蛋白质干预时间对重症患者的影响:系统性审查和元分析
Pranav Kumar Sharma1, Sanjiya Arora2, Tirth Bhavsar3
1Department of Internal Medicine, Lake Cumberland Regional Hospital, Somerset, Kentucky, USA.
概括
危急病患者早期的蛋白质补充剂不会显著改变死亡率或并发症. 然而,早期的蛋白质 (EP) 管理可能会减少重症监护室 (ICU) 停留时间和机械通风持续时间.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持 营养支持
- 代谢研究研究 代谢研究
背景情况:
- 重症患者面临的代谢变化导致肌肉缩和蛋白质分解,增加死亡风险.
- 在危急疾病中提供蛋白质的最佳时间受到争论,尽管证据有限,但指南建议设定更高的目标.
研究的目的:
- 评估早期与晚期蛋白质补充对严重病患者的死亡率,并发症和临床结果的影响.
主要方法:
- 2010年1月至2022年12月期间发表的研究的系统审查和元分析.
- 包括成年ICU患者,比较早期和晚期的蛋白质给药.
- 主要结局:死亡率,传染性/整体并发症,肺炎,ICU/住院时间,机械通风持续时间.
主要成果:
- 对13项研究 (10,672名患者) 的分析发现,早期蛋白质 (EP) 和晚期蛋白质 (LP) 组之间的死亡率,整体并发症,感染性并发症或肺炎没有显著差异.
- EP显著减少了ICU停留时间和机械通风持续时间.
- EP与整体住院时间较长有关.
结论:
- 危急病患者早期的蛋白质补充剂不会显著影响死亡率或重大并发症.
- 早期给予蛋白质可能会缩短ICU停留时间和机械通风持续时间.
- 一些结果的高度异质性需要谨慎地解释研究结果.
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