Kemper M, Weissman C, Hyman A I
Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Crit Care Med. 1992 Mar;20(3):344-8. doi: 10.1097/00003246-199203000-00009.
To compare the caloric intake with the caloric requirements in postoperative patients being fed enterally via nasoenteric tubes, parenterally, or by both enteral and parenteral methods.
Descriptive study.
Surgical ICU in a university teaching hospital.
Sample of 22 mechanically ventilated postoperative patients, mean age 62 +/- 17 yrs, selected from among those patients routinely scheduled to receive enteral or parenteral nutrition or both, for greater than or equal to 4 days. The patients were studied for a total of 144 study days.
Eight patients received total parenteral nutrition, eight patients received enteral nutrition, and six patients received both parenteral and enteral nutrition.
Resting energy expenditure was measured by using indirect calorimetry, and daily nutritional intake was quantitated.
The patients who received parenteral, or enteral plus parenteral nutrition received an average of 80% of their caloric requirements, while those patients who received only enteral nutrition received only 68% of their caloric requirements. There was more day-to-day variation in nutrient intake in the enteral group (40% +/- 56%) than in the parenteral group (12.2% +/- 24%, p less than .001).
Enteral nutrition delivered via nasoenteric tubes as the sole delivery method in postoperative critically ill patients resulted in an inadequate and inconsistent nutrient supply. The use of parenteral or parenteral plus enteral nutrition resulted in more stable and adequate feeding than feeding by enteral nutrition alone.
比较经鼻肠管肠内喂养、肠外喂养或肠内与肠外联合喂养的术后患者的热量摄入与热量需求。
描述性研究。
一所大学教学医院的外科重症监护病房。
从常规计划接受肠内或肠外营养或两者兼有的患者中选取22例机械通气的术后患者作为样本，年龄平均为62±17岁，营养支持时间≥4天。对这些患者共进行了144个研究日的研究。
8例患者接受全肠外营养，8例患者接受肠内营养，6例患者接受肠外和肠内联合营养。
采用间接测热法测量静息能量消耗，并对每日营养摄入量进行定量。
接受肠外营养或肠外加肠内营养的患者平均摄入热量为其热量需求的80%，而仅接受肠内营养的患者仅摄入其热量需求的68%。肠内营养组的营养摄入量每日变化（40%±56%）比肠外营养组（12.2%±24%，p<0.001）更大。
在术后重症患者中，经鼻肠管进行肠内营养作为唯一的营养供给方式会导致营养供给不足且不稳定。与单纯肠内营养相比，采用肠外营养或肠外加肠内营养能实现更稳定、充足的喂养。
