Radpay Rojan, Poor Zamany Nejat Kermany Mahtab, Radpay Badiozaman
Faculty of Nutrition and Nutritional Industry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2016;15(1):31-6.
Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method.
97 patients were enrolled and divided into two groups based on the inclusion criteria. Serum protein, serum albumin, serum transferrin, and total lymphocyte count were measured on days 7 and 14.
We did not find any statistically significant differences in clinical status or laboratory values between the two groups but there were significant improvements in measured lab values between days 7 and 14 (p<0.005) indicating improved nutritional status in each groups.
This study shows that both TPN and PPN can be used safely in chronic ICU patients to provide nutritional support and prevent catabolic state among chronic critically ill patients. We need to develop precise selection criteria in order to choose the patients who would benefit the most from TPN and PPN. In addition, appropriate laboratory markers are needed to monitor the metabolic requirements of the patients and assess their progress.
营养不良在长期住院患者中非常普遍,尤其是在重症监护病房(ICU)的患者。识别有风险的患者并提供适当的营养支持可以预防和/或克服他们的营养不良。全胃肠外营养(TPN)和部分胃肠外营养(PPN)是为住院患者提供营养的两种常见途径。我们进行了一项多中心、前瞻性双盲随机对照试验,以评估每种方法的益处并比较其不良反应。
根据纳入标准招募了97名患者并将其分为两组。在第7天和第14天测量血清蛋白、血清白蛋白、血清转铁蛋白和总淋巴细胞计数。
我们未发现两组之间在临床状态或实验室值上有任何统计学上的显著差异,但在第7天和第14天之间测量的实验室值有显著改善(p<0.005),表明每组的营养状况都有所改善。
本研究表明,TPN和PPN均可安全用于慢性ICU患者,以提供营养支持并预防慢性危重症患者的分解代谢状态。我们需要制定精确的选择标准,以便选择从TPN和PPN中获益最大的患者。此外,需要适当的实验室指标来监测患者的代谢需求并评估他们的进展。