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在三级儿科重症监护病房中,一个输出管后早期养协议 (PEEF):一个质量改善倡议
Sora Jung1, Sainath Raman2,3, Ian Hughes4,5
1Children's Critical Care Unit, Gold Coast University Hospital, Southport, Australia.
Journal of paediatrics and child health
|December 3, 2025
概括
输出管后早期养 (PEEF) 协议成功地缩短了恢复肠道营养的时间,并在儿科重症监护病房患者中达到输出管前养率. 需要进一步的评估和教育才能充分实现协议目标.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 临床营养学 临床营养学
- 质量改善举措 质量改善举措
背景情况:
- 输出管术后延迟恢复肠道营养是儿科重症监护室 (PICU) 的一个常见挑战.
- 早期的肠道营养对于患者的康复和结果至关重要.
研究的目的:
- 评价一个抽后早期养 (PEEF) 协议在第三级 PICU 中抽后恢复肠道营养的时间上的有效性.
- 评估PEEF协议对达到输出前养率所需时间的影响.
主要方法:
- 一个质量改进项目在第三级PICU中实施了PEEF协议.
- 在 (Nov 2019-Oct 2020) 之前和 (Nov 2021-Oct 2022) 协议实施后,从儿童 (0-18岁) 接受计划性输出的数据的回顾性分析.
- PEEF协议旨在在1小时内重新开始以50%的禁食前速率进行肠道营养,并在2小时内达到脱口前速率.
主要成果:
- 总共分析了795名患者 (372名PEEF前,423名PEEF后).
- 重新开始肠道营养的中位时间从PEEF前的4.2小时显著减少到PEEF后的3.2小时 (p < 0.0001).
- 达到禁食前食率的中位时间也从PEEF前的7.3小时减少到PEEF后的5小时 (p = 0.0005).
结论:
- 实施PEEF协议导致恢复肠道营养和达到目标养率的时间大幅缩短.
- 虽然有所改善,但结果并不总是符合PEEF协议规定的雄心勃勃的目标.
- 建议进行持续的评估和有针对性的教育,以进一步优化口养实践.
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