of the guidelines of specialty societies and review the recent studies that address these issues using critical insights from the authors' clinical experience. Associação Brasileira de Medicina intensiva 2013 /pmc/articles/PMC4031858/ /pubmed/23887760 http://dx.doi.org/10.1590/S0103-507X2013000100010 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
da Cunha, Haroldo Falcão Ramos da Rocha, Eduardo Eiras Moreira Hissa, Monica |
| spellingShingle |
da Cunha, Haroldo Falcão Ramos da Rocha, Eduardo Eiras Moreira Hissa, Monica Protein requirements, morbidity and mortality in critically ill patients: fundamentals and applications |
| author_facet |
da Cunha, Haroldo Falcão Ramos da Rocha, Eduardo Eiras Moreira Hissa, Monica |
| author_sort |
da Cunha, Haroldo Falcão Ramos |
| title |
Protein requirements, morbidity and mortality in critically ill patients:
fundamentals and applications |
| title_short |
Protein requirements, morbidity and mortality in critically ill patients:
fundamentals and applications |
| title_full |
Protein requirements, morbidity and mortality in critically ill patients:
fundamentals and applications |
| title_fullStr |
Protein requirements, morbidity and mortality in critically ill patients:
fundamentals and applications |
| title_full_unstemmed |
Protein requirements, morbidity and mortality in critically ill patients:
fundamentals and applications |
| title_sort |
protein requirements, morbidity and mortality in critically ill patients:
fundamentals and applications |
| description |
Recent evidence suggests that a negative protein balance secondary to severe disease
is associated with increased morbidity. A loss of total body protein is inevitable in
this scenario, even with an aggressive nutritional approach, primarily due to the
catabolism of skeletal muscle fibers. The ubiquitin-proteasome system is the primary
metabolic and biochemical mechanism involved in this process; paradoxically, this
system consumes adenosine triphosphate as its energy source. It is possible that a
neutral protein balance in these clinical situations is important for improving
outcomes and achieving the caloric goals estimated or measured by indirect
calorimetry. Recent studies have suggested that the use of higher protein
concentrations in nutritional therapy for critically ill patients may help to reduce
mortality. The purpose of this study was to review some of the nutrition therapy
principles related to protein metabolism, evaluate the main assertions of the
guidelines of specialty societies and review the recent studies that address these
issues using critical insights from the authors' clinical experience. |
| publisher |
Associação Brasileira de Medicina intensiva |
| publishDate |
2013 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031858/ |
| _version_ |
1612092596405927936 |