Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia.
JPEN J Parenter Enteral Nutr. 2018 May;42(4):748-757. doi: 10.1177/0148607117721917. Epub 2017 Dec 12.
Propofol sedation is common in critically ill patients, providing energy of 1.1 kcal/mL when administered as a 1% solution. We aimed to determine the proportion of energy administered as propofol on days 1-5 in the intensive care unit (ICU) and any association with outcomes.
Retrospective observational study in a quaternary ICU from January-December 2012. Inclusion criteria were length of stay (LOS) ≥5 days, age ≥18 years, and provision of mechanical ventilation (MV) for ≥5 days. Outcome measures included proportion of total daily energy provided as propofol, overall energy balance, hospital mortality, duration of MV, and ICU LOS.
Data from 370 patients were analyzed, 87.8% (n = 325) of whom received propofol during days 1-5 in ICU. A median [interquartile range (IQR)] of 119 [50-730] kcal was provided as propofol per patient-day. Proportion of energy provided by propofol as a percentage of total energy delivered was 55.4%, 15.4%, 9.3%, 7.9%, and 9.9% days 1-5, respectively. Patients administered propofol received a greater proportion of their total daily energy prescription compared with those who were not (P < .01). Proportion of energy provided as propofol was not significantly different based on hospital mortality (P = .62), duration of MV (P = .50), or ICU LOS (P = .15).
Propofol contributes to overall energy intake on days 1-5 of ICU admission. Energy balance was higher in those receiving propofol. No association was found between the proportion of energy delivered as propofol and outcomes.
在危重病患者中，丙泊酚镇静较为常见，以 1%溶液形式给予时，每毫升提供 1.1 千卡能量。我们旨在确定 ICU 入住第 1-5 天给予丙泊酚的能量比例及其与结局的任何关联。
这是 2012 年 1 月至 12 月在一家四级 ICU 进行的回顾性观察性研究。纳入标准为入住时间（LOS）≥5 天、年龄≥18 岁且接受机械通气（MV）≥5 天。结局指标包括丙泊酚提供的总日能量比例、总能量平衡、住院死亡率、MV 持续时间和 ICU LOS。
对 370 例患者的数据进行了分析，其中 87.8%（n=325）在 ICU 入住第 1-5 天期间接受了丙泊酚。每位患者每天提供 119[50-730]千卡的中位数[四分位间距（IQR）]丙泊酚。丙泊酚提供的能量比例分别占总能量输送的 55.4%、15.4%、9.3%、7.9%和 9.9%。与未接受丙泊酚的患者相比，接受丙泊酚的患者接受的总日能量处方比例更高（P<0.01）。根据住院死亡率（P=0.62）、MV 持续时间（P=0.50）或 ICU LOS（P=0.15），丙泊酚提供的能量比例无显著差异。
丙泊酚在 ICU 入住第 1-5 天为总能量摄入做出贡献。接受丙泊酚的患者能量平衡更高。丙泊酚提供的能量比例与结局之间没有发现关联。
