Effect of standard feeding with a high-protein diet on arterial blood gases in patients admitted to the intensive care units: A study protocol for a double-blinded, randomized controlled clinical trial

Critically ill patients admitted to the intensive care units (ICUs) often face numerous challenges, including severe metabolic stress, systemic inflammation, and compromised immune function. Studies have suggested that critically ill patients frequently experience a negative nitrogen balance due to a hypercatabolic state, leading to impaired organ function and muscle wasting, which can cause severe muscle weakness and physical disability for years after discharge. Arterial blood gases (ABG) reflect patients' oxygenation and acid-base status and are crucial indicators of respiratory and metabolic function in critically ill individuals. We aim to address this by conducting a double-blinded, randomized controlled clinical trial to compare the effects of standard feeding with a high-protein diet on ABG in ICU patients. In this double-blinded, randomized controlled clinical trial, we will use block randomization of 80 patients aged between 18 to 65 years old and Patients expected to be hospitalized in the ICU for at least 3 days from Kosar Hospital, Kurdistan, Iran. The intervention group (n=40) will receive a protein diet (consisting of 18.7% protein, 45% carbohydrates, and 35% fat per 1000cc). A control group (n=40) will receive a standard diet (14.4% protein, 54% carbohydrates, and 32.4% fat per 1000cc) for the same duration in addition to usual care. The caloric requirements of each patient will be determined by a nutritionist based on their nutritional status, height, weight, age, and initial diagnosis, utilizing the Harris-Benedict formula. The parameters of ABG, including PO2, PCO2, SAO2, HCO3, BE, and pH, will be assessed. By optimizing protein intake through a high-protein diet, we aim to improve the nutritional status of patients and enhance their overall clinical outcomes. This reassures us of the potential benefits of our study.