危急病患者中较高与较低的蛋白质输送:系统性审查和贝叶斯元分析
Samuel Heuts1,2, Zheng-Yii Lee3,4, Charles Chin Han Lew5,6
1Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Critical care medicine
|December 27, 2024
概括
危急病患者摄入较高的蛋白质可能会增加死亡风险. 这种贝叶斯元分析发现,危害概率为56.4%,益处为43.6%,这表明增加蛋白质输送时应谨慎.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持营养支持
- 贝叶斯的元分析 贝叶斯的元分析
背景情况:
- 在重症患者中提供更高的蛋白质供应是关于患者结果的辩论.
- 以前的试验表明,增加蛋白质摄入量可能会造成潜在的伤害.
研究的目的:
- 估计在重症患者中较高蛋白质输送的有益和有害影响的概率.
- 为了对最近的证据进行更新的贝叶斯元分析.
主要方法:
- 系统搜索三个数据库,截至2024年9月4日.
- 包括随机对照试验,比较成人重症患者的肠道/肠道蛋白质剂量.
- 用于分析的贝叶斯分层随机效应模型,估计治疗效应的后期概率.
主要成果:
- 分析了22项试验 (4164名患者).
- 较高的蛋白质供应 (1.5 g/kg/d) 与较低 (0.9 g/kg/d) 显示死亡率的中位风险比为1.01.
- 任何死亡益处的概率为43.6%,而伤害的概率为56.4%.
结论:
- 在重症患者中,蛋白质输送较高时,死亡风险增加的可能性很大.
- 虽然伤害更有可能发生,但不能完全排除临床上有益的影响.
- 目前的证据表明,在这个人群中增加蛋白质输送时,需要谨慎.
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