{"title":"危重病人的蛋白质摄入和临床结果：随机对照试验的剂量反应和两两荟萃分析。","authors":"Mohaddeseh Badpeyma, Faezeh Ghalichi, Roghayeh Molani-Gol, Hamed Valizadeh, Yousef Javadzadeh, Ahmadreza Rasouli, Mohammad Alizadeh, Sorayya Kheirouri","doi":"10.34172/hpp.025.43894","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The optimal protein intake for critically ill patients remains uncertain. This systematic review and dose-response meta-analysis aimed to evaluate the effect of high-protein nutritional support on clinical outcomes in intensive care unit (ICU) patients.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) comparing high- versus low-protein nutrition in critically ill adults with similar energy intake were identified through PubMed, Web of Science, and Scopus (up to June 2023). A random-effects model was used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Linear and non-linear trends were assessed using the one-stage cubic spline regression model.</p><p><strong>Results: </strong>Twenty-three RCTs were included. The summary RR was 0.83 (95% CI: 0.64-1.08; I<sup>2</sup>=63.6%; n=17) for mortality and 1.05 (95% CI: 0.88-1.25; I<sup>2</sup>=0%; n=7) for infections. The summary MD was -0.23% (-0.76 to 0.29, I<sup>2</sup>=5.6%, n=14) for mechanical ventilation days, -0.40 (-1.11 to 0.32, I<sup>2</sup>=0%, n=17) for ICU days, 0.73 (-1.11 to 2.58, I<sup>2</sup>=6%, n=10) for hospital days, and -3.44 (-4.99 to -1.90; I<sup>2</sup>=16.4%; n=5) for muscle atrophy. There was no evidence of linear or nonlinear trends.</p><p><strong>Conclusion: </strong>Although higher protein intake had no significant effect on mortality or length of stay, it was associated with reduced muscle wasting. This suggests a potential role in preserving lean mass and supporting long-term functional recovery.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024480303.</p>","PeriodicalId":46588,"journal":{"name":"Health Promotion Perspectives","volume":"15 2","pages":"98-109"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450574/pdf/","citationCount":"0","resultStr":"{\"title\":\"Protein intake and clinical outcomes in critically ill patients: A dose-response and pairwise meta-analysis of randomized controlled trials.\",\"authors\":\"Mohaddeseh Badpeyma, Faezeh Ghalichi, Roghayeh Molani-Gol, Hamed Valizadeh, Yousef Javadzadeh, Ahmadreza Rasouli, Mohammad Alizadeh, Sorayya Kheirouri\",\"doi\":\"10.34172/hpp.025.43894\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The optimal protein intake for critically ill patients remains uncertain. This systematic review and dose-response meta-analysis aimed to evaluate the effect of high-protein nutritional support on clinical outcomes in intensive care unit (ICU) patients.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) comparing high- versus low-protein nutrition in critically ill adults with similar energy intake were identified through PubMed, Web of Science, and Scopus (up to June 2023). A random-effects model was used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Linear and non-linear trends were assessed using the one-stage cubic spline regression model.</p><p><strong>Results: </strong>Twenty-three RCTs were included. The summary RR was 0.83 (95% CI: 0.64-1.08; I<sup>2</sup>=63.6%; n=17) for mortality and 1.05 (95% CI: 0.88-1.25; I<sup>2</sup>=0%; n=7) for infections. The summary MD was -0.23% (-0.76 to 0.29, I<sup>2</sup>=5.6%, n=14) for mechanical ventilation days, -0.40 (-1.11 to 0.32, I<sup>2</sup>=0%, n=17) for ICU days, 0.73 (-1.11 to 2.58, I<sup>2</sup>=6%, n=10) for hospital days, and -3.44 (-4.99 to -1.90; I<sup>2</sup>=16.4%; n=5) for muscle atrophy. There was no evidence of linear or nonlinear trends.</p><p><strong>Conclusion: </strong>Although higher protein intake had no significant effect on mortality or length of stay, it was associated with reduced muscle wasting. This suggests a potential role in preserving lean mass and supporting long-term functional recovery.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024480303.</p>\",\"PeriodicalId\":46588,\"journal\":{\"name\":\"Health Promotion Perspectives\",\"volume\":\"15 2\",\"pages\":\"98-109\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450574/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Promotion Perspectives\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34172/hpp.025.43894\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Promotion Perspectives","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34172/hpp.025.43894","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Protein intake and clinical outcomes in critically ill patients: A dose-response and pairwise meta-analysis of randomized controlled trials.
Background: The optimal protein intake for critically ill patients remains uncertain. This systematic review and dose-response meta-analysis aimed to evaluate the effect of high-protein nutritional support on clinical outcomes in intensive care unit (ICU) patients.
Methods: Randomized controlled trials (RCTs) comparing high- versus low-protein nutrition in critically ill adults with similar energy intake were identified through PubMed, Web of Science, and Scopus (up to June 2023). A random-effects model was used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Linear and non-linear trends were assessed using the one-stage cubic spline regression model.
Results: Twenty-three RCTs were included. The summary RR was 0.83 (95% CI: 0.64-1.08; I2=63.6%; n=17) for mortality and 1.05 (95% CI: 0.88-1.25; I2=0%; n=7) for infections. The summary MD was -0.23% (-0.76 to 0.29, I2=5.6%, n=14) for mechanical ventilation days, -0.40 (-1.11 to 0.32, I2=0%, n=17) for ICU days, 0.73 (-1.11 to 2.58, I2=6%, n=10) for hospital days, and -3.44 (-4.99 to -1.90; I2=16.4%; n=5) for muscle atrophy. There was no evidence of linear or nonlinear trends.
Conclusion: Although higher protein intake had no significant effect on mortality or length of stay, it was associated with reduced muscle wasting. This suggests a potential role in preserving lean mass and supporting long-term functional recovery.
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