透气多创伤患者的及时肠道营养:当前的标准和改进空间
Ottavio de la Vega1, Saskia Ridley-Smith1, Howard Huang1
1School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
概括
在通风多创伤患者中,早期肠道营养 (EN) 与更短的重症监护室 (ICU) 停留时间有关. 延迟EN启动与损伤严重程度的增加和多器官衰竭 (MOF) 的更高几率相关.
科学领域:
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
- 营养支持营养支持
背景情况:
- 在ICU中的多创伤患者患病和死亡风险很高.
- 充足的营养对于管理能量赤字和预防诸如多器官衰竭 (MOF) 等并发症至关重要.
研究的目的:
- 评估呼吸多创伤患者遵守肠道营养 (EN) 准则.
- 在这个患者群体中探索EN时间和临床结果之间的关系.
主要方法:
- 在一级创伤中心对182名通风多创伤患者 (2019-2022) 的回顾性分析.
- 收集的数据包括人口统计,损伤特征和EN输送模式.
- 早期EN被定义为在24小时内开始;统计分析检查了与ICU停留时间 (LOS) 和MOF等结果的关联.
主要成果:
- 在141名符合条件的患者中,64%接受了早期EN (中位数为17.8小时).
- 早期的EN与显著减少的ICU LOS相关 (p=0.016).
- 延迟的EN与较高的伤害严重程度相关 (p=0.008),每小时的延迟都会增加MOF的几率1.47%.
结论:
- 观察到与EN指导方针的显著偏差,40%的患者在24小时内没有接受EN,并且经常中断.
- 早期的EN启动与改善的结果有关,包括减少ICU LOS.
- 对于多创伤患者,建议改善EN协议和营养师的参与.
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