A long-awaited, international medical study recently published in the Lancet was made possible partly due to Abbotsford hospital patients and staff.
The study is called was co-authored by several Fraser Health clinicians and researchers, and shows that higher doses of protein do not improve clinical outcomes of some critically-ill patients. It’s not the result that researchers had been expecting, said a dietitian from Fraser Health. And critical care medical teams will start adjusting their practise right away, she added.
“The results will absolutely change clinical practice world-wide,” says Courtney Wedemire, study co-author and ICU dietitian at Abbotsford Regional Hospital. “There is this dogma that more protein is better and will improve patient outcomes. This study demonstrates that high dose protein doesn’t improve patient outcomes and may even be harmful to some patients.”
The study is called The Effect of Higher Protein Dosing in Critically Ill Patients (the EFFORT Protein Trial), and the researchers tracked 1,301 nutritionally high-risk patients undergoing mechanical ventilation at 85 hospitals internationally including: Surrey Memorial Hospital, Burnaby General Hospital, Royal Columbian Hospital and Abbotsford. Participants received high-dose protein or usual-dose protein within the recommended range of 1.2 to 2.2 grams of protein per kilogram of bodyweight per day.
Sixty days after patients were assigned to the groups, the incidence of alive hospital discharge was 46.1 per cent in the high-dose compared with 50.2 per cent in the usual dose protein group. The mortality rate was 34.6 per cent in the high dose protein group, compared with 32.1 per cent in the usual dose protein group. In addition, researchers found higher protein appeared to be harmful in patients with acute kidney injury.
Wedemire says the critical care nutrition community has been eagerly awaiting the results of this trial to guide future practice and make recommendations for clinicians. The study came from a need to clarify just how much protein critically ill patients should receive in ICUs.
While too much could be harmful, so could too little, Wedemire explained the News.
Low protein can result in sarcopenia, which having low muscle function and low muscle mass.
“Ultimately we want to create critical care survivors who are able to go back to moving around well, and enjoying life,” she said.
Abbotsford Regional Hospital was the top Canadian site and the six largest international site for patient recruitment, with 53 patients participating in the study. Researchers and clinicians at ARH are now participating in a supplemental study to examine the role of higher protein in a patient’s strength and functional status.
It’s not the first study Wedemire has co-written a study, and she said it was a good experience working with the international medical community and learning from their practises and perspectives.
She thanks the family members and other surrogates who agreed to participate in the study.
“I think there is tremendous value in doing and participating in research,” she said. “It helps guide how we treat patients in the future.”