急性阶段蛋白质剂量对临床结果的影响 危急病患者的临床结果
Sayaka Shiraishi1, Hiroomi Tatsumi2, Junpei Haruna3
1Nutrition Management Center, Sapporo Medical University Hospital, Sapporo, Hokkaido 060-8543, Japan; Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Hokkaido 060-8543, Japan.
Clinical nutrition ESPEN
|May 18, 2025
概括
在重症监护室 (ICU) 住院的第四天,严重病情严重的日本患者的高蛋白摄入量与更糟糕的生存率有关. 第7天的蛋白质剂量没有影响生存率.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持 营养支持
- 临床结果研究研究
背景情况:
- 对于重症患者的国际蛋白质摄入指南有所不同.
- 这些指导方针对于日本患者的适用性是不确定的,这些患者往往是年长且瘦的.
- 这项研究探讨了日本ICU患者蛋白质管理对生存的影响.
研究的目的:
- 评估蛋白质管理对日本重症患者生存的影响.
- 在危急疾病的早期急性阶段确定最佳的蛋白质剂量策略.
- 评估蛋白质摄入量对ICU第4和第7天的影响.
主要方法:
- 对262名在ICU中的成年患者进行了回顾性研究.
- 患者接受了人工营养,并停留了>8天.
- 在ICU第4和第7天分类为低 (<0.8g/kg/day),中等 (0.8-1.4g/kg/day) 和高 (≥1.4g/kg/day) 蛋白质摄入组.
主要成果:
- 在ICU第四天的高蛋白摄入量与28日和90日生存率显著降低有关.
- 第4天的高蛋白剂量是较差结果的独立风险因素.
- 在ICU第7天的蛋白质摄入量与存活率没有显著的关联.
结论:
- 在ICU第4天服用高剂量的蛋白质 (≥1.4g/kg/day) 可能会对日本重症患者的存活率产生负面影响.
- 建议在急性早期阶段仔细考虑蛋白质剂量.
- 可能需要进一步的研究来完善特定人群的蛋白质建议.
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