肠道养方案:在第三级重症监护病房中养中断和临床结果的质量改进项目
Boon Hui Ng1, Wan Rahiza Wan Mat2, Rufinah Teo2
1Department of Anaesthesia and Intensive Care, Duchess of Kent Sandakan Hospital, Sabah, Malaysia.
实施食方案改善了重症患者的营养,但并没有减少食中断. 与疾病相关的食中断与ICU患者的存活率下降有关.
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
- 重症监护病房 (ICU) 管理管理
背景情况:
- 食中断 (FI) 在重症患者中很常见,可能会影响临床结果.
- 优化营养供应对于ICU患者的康复至关重要.
- 结构化养方案在缓解FI和改善结果方面的有效性需要评估.
研究的目的:
- 评估食方案在减少食中断 (FI) 和改善临床结果的有效性.
- 评估营养摄入量和足够性的变化后的协议实施.
- 为了确定ICU死亡率的风险因素.
主要方法:
- 采用了单中心,回顾性和前性队列研究设计.
- 分析了FI的营养特征,充足性和原因.
- 确定了ICU死亡率的危险因素.
主要成果:
- 在实施协议后,能量和蛋白质摄入量显著改善,包括430名患者 (217名协议前,213名协议后).
- 后协议组接受了更多的能量密集配方,蛋白质补充剂和 prokinetic 剂.
- 在断食持续时间方面没有发现显著差异;ICU死亡率没有受到该协议的影响. 死亡率预测因素包括SOFA分数,体重不足状态和与疾病相关的FI.
结论:
- 食方案提高了营养摄入量和食策略,但没有减少食中断.
- 与疾病相关的食中断与重症患者的生存率降低有关.
- 可能需要进一步的研究来解决影响养和患者结果的疾病相关因素.
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