关键病症儿童的亲肠道营养开始时间:一项随机临床试验
Nagwan Y Saleh1, Hesham M Aboelghar1, Nehad B Abdelaty2
1Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt.
Clinical and experimental pediatrics
|June 15, 2023
概括
在重症儿童的早期亲肠道营养 (PN) 改善了结果. 在入院日开始PN可以减少机械通风的需求,并缩短儿科重症监护室 (PICU) 的停留时间,从而改善临床康复.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 营养支持 营养支持
- 临床试验研究 临床试验研究
背景情况:
- 在重症儿科患者中启动亲肠道营养 (PN) 的最佳时间尚未确立.
- 这种不确定性影响了儿科重症监护室 (PICU) 中关于营养支持的临床决策.
研究的目的:
- 确定在重症儿童中启动亲肠道营养 (PN) 的最佳时间.
- 评估早期与晚期PN启动对儿科重症监护机构的临床结果的影响.
主要方法:
- 一项随机临床试验,涉及140名在儿科重症监护室 (PICU) 中的重症儿童.
- 患者被随机分配,接受早期PN (1日入院) 或晚期PN (4日或7日).
- 主要结果是机械通风 (MV) 的要求;次要结果包括PICU停留时间和死亡率.
主要成果:
- 早期的PN启动导致了显著更早的肠道养 (中位数为6天而不是12天),并减少了食不耐受 (5.6%而不是18.8%).
- 接受早期PN的患者在PICU中位数停留时间较短 (P<0.001),需要机械通风的可能性降低 (P=0.018).
- 在早期PN组中,达到全肠热量摄入的时间显著较短 (P=0.004).
结论:
- 在重症儿童早期启动腹腔营养 (PN) 与改善临床结果有关.
- 早期的PN减少了机械通风 (MV) 的需要和持续时间,与晚期的PN相比.
- 早期PN表现出更有利的发病概况,支持其在儿科重症监护中的使用.
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