早期肠道营养可能会改善心脏性休克患者的生存率
Liangliang Zheng1, Jingwei Duan2, Baomin Duan3
1Emergency Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Emergency medicine international
|January 16, 2025
概括
早期肠道营养 (EEN) 可以改善心脏性休克 (CS) 患者的生存结果,而不会增加不良事件. 这种方法还可以减少住院时间,为严重病情的CS患者提供更安全,更有效的食策略.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 心脏病学 心脏病学
背景情况:
- 国际指导方针提倡在重症患者中提供早期肠道营养 (EEN).
- 在心脏性休克 (CS) 患者中,EN的最佳时间仍未得到充分研究.
- 这项研究调查了EEN与延迟EN在CS患者中的影响.
研究的目的:
- 在CS患者中比较EEN与延迟EN的临床结果和安全性.
- 评估在CS中EEN和生存率之间的关联.
- 评估CS中EEN的胃肠道不良事件风险.
主要方法:
- 使用MIMIC-IV数据库 (v2.2) 的回顾性队列研究 (v2.2).
- 1:1倾向分数匹配分析,比较EEN (2天内) 和延迟EN组.
- 调整了比例危险回归模型以确认生存关联.
主要成果:
- 在匹配后,每组 (EEN和延迟EN) 都有409名患者.
- EEN与显著改善的30,90和180天生存率相关 (HRs <1,p <0.05).
- 使用EEN并没有增加患乳,吸入性肺炎或胃肠道出血的风险;使用EEN的住院时间较短 (12 vs. 17天,p <0.001).
结论:
- 早期肠道营养 (EEN) 是安全的,并且与心脏性休克 (CS) 患者的生存率改善有关.
- EEN不会增加常见胃肠道并发症的风险.
- 研究结果表明,EEN是CS患者有益的营养策略,需要进一步调查.
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