确定重症儿科患者的能量和蛋白质需求:一个范围审查
Corinne Jotterand Chaparro1,2, Céline Pabion1, Lyvonne Tume1,3
1Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.
概括
确定重症儿童的营养需求是复杂的. 本次审查发现,目前用于估计儿科重症监护病房的能源需求的方法存在局限性,强调需要更好的验证.
科学领域:
- 儿科重症监护营养 儿科重症监护营养
- 儿童的新陈代谢评估.
- 在儿科重症监护中的基于证据的实践.
背景情况:
- 最佳的能量和蛋白质摄入量对于降低重症儿科患者的发病率和死亡率至关重要.
- 准确确定这一群体的营养需求仍然是一个重大的临床挑战.
- 关于评估这些需求的方法的现有证据是分散的.
研究的目的:
- 进行范围审查,以了解重症儿科患者确定能量和蛋白质需求的方法的证据的范围和性质.
- 识别当前科学文献中关于这些评估方法的空白.
主要方法:
- 一个国际专家组使用约翰娜·布里格斯研究所的方法进行了系统的范围审查.
- 2008年至2023年间发表的研究在两个电子数据库中进行了搜索.
- 数据提取和资格选由两名研究人员进行.
主要成果:
- 包括39项研究,主要关注需要机械通风的重症儿童.
- 预测用于估计静止能耗 (REE) 的预测方程显示了低估或高估的风险;斯科菲尔德方程最不准确.
- 没有新的间接热量计方法来确定蛋白质需求被验证,临床因素对REE的影响是不一致的.
结论:
- 对于衡量能量消耗和确定重症儿童蛋白质需求的方法,需要大量可靠的科学数据.
- 需要使用参考方法进行进一步的研究,以验证儿科重症监护中的间接热量计技术.
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