间歇性肠道营养可能会增加严重病患者的胃肠道并发症和死亡率
Panxin Hu1, Haopeng Wu1, Kai Zhang2
1Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, China.
持续肠道营养 (CEN) 优于间歇肠道营养 (IEN) 对于重症患者,特别是那些接受机械通风的人. CEN减少并发症和死亡率,支持在这个人群中优先使用它.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持 营养支持
- 基于证据的实践.
背景情况:
- 肠道营养 (EN) 对重症患者至关重要.
- 最佳的EN传递方法 (间歇性与连续性) 被辩论.
- 关于EN对患者结果的影响存在相互矛盾的证据.
研究的目的:
- 为了比较间歇性肠道营养 (IEN) 和持续性肠道营养 (CEN).
- 评估对重症患者并发症和临床结果的影响.
- 综合来自随机对照试验 (RCT) 的证据.
主要方法:
- 在主要数据库 (PubMed,Embase,Scopus,Cochrane) 进行系统搜索.
- 包括在重症患者中比较IEN和CEN的RCT.
- 使用随机效应模型进行元分析,汇集有关死亡率,并发症和ICU住院的数据.
主要成果:
- 与CEN相比,IEN与腹,腹和ICU死亡率的增加有关.
- 与长时间的ICU停留时间相关的IEN.
- 亚组分析显示,这些影响在机械通风患者中明显.
结论:
- 持续肠道营养 (CEN) 在重症患者中显示出优于间歇性肠道营养 (IEN) 的优势.
- 建议在机械通风患者中优先使用CEN.
- 考虑患者因素的个性化营养策略至关重要.
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