Juvany Roig R, Llop Talaverón J, Herrero Meseguer I, Jódar Masanés R
Servicio de Farmacia, Ciutat Sanitària i Universitària de Bellvitge, Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat, Barcelona, España.
Nutr Hosp. 2003 Jul-Aug;18(4):199-206.
To assess the degree of hypernutrition of critically-ill patients under treatment with parenteral nutrition (PN) in a multi-purpose intensive care unit (ICU).
Patients under treatment with parenteral nutrition in a multi-purpose intensive care unit. Prospective study lasting four months.
The amounts of the daily dose of glucose, lipids and nitrogen were calculated in PN, enteral nutrition (EN), dextrose solution (DS) and propofol. The daily dose of glucose and lipid administered intravenously (i.v.) was assessed with respect to the recommended value (4-5 mg/kg/min and 1.5 g/kg/day, respectively) and with respect to the dose prescribed in the PN regime The total daily calorie intake (i.v. plus EN) was assessed with respect to the recommended value (25-35 kcal/kg/day).
The study involved 30 patients totalling 488 days with PN. The total daily dose of i.v. lipids (PN plus propofol) exceeded the recommended value on 23.2% of the days with propofol (13 of 56) and on 3.7% of the days without propofol (16 of 432). The total daily dose of i.v. dextrose did not exceed any day the maximum metabolization threshold. On 28.2% of the days with EN and 39.6% of the days without EN, the total daily dose of i.v. dextrose exceeded the PN regimen. Similarly, on 41% of the days with propofol, the total daily dose of i.v. lipids exceeded the PN regimen. The total calorie intake (i.v. plus EN) exceeded the recommended value on 46.9% of the days with EN (51 of 109) and on 5% of the days without EN (19 of 379).
The glucose of dextrose solution and the propofol lipid are not routinely discounted from the PN regime. A trend towards hypernutrition of the critically-ill patient is shown, especially on days with simultaneous treatment with PN and EN.
评估在多功能重症监护病房（ICU）接受肠外营养（PN）治疗的重症患者的营养过剩程度。
在多功能重症监护病房接受肠外营养治疗的患者。为期四个月的前瞻性研究。
计算PN、肠内营养（EN）、葡萄糖溶液（DS）和丙泊酚中每日葡萄糖、脂质和氮的剂量。根据推荐值（分别为4 - 5毫克/千克/分钟和1.5克/千克/天）以及PN方案中规定的剂量，评估静脉注射（i.v.）的每日葡萄糖和脂质剂量。根据推荐值（25 - 35千卡/千克/天）评估每日总热量摄入（静脉注射加肠内营养）。
该研究纳入了30例患者，共进行了488天的PN治疗。静脉注射脂质的每日总剂量（PN加丙泊酚）在使用丙泊酚的日子里有23.2%（56天中的13天）超过推荐值，在未使用丙泊酚的日子里有3.7%（432天中的16天）超过推荐值。静脉注射葡萄糖的每日总剂量在任何一天都未超过最大代谢阈值。在有肠内营养的日子里，28.2%的日子静脉注射葡萄糖的每日总剂量超过PN方案；在没有肠内营养的日子里，39.6%的日子超过PN方案。同样，在使用丙泊酚的日子里，41%的日子静脉注射脂质的每日总剂量超过PN方案。每日总热量摄入（静脉注射加肠内营养）在有肠内营养的日子里有46.9%（109天中的51天）超过推荐值，在没有肠内营养的日子里有5%（379天中的19天）超过推荐值。
葡萄糖溶液中的葡萄糖和丙泊酚脂质在PN方案中未常规扣除。显示出重症患者有营养过剩的趋势，尤其是在同时进行PN和EN治疗的日子里。
