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间歇性与持续性肠道营养在重症患者中的安全性. 随机临床试验随机临床试验

María Dolores Saiz-Vinuesa¹, Eloina Rodriguez-Moreno¹, Francisca Calero-Yánez¹

¹Gerencia de Atención integrada de Albacete; Unidad de Cuidados Intensivos, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.

Enfermeria intensiva

|August 19, 2025

概括

在重症监护室 (ICU) 中间歇性肠道营养 (IEN) 与连续肠道营养 (CEN) 一样安全有效. IEN可能会导致更少的中断,可能会改善热量目标的实现,而不会增加并发症.

科学领域:

关键护理医学关键护理医学
营养支持营养支持
胃肠病学胃肠病学

背景情况:

肠道营养 (EN) 是重症监护室 (ICU) 营养支持的基石.
连续肠道营养 (CEN) 和间歇肠道营养 (IEN) 是主要的施用方法,关于它们的比较疗效和安全性仍在进行辩论.
仅有有限的证据可以确定CEN和IEN之间的选择,以优化营养状况和最大限度地减少不良事件.

研究的目的:

为了比较间歇性肠道营养 (IEN) 与持续性肠道营养 (CEN) 的安全性和有效性,在重症监护室 (ICU) 通过胃食管 (GFT) 接受EN的患者.
评估与每个EN注射方法相关的并发症,包括胃肠道,呼吸道和代谢问题.
评估实现热量目标 (CG) 和达到目标所需的时间.

主要方法:

一个随机的,开放的临床试验,涉及成人ICU患者,需要通过GFT通过EN.
患者被随机分配,接受CEN (对照组) 或IEN (实验组),IEN被分为四个剂量,每6小时服用1小时.
结果包括并发症,达到热量目标,营养状况和严重程度得分 (APACHE II).

主要成果:

总共包括了40名患者 (18名CEN,22名IEN). 除了APACHE II分数之外,各组的情况是可比的.
热量目标在很高比例的患者 (82.5%) 中实现,CEN (88.9%) 和IEN (77.3%) 之间没有显著差异.
虽然吐和腹的发病率相似,但IEN与CEN相比,IEN的中断次数显著减少 (中位数为1比2.5).

结论:

间歇性肠道营养 (IEN) 是ICU患者连续肠道营养 (CEN) 的安全有效替代品,并发症率和热量目标实现率相似.
通过减少中断的次数,IEN可能会提供优势,从而可能提高对营养计划的遵守.
需要对更大的样本进行进一步的研究,以充分阐明每个方法的好处和潜在缺点.

关键词:

持续的肠道营养不断的肠道营养关键的护理关键的护理关心的批评者.胃食管中的胃食管.间歇性肠道营养间歇性肠道营养持续的肠道营养持续的营养营养肠道间歇性间歇性鼻胃探针鼻胃探针

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