PD219 - IMPACT OF A HYPERPROTEIC VS NORMOPROTEIC INTAKE ON DIAPHRAGMATIC THICKNESS AND DAYS OFMECHANICAL VENTILATION.

PD219

IMPACT OF A HYPERPROTEIC VS NORMOPROTEIC INTAKE ON DIAPHRAGMATIC THICKNESS AND DAYS OF

MECHANICAL VENTILATION.

K. I. I. Gómez Alaniz^1,*, E. Pérez Cruz¹, M. A. Juan Gómez¹

¹ Nutritional and metabolic support unit, HOSPITAL JUÁREZ DE MEXICO, Mexico City, Mexico

Rationale: Critically ill patients develop a catabolic state with muscle mass loss, including diaphragmatic muscle, which prolongs mechanical ventilation and ICU stay. Early nutritional support and adequate protein intake are essential. This study evaluated the effect of a high-protein diet versus a normoprotein diet on diaphragmatic thickness and duration of mechanical ventilation.

Methods: A prospective cohort study included adult ICU patients requiring invasive mechanical ventilation within the first 48 hours and early nutritional support (≤72 hours).  Patients with prior myopathy, Karnofsky score <80, KDIGO stage V chronic kidney disease, Child-Pugh B liver failure, or interruption of nutritional support >48 hours were excluded. Patients were randomized 1:1 into two groups: normoprotein intake (1–1.2 g/kg/day) and hyperprotein intake (1.3–1.5 g/kg/day). Diaphragmatic thickness was measured at ICU admission and after 5 days using ultrasound. Data were analyzed with STATA v14.0. Between-group changes were analyzed using paired Student’s t-test or Wilcoxon test, considering p<0.05 statistically significant.

Results: A total of 25 patients were included: 14 in the hyperprotein group and 11 in the normoprotein group. Most patients were male (60%), with a mean age of 53.7 ± 17.1 years. Nutritional support was initiated within the first 24 hours in 58% of patients, within 48 hours in 29%, and within 72 hours in 13%. The mean change in diaphragmatic thickness was 0.02 cm in the hyperprotein group versus 0.11 cm in the normoprotein group (p = 0.22). No significant differences were observed between groups in days of mechanical ventilation, ICU length of stay, or mortality.

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Conclusion: The hyperproteic diet showed a tendency to decrease diaphragmatic thickness and fewer days of mechanical ventilation in the Adult Intensive Care Unit.

Disclosure of Interest: None declared