在体外膜氧化 (ECMO) 中患有心脏病的儿童的营养提供
Jason S Kerstein1,2, Caroline R Pane1, Lynn A Sleeper1,2
1Department of Cardiology, Boston Children's Hospital, Boston, MA, USA.
Pediatric cardiology
|August 26, 2024
概括
提供足够的营养,为儿科心脏病患者在体外膜氧化 (ECMO) 是至关重要的. 虽然亲肠道营养改善了足够性,但它与医院获得的感染增加有关,这表明需要优化肠道营养策略.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 心血管研究的心血管研究.
- 营养科学 营养科学
背景情况:
- 需要体外膜氧化 (ECMO) 的儿科患者的营养管理面临复杂的挑战.
- 优化能量和蛋白质的输送对于患有心脏病的重症儿童的临床结果至关重要.
研究的目的:
- 检查心脏病患者接受ECMO的儿童的营养供应.
- 调查营养充足度 (能量和蛋白质) 和末端器官功能 (pSOFA分数) 之间的关系.
主要方法:
- 对259个ECMO运行在252名儿科患者 (2013-2020年) 中进行的回顾性分析.
- 评估中位能量和蛋白质的输送和足够性 (kcal/kg/day和g/kg/day).
- 使用儿科顺序性器官衰竭评估 (pSOFA) 评分对末端器官功能进行评估.
主要成果:
- 平均能量和蛋白质充足率分别为58.3%和35.7%.
- 营养充足度与pSOFA分数的变化之间没有发现显著的关联.
- 通过肠道营养获得的更高的营养充足度与医院获得感染 (HAI) 的增加相关.
结论:
- 在ECMO上,营养充足主要是通过腹腔营养来实现的.
- 虽然亲肠道营养改善了足够性,但它与更高的HAI发病率有关.
- 对儿科ECMO患者的最佳肠道营养策略进行进一步研究是有必要的,以平衡营养需求和感染风险.
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