在易于通风的过程中肠道营养的安全性和有效性:元分析
Pan Jianzhen1, Gu Mei1, Zhao Jianghong1
1Department of Critical Care Medicine, Hunan Cancer Hospital, Affiliated Hospital of Xiangya School of Medicine, Central South University Changsha, Hunan, China.
The Journal of international medical research
|April 3, 2025
概括
容易通风期间的肠道营养会增加吐和肺炎的风险,但不会影响死亡率. 需要小心管理在临界病患者接受营养在容易的位置.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 倾向于通风增强了急性呼吸困难综合征 (ARDS) 的氧化.
- 在易于通风的过程中管理肠道营养,由于身体位置的变化,这会带来挑战.
- 在重症患者中优化营养供应对于康复至关重要.
研究的目的:
- 为了评估肠道营养的安全性和有效性,在易受呼吸的患者的倾斜位置.
- 为了比较腹腔营养的结果,倾向于躺着和躺着的位置.
- 为了确定与易受肠道营养相关的潜在并发症.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane等) 的系统文献搜索. 在2024年12月之前.
- 五项涉及319名危急病患者的研究的元分析.
- 使用纽卡斯尔-太华尺度进行质量评估,使用埃格尔测试进行出版偏差检查.
主要成果:
- 倾向于肠道营养与较低的能量成就率相关 (MD: -0.88).
- 与呼吸机相关的肺炎 (OR: 2.11),吐 (OR: 2.38) 和胃残留体积 (OR: 2.72) 的发生率增加.
- 观察到更高的肠道营养中断率 (OR:4.75);死亡率没有显著差异 (OR:1.11).
结论:
- 躺卧的肠道营养与胃残留体积增加,吐,呼吸机相关的肺炎和食中断有关.
- 在俯卧和仰卧位置之间没有发现死亡率的统计学上显著差异.
- 虽然能量的输送可能会略有减少,但容易通风对氧化的好处应该与这些营养管理挑战相对衡量.
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