Evidence map›Paper›PMID 34620353›Full record

ArticleClinical nutrition ESPEN2021

Assessing calorie and protein recommendations for survivors of critical illness weaning from prolonged mechanical ventilation - can we find a proper balance?

Shanti Balasubramanian, Dena H Tran, Monica Serra, Elizabeth A Parker, Montserrat Diaz-Abad, Janaki Deepak, Michael T McCurdy, Avelino C Verceles

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical nutrition ESPEN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Shanti BalasubramanianDepartment of Internal Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Dena H TranDepartment of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA.
Monica SerraDepartment of Geriatrics, Gerontology & Palliative Medicine, San Antonio GRECC, University of Texas Health San Antonio, USA.
Elizabeth A ParkerDepartment of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Montserrat Diaz-AbadDivision of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Janaki DeepakDivision of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Michael T McCurdyDivision of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Avelino C VercelesDivision of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; University of Maryland, Claude D. Pepper Older Americans Independence Center, The Mid-Atlantic Nutrition Obesity Research Center, USA. Electronic address: avercele@som.umaryland.edu.
University of Maryland, Baltimore · USThe University of Texas Health Science Center at San Antonio · US

Funding

University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC)P30AG028747 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI Stephen L. Seliger · 2006 to 2026
$28.9M
Research BaseP30DK072488 · NIDDK · UNIVERSITY OF MARYLAND BALTIMORE · PI MITCHELL, BRAXTON D, TAYLOR, SIMEON I. · 2005 to 2019
$17.3M
Rehabilitation, NMES and High Protein to Reduce Post ICU Syndrome in the ElderlyR21AG050890 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI VERCELES, AVELINO CATALINO · 2015 to 2016
$422k
The Multimodal Rehabilitation of Older Ventilated Survivors Of Critical IllnessR03AG045100 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI VERCELES, AVELINO CATALINO · 2013 to 2014
$154k
NIA NIH HHS P30 AG028747NIA NIH HHS R03 AG045100NIA NIH HHS R21 AG050890NIDDK NIH HHS P30 DK072488
6 · The paper itself

Abstract

BACKGROUND &

aimsSurvivors of critical illness requiring prolonged mechanical ventilation (PMV) are predisposed to malnutrition, muscle wasting, and weakness. There is a lack of data regarding nutrition adequacy among these patients, and although nitrogen balance has been studied as a marker of adequate protein intake in healthy individuals and acutely critically ill patients, it has not been well studied in critically ill patients with PMV. The purpose of this study was to determine if patients requiring PMV admitted to a long-term acute care hospital (LTACH) achieved registered dietitian (RD) recommended goals for energy and protein intake and if the recommendations were adequate to avoid negative nitrogen balance.

methodsUsing a retrospective, cohort study design, patients requiring PMV who had orders for 24-h urine collections for urea nitrogen (24hrUUN) were included. Energy and protein intake was calculated from chart documentation of dietary intake for the 24-h period during which patients underwent a 24hrUUN. Nitrogen intake was estimated from protein intake. Dietary intake was compared to RD-recommendations to determine the percentage of RD-recommendations achieved. Nitrogen balance was calculated as nitrogen intake minus nitrogen loss, with negative balance categorized as less than -1.

resultsSubjects (n = 16) were 38% male and 75% African American (mean age 61.5 ± 3.2 years; mean BMI 27.5 ± 2.5 kg/m

conclusionSurvivors of critical illness requiring PMV achieved a high percentage of RD-recommended protein and calories, and prevented a negative nitrogen balance in a majority of patients. Increasing protein intake can prevent a negative nitrogen balance. Future studies should evaluate whether these patients are able to maintain a steady state of nitrogen intake and excretion over time and how this affects time to and/or success of weaning.

Indexed as

Critical IllnessRespiration, ArtificialCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesSurvivorsCaloric intakeCritical illnessMechanical ventilationNutritional therapy

Identifiers

PMID34620353
PMCPMC8925994
OpenAlexW3186804416

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.