危急病患者的热量摄入量和临床结果之间的关系:一项回顾性研究
You-Ru Lin1, Po-Chuan Chen2, Wei-Ting Li3
1Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Clinical nutrition ESPEN
|November 17, 2024
概括
在重症监护室 (ICU) 住院的第一周内,热量不足会增加死亡风险. 积极的营养支持,特别是在本周晚些时候,可能会改善危急病患者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持 营养支持
- 临床营养学 临床营养学
背景情况:
- 由于代谢变化,在重症监护室 (ICU) 中提供最佳的营养支持仍然具有挑战性.
- 初始ICU周的卡路里不足会影响重症患者的治疗结果.
研究的目的:
- 评估ICU住院第一周卡路里缺乏对营养护理和死亡率的影响.
- 评估早期热量摄入量与危急病患者28天死亡率之间的关系.
主要方法:
- 对3544例ICU住院病例 (2018年1月 - 2021年9月) 的回顾性研究,ICU住院时间>7天.
- 分析2至7天的平均热量摄入量 (实际与计算需求)
- 考克斯比例危险模型用于分析28天死亡率.
主要成果:
- 在第一周ICU中摄取<60%的目标卡路里与较高的28天死亡率相关 (HR:1.41,p<0.0001).
- 摄入量<30%的目标从第5天起增加死亡风险.
- 摄入量>80%的目标从第6天起显著减少了28天的死亡率.
结论:
- 在初始ICU周的热量不足 (<60%) 与增加的死亡率有关.
- 在第一周末的积极营养干预可能是有益的.
- 这些发现为重症监护中的营养策略提供了指导.
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