在手术ICU的营养支持小组干预及其对重症患者营养供应和质量的影响
Andrés Martinuzzi1, Adriana Crivelli2, Ariel Lopez3
1Universidad Nacional de La Plata, Critical Care Specialist SATI-UBA (Argentine Society of Critical Care - University of Buenos Aires) and Nutritional Support Expert AANEP (Argentine Association of Enteral and Parenteral Nutrition), Neuquén, Argentina.
实施营养支持团队 (NST) 显著提高了重症手术患者实现营养目标的可能性. 这种多学科的方法增强了重症监护室 (ICU) 的营养支持 (NS).
科学领域:
- 关键护理医学 关键护理医学
- 手术营养是指手术营养.
- 改善医疗保健的质量.
背景情况:
- 重症手术患者在满足营养目标方面面临重大挑战.
- 多学科营养支持团队 (NST) 在营养支持 (NS) 管理方面已经证明了好处.
- 研究了在手术重症监护室 (ICU) 实施NST以改善NS目标实现的有效性.
研究的目的:
- 评估实施多学科营养支持团队 (NST) 对在重症手术患者中实现营养目标的影响.
- 为了比较营养支持实践和结果之前和之后NST在手术ICU的实施.
主要方法:
- 采用了一个多中心的"BEFORE & AFTER"研究设计.
- 在"BEFORE"阶段 (没有NST) 和"AFTER"阶段 (有NST) 中,在三个ICU中进行了营养支持 (NS) 审计.
- 统计分析包括t测试,曼·惠特尼U测试,奇平方测试和二项逻辑回归来评估差异并确定NS成就的预测因素.
主要成果:
- "After"阶段包括85名患者,而"BEFORE"阶段为83名患者,观察到营养风险和营养不良的频率更高.
- 在"After"阶段, laparoscopy 作为外科手术技术的使用更为频繁.
- NST实施 (OR 3.582) 和手术技术 (OR 3.231) 是实现NS目标的独立预测因素;ICU/医院LOS和90天生存率没有显著差异.
结论:
- 营养支持团队 (NST) 的实施对在重症手术患者中实现营养支持 (NS) 目标产生了积极的影响.
- 由NST进行的多学科管理对于优化外科ICU环境中的营养结果至关重要.
- 进一步的研究可能会探索推动这些改进的NST干预措施的具体组成部分.
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