栄養支援と重症病棟での肺移植後の患者の臨床結果との関連: 遡及的研究

Malika Udagedara^1,2, Katherine J P Schwenger¹, Yasaman Ghorbani^1,3

¹Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Canada.

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

|September 3, 2025

まとめ

肺移植患者のタンパク質摂取量の増加は,集中治療室 (ICU) の滞在の延長と関連していました. この効果は病気の重症度によって変化し,重症患者のための個別化された栄養プランの必要性を強調しました.

科学分野:

クリティカルケア医療
移植医学
栄養学

背景:

固体臓器移植後の結果は,栄養状態によって著しく影響されます.
肺移植 (LTx) 患者の集中治療室 (ICU) 内のエネルギーとタンパク質の摂取に関するデータは限られている.

研究の目的:

医療栄養療法と機械呼吸器を用いた成人LTx後の患者の臨床結果を検証する.
栄養,特にタンパク質とエネルギー摂取とICU滞在期間 (LOS) などのアウトカムとの関係を調査する.

主な方法:

ICUで機械呼吸器を受けている100人の成人後のLTx患者 (2022-2023) の遡及的研究.
ICUでの最初の14日間の臨床および栄養のパラメータを記録した.
ウィルコクソンランクサムテスト,フィッシャー正確なテスト,およびICU LOSの予測要因を特定するために多変量分析を使用しました.

主要な成果:

> 1.2 g/ kg/ dayのタンパク質を摂取した患者は,ICUと病院での LOSを長期間経験しました.
エネルギー摂取と栄養状態はLOSに影響しなかった.
死亡率や感染率との有意な関連は見つかりませんでした.
多変量分析により,ICU LOSに影響するタンパク質摂取と疾患の重症度 (APACHEスコア) の間の有意な相互作用が示されました.

結論:

深刻な病状のLTx後の患者のタンパク質摂取量の増加は,ICUと病院でのLOSの延長と関連しています.
病状の重さは,ICU LOSに対するタンパク質摂取の影響を変化させる.
個別化された栄養戦略はこのリスクの高い集団の結果を最適化するために不可欠です

キーワード:

深刻な病気キロカロリー滞在期間肺移植機械的な換気死亡率栄養補助移植後の状態タンパク質

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