Evidence map›Paper›PMID 40944133›Full record

ArticleNutrients2025

The Effects of Higher Protein Intake on Muscle Mass and Clinical Outcomes in Critically Ill Cancer Patients: A Prespecified Per-Protocol Analysis.

Jerusa Marcia Toloi, Ana Carolina Gallo Laranja, Diogo Oliveira Toledo, Ricardo Esper Treml, Luiz Marcelo S Malbouisson, William Manzanares, João Manoel Silva-Jr

Abstract read
In one paragraph

Article in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Jerusa Marcia ToloiDivision of Anesthesiology, Postgraduate Program of Anesthesiology, Surgical Sciences and Perioperative Medicine, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo 455, Sao Paulo 05403-000, Brazil.ORCID 0000-0003-4943-4670
Ana Carolina Gallo LaranjaDepartment of Nutrition, Barretos Cancer Hospital, R. Antenor Duarte Vilela 1331, Barretos 14784-400, Brazil.ORCID 0000-0002-1343-3011
Diogo Oliveira ToledoDepartment of Nutrition, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, Sao Paulo 05652-900, Brazil.
Ricardo Esper TremlDepartment of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA 94305, USA.
Luiz Marcelo S MalbouissonDivision of Anesthesiology, Postgraduate Program of Anesthesiology, Surgical Sciences and Perioperative Medicine, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo 455, Sao Paulo 05403-000, Brazil.ORCID 0000-0002-3261-5603
William ManzanaresDepartment of Critical Care, University Hospital of Universidad de la Republica (UDELAR), Av. Italia, Montevideo 11.600, Uruguay.
João Manoel Silva-JrDivision of Anesthesiology, Postgraduate Program of Anesthesiology, Surgical Sciences and Perioperative Medicine, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo 455, Sao Paulo 05403-000, Brazil.ORCID 0000-0003-1494-0784

Funding

Coordenação de Aperfeicoamento de Pessoal de Nível Superior 88887.713853/2022-00
6 · The paper itself

Abstract

BACKGROUND/

objectivesThe optimal protein dose for critically ill cancer patients, especially for muscle mass preservation and survival, remains unclear. This study evaluated whether a higher protein intake, compared to usual intake, was associated with improved clinical outcomes in this population.

methodsThis was a prospective analysis of critically ill adult cancer patients admitted to an oncological intensive care unit (ICU). Patients were initially assigned to receive protein prescriptions of either 1.5 or 2.0 g per kilogram per day (g/kg/day), but due to common limitations in achieving prescribed targets in this setting, a prespecified per-protocol analysis was conducted. After three days of exclusive nutritional therapy, patients were reclassified into two groups based on actual protein intake: >1.5 g/kg/day (higher intake group, IG) and ≤1.5 g/kg/day (usual intake group, CG). The primary outcome was muscle mass preservation, measured by quadriceps muscle thickness (QMT) via ultrasound on days 1, 7, and 14. Secondary outcomes included ICU survival, hospital and ICU length of stay, mechanical ventilation duration, dialysis requirement, and 60-day survival.

resultsFrom June 2019 to September 2023, 117 patients were included. Following the planned interim analysis, the study was stopped after meeting the Pocock criterion for ICU survival (

conclusionsHigher protein intake (>1.5 g/kg/day) was associated with better muscle mass preservation and improved clinical outcomes in critically ill cancer patients.

Indexed as

Critical IllnessDietary ProteinsMuscle, SkeletalNeoplasmsAgedFemaleHumansIntensive Care UnitsLength of StayMaleMiddle AgedProspective StudiesQuadriceps MuscleRespiration, ArtificialTreatment OutcomeDietary Proteinscancercritical carenutrition assessmentprotein requirementquadriceps muscleultrasonography

Identifiers

PMID40944133
PMCPMC12429859

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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.