Outcomes after Critical Illness and Surgery Group, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Am J Respir Crit Care Med. 2013 Sep 1;188(5):567-76. doi: 10.1164/rccm.201304-0651OC.
We hypothesized that providing patients with acute lung injury two different protein/calorie nutritional strategies in the intensive care unit may affect longer-term physical and cognitive performance.
To assess physical and cognitive performance 6 and 12 months after acute lung injury, and to evaluate the effect of trophic versus full enteral feeding, provided for the first 6 days of mechanical ventilation, on 6-minute-walk distance, cognitive impairment, and secondary outcomes.
A prospective, longitudinal ancillary study of the ARDS Network EDEN trial evaluating 174 consecutive survivors from 5 of 12 centers. Blinded assessments of patients' arm anthropometrics, strength, pulmonary function, 6-minute-walk distance, and cognitive status (executive function, language, memory, verbal reasoning/concept formation, and attention) were performed.
At 6 and 12 months, respectively, the mean (SD) percent predicted for 6-minute-walk distance was 64% (22%) and 66% (25%) (P = 0.011 for difference between assessments), and 36 and 25% of survivors had cognitive impairment (P = 0.001). Patients performed below predicted values for secondary physical tests with small improvement from 6 to 12 months. There was no significant effect of initial trophic versus full feeding for the first 6 days after randomization on survivors' percent predicted for 6-minute-walk distance, cognitive impairment status, and all secondary outcomes.
EDEN trial survivors performed below predicted values for physical and cognitive performance at 6 and 12 months, with some improvement over time. Initial trophic versus full enteral feeding for the first 6 days after randomization did not affect physical and cognitive performance.
我们假设，在重症监护病房为急性肺损伤患者提供两种不同的蛋白质/卡路里营养策略，可能会影响其长期的身体和认知功能。
评估急性肺损伤后 6 个月和 12 个月的身体和认知功能，并评估营养支持与全肠内营养（机械通气的前 6 天）对 6 分钟步行距离、认知障碍和次要结局的影响。
这是一项对 ARDS 网络 EDEN 试验的前瞻性、纵向辅助研究，共纳入来自 12 个中心的 5 个中心的 174 例连续幸存者。对患者的手臂人体测量学、力量、肺功能、6 分钟步行距离和认知状态（执行功能、语言、记忆、言语推理/概念形成和注意力）进行了盲法评估。
分别在 6 个月和 12 个月时，6 分钟步行距离的预测百分比均值（标准差）为 64%（22%）和 66%（25%）（评估之间的差异 P = 0.011），36%和 25%的幸存者有认知障碍（P = 0.001）。患者的次要身体测试表现低于预测值，从 6 个月到 12 个月有较小的改善。随机分组后前 6 天的初始营养支持（营养支持与全肠内营养）对幸存者的 6 分钟步行距离、认知障碍状况和所有次要结局的预测百分比没有显著影响。
EDEN 试验幸存者在 6 个月和 12 个月时的身体和认知功能表现低于预测值，随着时间的推移有一定的改善。随机分组后前 6 天的初始营养支持（营养支持与全肠内营养）并没有影响身体和认知功能。
