严重疾病期间蛋白质的效果取决于人体组成:对前性观察性研究的二次分析
Michele Umbrello1, Elda Diletta Sterchele1, Ada Cosmina Cioata2
1SC Rianimazione e Anestesia Legnano, ASST Ovest Milanese, Ospedale Civile di Legnano, Legnano MI, Italy.
危急病患者的最佳蛋白质摄入量取决于肌肉质量. 通过生物阻抗分析或超声波评估,较高的蛋白质剂量与肌肉质量较大患者的死亡率降低相关.
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
- 身体组成分析分析.
背景情况:
- 对重症患者的最佳蛋白质剂量仍然存在争议.
- 现有的研究提出了关于蛋白质管理效应的相互矛盾的发现.
- 肌肉质量可能会影响严重疾病中蛋白质摄入量的影响.
研究的目的:
- 研究重症患者蛋白质摄入量与死亡率之间的关系.
- 为了确定肌肉质量是否调节蛋白质管理对患者结果的影响.
- 探索身体成分指标在指导营养治疗中的实用性.
主要方法:
- 一项前性观察性研究的二次分析,涉及机械通风ICU患者.
- 在ICU入院后24小时内,使用生物阻抗衍生的肌肉质量 (BIA MM) 和直骨骨横截面积 (RF CSA) 评估身体组成.
- 蛋白质和卡路里摄入量记录在第7 ICU 日.
主要成果:
- 分析了94名患者;实际体重与BIA MM的相关性很弱,而不是RF CSA.
- 较高的蛋白质摄入量与BIA MM和RF CSA的最高四分位数内的患者的ICU死亡率降低有关.
- 特定的几率比率表明,在肌肉质量较大的患者中,增加蛋白质的生存益处较大.
结论:
- 较高的蛋白质摄入量与较低的ICU死亡率有关,但这种益处主要在肌肉质量较高的患者中观察到.
- 通过生物阻抗分析或超声波评估的肌肉质量是确定蛋白质补充剂有效性的关键因素.
- 这些发现表明,基于人体成分的个性化营养策略对于重症患者是有必要的.
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