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  • Assessment
    What level of protein intake or what protein delivery is associated with improvements in mortality?
    • Conclusion
      To date, no studies were found in generalized critical care populations that demonstrated a significant difference in mortality based on level of protein intake or delivery. In critically ill patients undergoing continuous renal replacement therapy, a single study indicates that protein intake > 2.0 g per kg per day is more likely to promote positive N balance (P=0.0001).  And, while a more positive N balance is associated with decreased mortality, a higher protein intake was not associated with mortality.
       
       
    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What level of protein intake or what protein delivery is associated with improvements in rate of infectious complications?
    • Conclusion
      To date, adequately powered studies have not been conducted to demonstrate a significant difference in rate of infectious complications when comparing critically ill patients with positive or negative N balance.
    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What level of protein intake or what protein delivery is associated with improvements in length of hospital stay?
    • Conclusion
      To date, no studies were found that demonstrated a significant difference in LOS or ICU length of stay based on level of protein intake or protein delivery. In critically ill patients undergoing continuous renal replacement therapy, a single study indicates that protein intake > 2.0 g per kg per day is more likely to promote positive N balance (p=.0001), however, LOS was not related to N balance.
       
       
    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What level of protein intake or what protein delivery is associated with improvements in days on mechanical ventilation?
    • Conclusion
      To date, adequately powered studies have not been conducted to demonstrate a significant difference in days on mechanical ventilation when comparing critically ill patients with positive or negative N balance.
    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What level of protein intake or what protein delivery is associated with improvements in cost of medical care?
    • Conclusion
      To date, adequately powered studies have not been conducted to demonstrate a significant difference in cost of medical care when comparing critically ill patients with positive or negative N balance.
    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.