在烧伤后24小时内开始适应性养,可以改善严重烧伤患者的营养治疗
Yin Zhang1, Yi Dou1, Zongqi Yin1
1Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Frontiers in nutrition
|July 11, 2024
概括
严重烧伤患者的适应性养加速了肠道营养的启动. 这种方法,与完全禁食不同,缩短了营养的时间,而不会增加不耐受性,有助于恢复.
科学领域:
- 烧伤护理和重症监护医学
- 在创伤中提供营养支持.
- 手术患者的管理管理.
背景情况:
- 营养治疗对于严重烧伤患者至关重要,平衡早期侵略性养的风险与营养中断的后果.
- 传统方法包括完全禁食或适应性养,适应性养模仿早期肠道营养.
- 延迟营养会增加感染风险,并阻碍伤口愈合.
研究的目的:
- 分析影响早期燃烧管理中禁食和适应性养之间的选择因素.
- 评估适应性养作为肠道营养前体的好处.
- 促进适应性养,以优化严重烧伤患者的营养支持.
主要方法:
- 在24小时内入院的成人患者的回顾性分析,总体表面积 (TBSA) 烧伤>30%.
- 两个组的比较:适应性养与完全禁食.
- 分析因素,包括烧伤区域,烧伤类型,吸入伤害,营养干预的时间;死亡率和住院作为结果.
主要成果:
- 完全厚度的烧伤区域和吸入伤害显著影响了禁食对适应性养的选择.
- 适应性养与肠道营养后倾向性得分匹配的显著较早开始时间有关.
- 两组之间在整体死亡率,28天死亡率或住院时间长度方面没有发现显著差异.
结论:
- 医生选择完全禁食的严重烧伤主要是由于大全厚烧伤区域和吸入伤害.
- 适应性养有助于更早地启动肠道营养,改善营养治疗时间.
- 尽管存在担忧,但完全禁食会延迟肠道营养,但不会减少不耐受性,突出了适应性养的好处.
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