重症患者的能量密集与常规肠道营养:系统性审查和元分析
Zonghong Zhang1,2, Chuanlai Zhang1,2, Huiling Pan1,2
1Intensive Care Unit, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Frontiers in nutrition
|September 17, 2025
概括
能量密集的肠道营养 (EN) 改善了营养状况,并减少了机械通风的持续时间和重症病患者的ICU停留时间 (LOS). 虽然通常是安全的,但需要进一步的研究来确认发现.
科学领域:
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
- 基于证据的医学是基于证据的医学.
背景情况:
- 危急病患者往往没有最佳的肠道营养 (EN) 供应,导致营养不良.
- 能量密集的EN可能会增加热量摄入量,但其临床影响需要评估.
研究的目的:
- 在重症患者中,系统地审查能量密集EN与常规EN的影响.
- 评估对营养状况,临床结果和安全性的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,直到2024年12月.
- 评估结果包括死亡率,停留时间,通风持续时间和胃肠道耐受性.
主要成果:
- 能源密集的EN显著减少了机械通风的持续时间和ICU停留时间.
- 观察到改善了蛋白和前蛋白等营养标志物.
- 整体死亡率或重大胃肠道并发症没有显著差异;高胃残留体积 (GRV) 风险略有增加.
结论:
- 能量密集的EN是安全有效的,可以改善营养状况,减少ICU LOS和重症患者的通风持续时间.
- 限制包括潜在的偏见和不一致的GRV定义.
- 建议进行高质量,大规模的RCT验证.
更多相关视频
相关概念视频
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
853
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
853
Enteral Nutrition I: Orogastric and Nasogastric Feeding
1.3K
Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
1.3K
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
773
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
773
Energy Balance
1.2K
The human body gets energy from the three macronutrients: carbohydrates, proteins, and fats. Energy is released when the chemical bonds in the organic compounds present in the food are broken down. The energy content of food is measured in kilocalories (kcal), defined as the amount of heat required to raise the temperature of one kilogram of water by one degree Celsius. This value is determined by measuring the temperature change of the water surrounding a calorimeter after the complete...
1.2K
Chronic Kidney Disease III: Interprofessional Care
344
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
344
Bioavailability Study Design: Healthy Subjects Versus Patients
144
Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
144


