危急病患者的蛋白质摄入量和临床结果:随机对照试验的剂量反应和对对元分析
Mohaddeseh Badpeyma1,2, Faezeh Ghalichi3, Roghayeh Molani-Gol1,2
1Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Health promotion perspectives
|September 24, 2025
概括
高蛋白质营养支持在重症监护室 (ICU) 并没有显著影响死亡率或停留时间. 然而,增加蛋白质摄入量与减少肌肉消耗有关,可能有助于重症患者的长期康复.
科学领域:
- 关键护理医学 关键护理医学
- 营养科学 营养科学
- 临床营养学 临床营养学
背景情况:
- 在重症监护室 (ICU) 中的重症患者的最佳蛋白质摄入量仍然是正在进行的研究领域.
- 高蛋白质营养支持是改善这一弱势群体结果的潜在策略.
- 现有证据需要通过系统审查和元分析进行综合.
研究的目的:
- 进行系统性审查和剂量反应元分析,评估高蛋白营养支持对ICU患者临床结果的影响.
- 评估不同蛋白质摄入水平对死亡率,感染率和资源利用的影响.
- 为了探索肌肉质量保护的潜在好处.
主要方法:
- 在PubMed,Web of Science和Scopus进行了全面的搜索,直到2023年6月,以确定相关的随机对照试验 (RCT).
- 包括比较高蛋白与低蛋白营养的临床试验在重症成年人中,具有类似的能量摄入量.
- 随机效应模型被用于元分析,使用立方线回归评估线性和非线性趋势.
主要成果:
- 分析了23个RCT. 在死亡率 (RR:0.83;95% CI:0.64-1.08) 或感染率 (RR:1.05;95% CI:0.88-1.25) 中没有发现显著差异.
- 机械通风日,ICU停留时间和住院日没有显著变化.
- 随着较高的蛋白质摄入量 (MD: -3.44%; 95% CI: -4.99至 -1.90) 观察到肌肉缩的显著减少.
结论:
- 虽然高蛋白营养支持并没有显著改变ICU患者的死亡率或逗留时间,但它在减少肌肉消耗方面显示出好处.
- 这一发现表明,较高的蛋白质摄入量在保持瘦体质量方面可能起到作用.
- 进一步的研究可能会阐明与在危急疾病中优化蛋白质供应相关的长期功能恢复益处.
相关概念视频
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
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
407
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
407
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
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
209
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
209
Dosage Regimen: Individualization
166
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
166
Clinical Trials
10.1K
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
10.1K


