Whey protein supplementation improves hypoalbuminemia in critically ill neurological patients: a single-center randomized study

Abstract

Abstract Background:Whether whey protein supplementation can reduce the occurrence of hypoproteinemia in patients with acute critically ill neurological diseases on the basis of standard intact EN has not been confirmed by randomized controlled clinical trials. Objective:We evaluated the effect of whey protein powder on serum albumin in acute critically ill neurological patients. Methods:Critically ill neurological patients expected to stay longer than 7 days were randomized. For the intact protein formula (IPF) group, only an intact protein formula was given. For the whey protein supplementation formula (WPF) group, whey protein powder was added on the basis of an intact protein formula. Results: The serum albumin level in the WPF group was higher than that in the IPF group (31.92 ± 4.48 / 29.55 ± 4.31, P = 0.005, 95%CI 0.746 −3.981). There was no significant difference in the complications of enteral nutrition treatment between the two groups (p＞0.05). The serum albumin levels in the WPF group was higher than that in the IPF group for patients 60 years or older and for stroke patients respectively (P＜0.05). Interleukin-6 (OR = -0.023, P = 0.018, 95%CI -0.042 − -0.004) and procalcitonin (OR = -8.331, P = 0.004, 95%CI -13.931 − -2.730) were negatively independently correlated with the serum albumin levels respectively. There was no significant difference in the mRS between the two groups at 14 days and 90 days after onset (p＞0.05). Conclusion: Whey protein supplementation can improve the severity of hypoproteinemia in critically ill patients with neurological disease, especially in elderly patients and in patients with stroke. At the same time, we need to pay more attention to persistent inflammatory responses and secondary infections. Further clinical studiesat different levels are needed to discover more evidence to help better managethese patients. URL: https://clinicaltrials.gov/ct2/show/NCT04361357?term=04361357&draw=2&rank=1. Registration ID: NCT04361357