Nitrogen balance as a tool for identifying ideal protein intake in critically ill patients: an integrative review

Authors

DOI:

https://doi.org/10.55892/jrg.v8i18.1877

Keywords:

Critical patient. Nitrogen balance. Protein intake. Intensive care.

Abstract

This study is an integrative review and aims to verify the main findings on the ideal amount of protein in the nutritional therapy of critically ill patients in order to stimulate positive nitrogen balance. The articles selected for this review indicated that a high-protein diet, with 1.2 to 2 grams of protein per kg of weight, is related to better results in nitrogen balance, as well as more favorable clinical outcomes, such as shorter mechanical ventilation time, ICU stay, hospital stay, in addition to reducing mortality. Thus, it can be concluded that a high-protein diet stimulates positive nitrogen balance. However, the ideal amount of protein for this stimulus is controversial in the literature, due to the multiple specificities of intensive care patients.

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Author Biographies

Leila Marques de Souza Paiva, Fundação de Ensino e Pesquisa em Ciências da Saúde, DF, Brasil

Graduado em Nutrição pelo UniCEUB.

Juliana Frossard Ribeiro Mendes, Escola de Saude Publica do Distrito Federal, DF, Brasil

Doutorado (2013) e Mestrado (2009) em Nutrição Humana pela Universidade de Brasília; Especialização em Preceptoria de Residência em Área Profissional de Saúde (2023) pela ESCS; Especialização em Nutrição Clínica, Enteral e Parenteral (2011) pelo GANEP; Especialização aos moldes de Residência em Nutrição Clínica (2005) pela ESCS e Graduação em Nutrição (2002) pela Universidade de Brasília.

References

ALLINGSTRUP, Matilde Jo et al. Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial. Intensive care medicine, v. 43, p. 1637-1647, 2017.

ALLINGSTRUP, Matilde Jo et al. Provision of protein and energy in relation to measured requirements in intensive care patients. Clinical nutrition, v. 31, n. 4, p. 462-468, 2012.

CASTRO, Melina Gouveia et al. Diretriz BRASPEN de Terapia Nutricional no Paciente Grave. BRASPEN Journal, v. 38, n. 2, Supl 2, p. 0-0, 2023.

DANIELIS, M. et al. Effect of Protein‑fortified diet on nitrogen balance in critically ill patients: results from the OPINiB trial. Nutrients. 2019; 11 (5): 972.

DICKERSON, Roland N. et al. A reappraisal of nitrogen requirements for patients with critical illness and trauma. Journal of Trauma and Acute Care Surgery, v. 73, n. 3, p. 549-557, 2012.

KIM, Tae Jung et al. Optimizing nitrogen balance is associated with better outcomes in neurocritically ill patients. Nutrients, v. 12, n. 10, p. 3137, 2020.

PREISER, J.-C. et al. Metabolic response to the stress of critical illness. British journal of anaesthesia, v. 113, n. 6, p. 945-954, 2014.

VERCELES, Avelino C. et al. Combining exercise, protein supplementation and electric stimulation to mitigate muscle wasting and improve outcomes for survivors of critical illness—the ExPrES study. Heart & Lung, v. 58, p. 229-235, 2023.

ZHU, Yi-Bing et al. Nitrogen balance and outcomes in critically ill patients: A systematic review and meta-analysis. Frontiers in Nutrition, v. 9, p. 961207, 2022.

Published

2025-02-07

How to Cite

PAIVA, L. M. de S.; MENDES, J. F. R. Nitrogen balance as a tool for identifying ideal protein intake in critically ill patients: an integrative review. JRG Journal of Academic Studies, Brasil, São Paulo, v. 8, n. 18, p. e081877, 2025. DOI: 10.55892/jrg.v8i18.1877. Disponível em: http://revistajrg.com/index.php/jrg/article/view/1877. Acesso em: 22 feb. 2025.

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