在非侵入性通风患者中实施养方案改善了肠道营养:NIVEN研究
Javier Rodriguez-Fanjul1, Clara Sorribes Ortí2, Ana Santos Monton2
1Pediatric Intensive Care Unit, Pediatric Service, Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, and Institut d'Investigació Germans Trias i Pujol, Badalona, Spain.
Hospital pediatrics
|January 22, 2025
概括
在双相正气道压力 (BiPAP) 上为患有支气管炎的儿童实施标准化肠道营养 (EN) 协议,显著减少了EN启动时间和达到卡路里目标的时间,没有观察到任何不良影响.
科学领域:
- 儿科重症监护 儿科重症监护
- 呼吸系统药物 呼吸系统药物
- 临床营养学 临床营养学
背景情况:
- 支气管炎是一种常见的儿科呼吸道疾病.
- 患有支气管炎的儿童通常需要呼吸支持,包括双相正气道压力 (BiPAP).
- 对于这些患者来说,最佳的肠道营养 (EN) 策略尚不清楚.
研究的目的:
- 评估标准化肠道营养 (EN) 方案对接受双相正气道压力 (BiPAP) 支持的支气管炎儿童的影响.
- 在开始BiPAP后,将EN启动的平均时间减少50%.
- 评估二次结果,包括达到目标卡路里的时间,BiPAP持续时间和不良事件.
主要方法:
- 一个质量改进项目比较了两个时期:在 (n=48) 之前和 (n=54) 协议实施后.
- 接受BiPAP治疗的支气管炎患者通过鼻胃管接收EN.
- 一个由利益相关者开发的算法指导了EN的启动和推进.
主要成果:
- 到EN启动的中位时间从18小时减少到6小时 (P < 0.05).
- 达到目标卡路里 (100千卡/千克/天) 的中位时间从103小时减少到48小时 (P <0.05).
- 在BiPAP持续时间或记录的不良事件 (包括吸收) 中没有显著差异.
结论:
- 对于接受BiPAP治疗的儿科患者来说,一个标准化的EN通路加速了营养递送.
- 观察到更快的EN启动和达到热量目标,没有增加不良事件.
- 这些发现支持在非侵入性通风的儿科患者中考虑更积极的肠道养.
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