Couto Cecília Flávia Lopes, Dariano Ângela, Texeira Cassiano, Silva Carolina Hauber da, Torbes Anelise Bertotti, Friedman Gilberto
Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
Unidade de Terapia Intensiva, Hospital Moinhos de Vento - Porto Alegre (RS), Brasil.
Rev Bras Ter Intensiva. 2019;31(1):34-38. doi: 10.5935/0103-507X.20190004. Epub 2019 Mar 14.
To correlate short-term (duration of mechanical ventilation and length of intensive care unit stay) and long-term (functional capacity) clinical outcomes of patients who reached nutritional adequacy ≥ 70% of predicted in the first 72 hours of hospitalization in the intensive care unit.
This was a prospective observational pilot study conducted in an 18-bed intensive care unit. A total of 100 mechanically ventilated patients receiving exclusive enteral nutritional support and receiving intensive care for more than 72 hours were included. Patients who never received enteral nutrition, those with spinal cord trauma, pregnant women, organ donors and cases of family refusal were excluded. The variables studied were nutritional adequacy ≥ 70% of predicted in the first 72 hours of hospitalization, length of intensive care unit stay, duration of mechanical ventilation and the ability to perform activities of daily living after 12 months, assessed via telephone contact using the Lawton Activities of Daily Living Scale.
The mean duration of mechanical ventilation was 18 ± 9 days, and the mean intensive care unit length of stay was 19 ± 8 days. Only 45% of the patients received more than 70% of the target nutrition in 72 hours. There was no association between nutritional adequacy and short-term (duration of mechanical ventilation, length of stay in the intensive care unit and mortality) or long-term (functional capacity and mortality) clinical outcomes.
Critically ill patients receiving caloric intake ≥ 70% in the first 72 hours of hospitalization did not present better outcomes in the short term or after 1 year.
将重症监护病房住院72小时内达到营养充足水平≥预期值70%的患者的短期(机械通气时间和重症监护病房住院时长)和长期(功能能力)临床结局进行关联分析。
这是一项在拥有18张床位的重症监护病房开展的前瞻性观察性试点研究。共纳入100例接受纯肠内营养支持且机械通气超过72小时的患者。未接受过肠内营养的患者、脊髓损伤患者、孕妇、器官捐献者及家属拒绝的病例被排除。研究变量包括住院72小时内营养充足水平≥预期值70%、重症监护病房住院时长、机械通气时间以及12个月后通过使用Lawton日常生活活动量表进行电话联系评估的日常生活活动能力。
机械通气的平均时长为18±9天,重症监护病房的平均住院时长为19±8天。仅45%的患者在72小时内接受了超过目标营养量70%的营养支持。营养充足水平与短期(机械通气时间、重症监护病房住院时长及死亡率)或长期(功能能力及死亡率)临床结局之间无关联。
在住院72小时内热量摄入≥70%的危重症患者在短期或1年后并未表现出更好的结局。