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Annually about 92.000 patients are admitted acutely to an ICU in Belgium and the Netherlands. 25-30% of these patients require more than 3 days of invasive ventilation, with an average ICU stay of 10 days. This prolonged ICU stay is associated with a severe catabolic condition, leading to the loss of 10-15% of total muscle mass during the first week, resulting in a delayed ICU and eventually hospital discharge.

 

High protein provision by enteral feeding could have a positive effect on muscle protein synthesis and function and recovery of ICU patients. Observational data appear to confirm this hypothesis but may be hampered by selection bias. There are some indications though, that provision of high protein amounts could be detrimental in the early of critical illness as it may lead to overfeeding and inhibition of the beneficial effects of autophagia.

 

In this multicentre, double-blinded, randomized clinical trial, the impact of a high versus a standard enteral protein formula on functional recovery of ICU patients will be examined for up to 6 months following ICU discharge. Functional recovery will be assessed using a COMET registered Core Outcome Measures set containing patient and health care decisionmakers relevant endpoints. 824 patients will be randomized among 9 participating hospitals across Belgium and the Netherlands.

The high annual incidence and cost of prolonged critical illness make an intervention leading to enhanced recovery from critical illness very appealing from a health-economic perspective.

 

If this study shows a positive effect of high protein enteral nutrition on functional recovery, an annual saving ranging between 9.5 and 65 million euro's can be achieved.

 

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