深入研究关键疾病儿童与器官功能障碍的营养支持和充足性
Nicole Knebusch1,2, Paola Hong-Zhu3, Marwa Mansour1,2
1Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Children (Basel, Switzerland)
|June 27, 2024
概括
患有器官功能障碍 (OD) 的儿科重症监护室 (PICU) 的重症儿童在病情改善或稳定后,获得更高的热量和蛋白质摄入量. 根据器官功能障碍的严重程度,营养支持有显著的变化.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
背景情况:
- 个性化营养支持对于儿科重症监护室 (PICU) 患者至关重要.
- 器官功能障碍 (OD) 在重症儿童中很常见,需要量身定制的营养策略.
- 了解危急疾病早期的营养供应对于优化结果至关重要.
研究的目的:
- 评估体内器官功能障碍 (OD) 严重的儿童在住院前七天的热量和蛋白质供应.
- 评估营养摄入量与器官功能障碍严重程度之间的关系,用儿科序列器官衰竭评估 (pSOFA) 评分来衡量.
主要方法:
- 在164名儿童 (2-18岁) 的回顾性队列研究中,在2016-2017年期间,他们被录取到PICU.
- 纳入标准:机械通风>48小时,PICU停留>7天.
- 器官功能障碍 (OD) 被定义为儿科序列器官衰竭评估 (pSOFA) 评分>5在第1或第3天;通过肠道和亲肠道途径评估的营养.
主要成果:
- 器官功能障碍 (OD) 的患病率很高 (第1天为79.3%,第3天为78.7%).
- 在第3天,当pSOFA得分呈上升趋势 (0千卡/千克/天) 时,相比于降低 (9.2千卡/千克/天) 或不变 (22千卡/千克/天) 的得分 (p=0.0032) 时,中位热量摄入量明显较低.
- 同样,蛋白质摄入量较低,pSOFA得分上升趋势 (0 g/kg/day) 与减少 (0.44 g/kg/day) 或不变 (0.66 g/kg/day) 的得分相比较低 (p=0.0023).
结论:
- 在PICU入院后的最初72小时内,器官功能障碍很普遍.
- 与功能障碍恶化患者相比,器官功能障碍得分下降或保持稳定的患者的卡路里和蛋白质供应更高.
- 营养支持需要根据严重疾病儿童器官功能障碍严重程度的动态变化进行仔细调整.
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