肌肉质量变化与重症儿童的蛋白质或能量摄入量之间的关系:系统性审查和元分析
Lewis J Stacey1, Frederic V Valla2, Chao Huang3
1Edge Hill University, Ormskirk, UK.
JPEN. Journal of parenteral and enteral nutrition
|December 24, 2024
概括
儿科重症幸存者经常经历肌肉损失. 这项审查发现,在儿科重症监护室 (PICU) 的第一周,肌肉质量减少了近10%,近一半的儿童患有肌肉缩.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 肌肉生理学 肌肉生理学
- 营养支持 营养支持
背景情况:
- 在发达国家,儿科重症后的生存率正在改善.
- 然而,许多儿童经历了长期的身体疾病,包括肌肉质量变化.
- 儿科研究越来越多地报告了使用超声波的肌肉质量变化,但结果各不相同.
研究的目的:
- 系统地审查重症儿童的肌肉质量变化,使用四肢骨肌肉的超声波.
- 调查肌肉质量变化与蛋白质/能量摄入之间的关联.
- 评估这个人群中肌肉缩的发生率.
主要方法:
- 在2024年7月,通过搜索数据库进行了系统的文献审查.
- 包括的研究是实验性或观察性,发表于2010年1月至2024年7月,涉及重症儿童 (≥37周妊娠年龄至18岁).
- 使用Joanna Briggs研究所的批判性评估仪器来评估方法质量.
主要成果:
- 包括8项前性队列研究,涉及411名儿童.
- 八项研究中的七项报告了从基线到5-7天的8.9% (95%CI6.6-11.4) 的综合平均肌肉质量损失.
- 使用>10%的降低截止值,49.2%的儿童在儿童重症监护室 (PICU) 入院期间发生肌肉缩.
结论:
- 重症儿童在PICU入院的第一周内经历了显著的肌肉质量损失.
- 这些儿童中近一半患有肌肉缩,这凸显了对干预的迫切需要.
- 进一步的研究应该探索营养干预措施,以减轻肌肉损失.
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