父母肠道营养:当前使用,并发症,以及重症患者的营养供应
Juan Carlos Lopez-Delgado1,2, Teodoro Grau-Carmona3,4, Esther Mor-Marco5
1Hospital Clinic, Medical ICU, Clinical Institute of Internal Medicine & Dermatology (ICMiD), C/Villarroel, 170, 08036 Barcelona, Spain.
Nutrients
|November 14, 2023
概括
亲肠道营养 (PN) 对重症成年人来说是安全有效的,提供足够的营养. 稍后添加肠道营养 (EN) 可能可以优化蛋白质摄入量,以较长的ICU停留的严重病例.
科学领域:
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
- 重症监护病房 (ICU) 管理管理
背景情况:
- 在肠道营养 (EN) 不可行时,关节营养 (PN) 对重症患者至关重要,防止营养不良.
- 早期PN的管理越来越多地被用作重症监护病房 (ICU) 的初始营养疗法.
研究的目的:
- 评估PN在重症成年人中的利用,并发症和营养供应,特别是当早期启动时.
- 为了比较仅接受PN的患者和从PN过渡到EN (PN-EN) 的患者之间的结果.
主要方法:
- 一项前性观察性研究,涉及37个中心和629名成年重症患者.
- 数据收集包括临床特征,结果和与营养相关的变量.
- 进行了统计分析,以比较子组,包括PN单独与PN-EN.
主要成果:
- 在29.6%的患者中,PN是最初的营养路线,75.3%的患者在48小时内开始.
- PN为EN提供了可比的热量和蛋白质供应,没有PN相关的严重并发症.
- PN-EN小组经历了更多与EN相关的并发症,但获得了更高的蛋白质输送 (1.17 g/kg/day对比0.95 g/kg/day).
- 与PN-EN组相比,仅接受PN的患者的蛋白质摄入量显著降低,ICU停留时间更短,机械通风日数也更少.
结论:
- 早期亲肠道营养 (PN) 是一种安全有效的方法,可以为重症患者提供足够的营养.
- 在可行的情况下,补充肠道营养 (EN) 可能有助于优化蛋白质输送,特别是在需要长时间的ICU护理的严重病例中.
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