在三级儿科重症监护病房满足营养建议的障碍
Claire Morice1, Corinne Jotterand Chaparro2, Angelo Polito1
1Pediatric and Neonatal Intensive Care Unit, Pediatric Specialities Division, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland.
Journal of pediatric gastroenterology and nutrition
|February 3, 2025
概括
危急病患的儿童经常错过营养目标,原因是临床因素,如通风和血液动力学支持. 这些障碍,特别是在前48小时,影响了儿童营养指南的遵守.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 临床营养学 临床营养学
- 基于证据的实践实践.
背景情况:
- 对重症儿童来说,最佳营养至关重要.
- 关键护理医学协会和ASPEN的2017年更新的指南旨在改善营养支持.
- 临床障碍可能会阻碍儿科重症监护室 (PICU) 实施指南.
研究的目的:
- 评估在PICU中遵守美国肠道和肠道营养学会 (ASPEN) 的指导方针.
- 确定阻碍实施营养支持建议的临床障碍.
- 假设护理人员偏见和临床因素对准则遵守的影响.
主要方法:
- 在2017年7月至2020年1月期间入院于PICU的533名儿童 (1个月至16岁) 的回顾性图表审查.
- 评估两个ASPEN建议:在48小时内养,并在第7天满足三分之二的热量需求.
- 在入院时收集营养和临床数据,48小时和7天.
主要成果:
- 75.4%的患者在48小时内获得了食;障碍包括侵入性通风和血液动力学支持.
- 80.5%的患者在第7天达到三分之二的热量需求.
- 侵袭性通风是达到7天热量目标的主要障碍.
结论:
- 在第三级PICU中遵守ASPEN营养指南受到临床因素的挑战.
- 血液动力学不稳定性和侵入性通风是重要的障碍,特别是在PICU入院后的前48小时内.
- 可能需要有针对性的干预措施来克服这些障碍,并优化重症儿童的营养.
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