California State University San Bernardino, CA, USA.
J Neurosci Nurs. 2011 Dec;43(6):291-7. doi: 10.1097/JNN.0b013e318234e9b2.
Pediatric severe traumatic brain injury treatment guidelines for nutrition indicate that "there are insufficient data to support a treatment guideline for this topic" (P. D. Adelson et al., 2003). Based on adult studies, the guideline provided an option for practitioners to start nutritional support within 72 hours of admission and full replacement by day 7. This retrospective, descriptive correlation study examined the timing of nutritional supplement initiation and the timing of achieving full caloric intake in relation to length of stay (LOS) in the intensive care unit (ICU) and patient disposition status at discharge from hospital in children 8-18 years old. Median time to initiation of nutrition was 1.5 days (0.02-11.9 days), and full caloric goals were achieved in 3.4 days (0.5-19.6 days). Median ICU LOS was 2.1 days (0.01-97.9 days). Overall, 48% of patients were discharged home; 28% experienced mild, moderate, or severe disability; and 24% either died or survived in a vegetative state. Early initiation and achieving full caloric intake were both positively correlated with shorter LOS in the ICU (p < .01, Spearman's rho correlational matrix) and better disposition status at discharge from the hospital (p < .05, Kruskal-Wallis test).
儿科严重创伤性脑损伤治疗营养指南指出，“缺乏支持这一主题的治疗指南的数据”（P.D.Adelson 等人，2003 年）。基于成人研究，该指南为从业者提供了一种选择，即在入院后 72 小时内开始营养支持，并在第 7 天完全替代。这项回顾性描述性相关性研究检查了营养补充剂的起始时间和达到全热量摄入的时间与入住重症监护病房（ICU）的时间以及 8-18 岁儿童出院时患者处置状态之间的关系。营养开始的中位数时间为 1.5 天（0.02-11.9 天），而达到全热量目标的中位数时间为 3.4 天（0.5-19.6 天）。ICU 入住中位数时间为 2.1 天（0.01-97.9 天）。总体而言，48%的患者出院回家；28%的患者有轻度、中度或重度残疾；24%的患者要么死亡，要么在植物人状态下存活。早期启动和实现全热量摄入均与 ICU 入住时间缩短呈正相关（p<0.01，Spearman's rho 相关矩阵），且出院时的处置状态更好（p<0.05，Kruskal-Wallis 检验）。
