输出管和其他程序的食中断
Mickael Landais1, Stephan Ehrmann2, Christophe Guitton3
1Service de réanimation médico-chirurgicale polyvantre centre hospitalier Le Mans.
Current opinion in clinical nutrition and metabolic care
|January 17, 2025
概括
持续肠道营养直到输出管是像禁食6小时一样有效,减少输出管失败. 这挑战了常见的重症监护室 (ICU) 的食中断做法.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 手术营养是指手术营养.
背景情况:
- 输出管之前的食中断在ICU中很常见,通常基于历史的麻醉实践.
- 在输出管之前禁食的生理学理由受到争议,在减少胃内容或吸入风险方面有效性的证据有限.
研究的目的:
- 审查有关输出管和其他ICU程序之前断食断食的证据.
- 分析食中断的生理机制,风险和临床结果.
- 为了探索当前的实践,建议和创新,在外抽前营养管理.
主要方法:
- 对现有证据的系统审查,包括临床研究和指南.
- 分析与食和吸收有关的生理机制.
- 评估最近的研究,如安布罗西试验,对外输出周围营养的评估.
主要成果:
- 排泄前的禁食是一种异质的做法;持续肠道营养直到排泄是不低于排泄失败的6小时禁食.
- 从生理学上看,禁食在减少胃内含量或防止吸收方面似乎无效.
- 在其他ICU手术中禁食的证据是混合的;在某些侵入性手术中,持续营养是合理的,但在其他手术中存在风险,例如皮肤穿透气管切除术.
结论:
- 持续肠道营养直到输出管是传统的6小时禁食的可行替代方案,而不会增加输出管失败.
- 关于ICU中断食的现行做法需要根据新出现的临床证据重新评估.
- 需要进一步的研究,以优化在ICU的侵入性手术期间的营养管理.
相关概念视频
Endotracheal Intubation II: Nursing Management
461
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
461
Endotracheal Tube Extubation
374
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
374
Endotracheal Intubation I: Procedure
668
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
668
Enteral Nutrition I: Orogastric and Nasogastric Feeding
191
Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
191
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
74
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
74
Suctioning the Nasopharyngeal Airway
263
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
263


