{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:55:23Z","timestamp":1786964123558,"version":"build-2736575974"},"reference-count":0,"publisher":"Maad Rayan Publishing Company","issue":"2","content-domain":{"domain":["hpp.tbzmed.ac.ir"],"crossmark-restriction":false},"short-container-title":["Health Promot Perspect"],"abstract":"<jats:p>Background: The optimal protein intake for critically ill patients remains uncertain. This systematic review and dose\u2013response meta-analysis aimed to evaluate the effect of high-protein nutritional support on clinical outcomes in intensive care unit (ICU) patients. Methods: Randomized controlled trials (RCTs) comparing high- versus low-protein nutrition in critically ill adults with similar energy intake were identified through PubMed, Web of Science, and Scopus (up to June 2023). A random-effects model was used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Linear and non-linear trends were assessed using the one-stage cubic spline regression model. Results: Twenty-three RCTs were included. The summary RR was 0.83 (95% CI: 0.64\u20131.08; I2=63.6%; n=17) for mortality and 1.05 (95% CI: 0.88\u20131.25; I2=0%; n=7) for infections. The summary MD was -0.23% (-0.76 to 0.29, I2=5.6%, n=14) for mechanical ventilation days, -0.40 (-1.11 to 0.32, I2=0%, n=17) for ICU days, 0.73 (-1.11 to 2.58, I2=6%, n=10) for hospital days, and -3.44 (-4.99 to -1.90; I2=16.4%; n=5) for muscle atrophy. There was no evidence of linear or nonlinear trends. Conclusion: Although higher protein intake had no significant effect on mortality or length of stay, it was associated with reduced muscle wasting. This suggests a potential role in preserving lean mass and supporting long-term functional recovery. Systematic Review Registration: PROSPERO CRD42024480303. <\/jats:p>","DOI":"10.34172\/hpp.025.43894","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T05:04:43Z","timestamp":1755752683000},"page":"98-109","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Protein intake and clinical outcomes in critically ill patients: A dose\u2013response and pairwise meta-analysis of randomized controlled trials"],"prefix":"10.34172","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8150-8997","authenticated-orcid":true,"given":"Mohaddeseh","family":"Badpeyma","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran"},{"name":"Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Ghalichi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roghayeh","family":"Molani-Gol","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran"},{"name":"Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Valizadeh","sequence":"additional","affiliation":[{"name":"Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Javadzadeh","sequence":"additional","affiliation":[{"name":"Biotechnology Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmadreza","family":"Rasouli","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran"},{"name":"Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7408-8573","authenticated-orcid":true,"given":"Mohammad","family":"Alizadeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-4462","authenticated-orcid":true,"given":"Sorayya","family":"Kheirouri","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"20123","published-online":{"date-parts":[[2025,7,15]]},"container-title":["Health Promotion Perspectives"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/hpp.tbzmed.ac.ir\/PDF\/hpp-15-98.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/hpp.tbzmed.ac.ir\/PDF\/hpp-15-98.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T05:04:43Z","timestamp":1755752683000},"score":1,"resource":{"primary":{"URL":"https:\/\/hpp.tbzmed.ac.ir\/Article\/hpp-43894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,7,15]]}},"URL":"https:\/\/doi.org\/10.34172\/hpp.025.43894","relation":{},"ISSN":["2228-6497"],"issn-type":[{"value":"2228-6497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]},"assertion":[{"value":"Tabriz University of Medical Sciences","name":"journal_owner","label":"Journal Owner"},{"value":"Tabriz University of Medical Sciences","name":"journal_publisher","label":"Journal Publisher"},{"value":"2024-12-08","order":1,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}