在重症患者中,负荷受到高蛋白质供应的影响,这取决于功能
Masaki Mochizuki1, Hidehiko Nakano1, Daisuke Ikechi1
1Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki 317-0077, Japan.
Journal of clinical biochemistry and nutrition
|May 30, 2023
概括
患有功能障碍的重症患者的高蛋白摄入量增加了血液尿素 (BUN). 然而,这种较高的蛋白质剂量被耐受,不需要脏替代疗法 (RRT).
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 营养科学 营养科学
背景情况:
- 对于患有功能障碍的重症患者来说,蛋白质的输送至关重要.
- 不同的蛋白质和负荷对这些患者功能的影响尚不清楚.
研究的目的:
- 为了研究高蛋白输送 (1.8 g/kg/day) 与标准护理 (0.9 g/kg/day) 相比,高蛋白输送在患有功能障碍的重症患者中对功能标志物的影响.
主要方法:
- 一项涉及重症监护病房患者的研究,将标准护理组 (0.9克/千克/天蛋白质) 与接受活性营养治疗 (1.8克/千克/天蛋白质) 的干预组进行比较.
- 对最大血尿素 (BUN) 和肌素 (Cre) 水平的分析,以及对脏替代疗法 (RRT) 的需要.
- 基于估计的淋巴细胞过率 (eGFR <50和<30毫升/分钟/1.73米2) 的子组分析.
主要成果:
- 与标准护理组相比,高蛋白组显示最大BUN (7-10天) 的显著增加 (p=0.031).
- 这种BUN增加在EGFR<50毫升/分钟/1.73米2 (p=0.047) 的患者中更为明显,并在EGFR<30毫升/分钟/1.73米2的患者中进一步放大.
- 两组之间最大CRE或RRT利用率没有发现显著差异.
结论:
- 在患有功能障碍的重症患者中,每天提供1.8g/kg蛋白质与BUN水平升高有关.
- 这种较高的蛋白质摄入量被安全地容忍,没有增加RRT的需要证明了这一点.
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