1. The Effect of Higher Protein Dosing in Critically ill Patients: A Multicentre Registry-based Randomized Trial
Timelines: Patients are to be screened and randomized within 96 hours of their admission to your ICU.
Inclusion Criteria
Patients must meet all inclusion criteria to be included in the trial.
Adult patients >18 years old
2) Have >1 of the following high nutrition risk factors:
Low (<25) or high BMI (>35)
Moderate to severe malnutrition (as defined by local assessments).
Frailty (Clinical Frailty Scale >5, obtained from proxy)
Sarcopenia (SARC-F score >4, obtained from proxy)
From point of screening, projected duration of mechanical ventilation >4 days
3) Expected to be mechanically ventilated for an additional 48 hours from screening

2. The Effect of Higher Protein Dosing in Critically ill Patients: A Multicentre Registry-based Randomized Trial
Exclusion Criteria
>96 continuous hours of mechanical ventilation before screening
Expected death or withdrawal of life- sustaining treatments within 7 days from screening
Pregnant
The responsible clinician feels that the patient either needs low or high protein
Patient requires parenteral nutrition only and site does not have products to reach the high protein dose group.
Randomizing Patients
All screened patients that meet all inclusion criteria are entered into REDCap, regardless if they meet exclusion criteria.
All data collected for randomized patients are to be entered in REDCap.
Contact the Project Leader, [NAME], at [ ] if you have any questions.