描述和预测接受低或高剂量的蛋白质与中等能量支持的重症患者的结果:一项回顾性研究
Orit Raphaeli1,2,3, Pierre Singer3,4, Eyal Robinson4
1Industrial Engineering and Management, Ariel University, Ariel 40700, Israel.
Nutrients
|October 16, 2024
概括
低蛋白饮食和中等能量摄入量的重症患者如果年轻,APACHE II分数较低,以及与创伤相关的入院,则存活率更高. 高蛋白饮食有利于年轻的患者,他们的BMI较高,没有败血症.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持 营养支持
- 临床结果 临床结果
背景情况:
- 在重症患者中优化能量和蛋白质的输送是复杂的.
- 个体患者对蛋白质摄入的反应各不相同.
- 这项研究研究了基于中等能量的ICU中蛋白质剂量的结果.
研究的目的:
- 描述接受中等能量和高或低剂量的蛋白质的危急病患者.
- 根据蛋白质的摄入水平来预测患者的结果.
- 在不同蛋白质摄入群体中确定影响生存的因素.
主要方法:
- 在5天内分析了646名成年ICU患者的队列.
- 患者接受10-20 kcal/kg/day的低蛋白 (LP; ≤1 g/kg/day) 或高蛋白 (HP; >1 g/kg/day) 支持.
- 多重逻辑回归评估了患者特征与90天生存率之间的关联.
主要成果:
- 在LP组中,增加年龄,APACHE II评分和补充性肠外营养 (SPN) 降低了生存率;创伤入院增加了生存率.
- 在HP组中,增加年龄降低了生存率,而更高的BMI改善了生存率.
- 老年HP幸存者的BMI比非幸存者的BMI高.
结论:
- 低蛋白质支持的幸存者更年轻,APACHE II分数较低,创伤入院,没有功能衰竭.
- 高蛋白质支持的幸存者更年轻,BMI更高,没有败血症.
- 建议进行前性随机对照试验,以证实这些发现.
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