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Do We Have Clinical Equipoise (or Uncertainty) About How Much Protein to Provide to Critically Ill Patients?
Author(s) -
Patel Jayshil J.,
Rice Todd,
Compher Charlene,
Heyland Daren K.
Publication year - 2020
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10320
Subject(s) - medicine , critically ill , guideline , dosing , intensive care medicine , clinical trial , clinical equipoise , randomized controlled trial , pharmacology , pathology
The current recommendation for protein dose in critically ill patients is 1.2–2.0 g/kg/d. Despite this recommendation, there is significant variation in the amount of protein prescribed and delivered worldwide. We contend clinical equipoise, or a state of genuine uncertainty about 2 (dosing) strategies, exists because guideline‐based recommendations for protein dose in critically ill patients are rooted in a weak evidentiary base, leaving the clinician with no good basis for choosing a lower or higher protein dose. We outline evidence for and against high protein dose and introduce a pragmatic, registry‐based, multicenter, randomized controlled trial, known as EFFORT, which aims to resolve the high vs low protein dose controversy.

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