一个多中心随机对照试验,比较每天三次间歇性肠道姿势养与机械通风患者在重症监护室的连续肠道养
Rakshit Panwar1, Amber-Louise Poulter2, Mary Nourse3
1Intensive Care Unit, John Hunter Hospital, Newcastle, Australia; School of Medicine and Public Health, University of Newcastle, Australia.
与ICU患者的连续食相比,在右侧位置间歇性胃食显示出类似的耐受性和胃肠不耐受率. 需要进一步的试验来评估其他临床结果.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 临床营养学 临床营养学
背景情况:
- 之前对间歇性和连续性养进行比较的研究存在方法上的局限性.
- 长时间的禁食间隔和特定的患者定位可能会改善胃排空.
- 有证据表明,右侧位置可以提高胃排空效率.
研究的目的:
- 为了比较间歇性姿势养 (每天三次,右侧位置) 与标准连续养.
- 评估对机械通风ICU患者的胃肠道不耐受和死亡率的影响.
主要方法:
- 多中心随机对照试验 (RCT) 涉及120名需要机械呼吸的成年ICU患者.
- 患者被随机分配到间歇性姿势养或标准连续养.
- 主要结局:每100个患者日中胃肠道不耐受 (吐,腹,便秘) 的发病率.
主要成果:
- 两组之间胃肠道不耐受的主要结局没有显著差异 (8.5对6.2每100个患者日;p=0.23).
- 胃肠道不耐受性无天和吐,腹或便秘的发作率相似.
- 间歇性治疗组的全病因医院死亡率为20%,标准治疗组为31% (p=0.17),不具有统计学意义.
结论:
- 在机械通风ICU患者中,在右侧位置间歇性胃食与连续的肠道食一样耐受.
- 确定的RCT是有必要的,以评估其他临床上显著的结果.
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