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Comment & Response
September 18, 2013

Early Parenteral Nutrition in Critical Illness—Reply

Author Affiliations
  • 1Northern Clinical School Intensive Care Research Unit, University of Sydney, Sydney, Australia
JAMA. 2013;310(11):1184. doi:10.1001/jama.2013.276779

In Reply We agree with Dr Hoffer that more evidence from large-scale clinical trials is needed to investigate appropriate protein dosing in patients with critical illness. Figure 2C in the article showed patients allocated to receive early parenteral nutrition achieved a mean protein intake of 50 to 60 g/d by study day 3 or 4, which was significantly higher than standard care patients, who received 20 to 30 g/d by study day 3 or 4.

The protein intake achieved in the intervention group of our clinical trial is similar to the protein intake routinely achieved by usual care delivered in Australia and New Zealand.1 The benefits of higher protein doses merit further study.