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临床因素对成年创伤患者重症监护病房住院期间热量和蛋白质摄入量的影响:一项前瞻性观察性研究的结果

Impact of clinical factors on calorie and protein intakes during Icu stay in adults trauma patients: results from a prospective observational study.

作者信息

Davari Mina, Moludi Jalal, Asghari Jafarabadi Mohammad, Ahmadi-Nejad Mehdi, Sanaie Sarvin, Aref-Hosseini Seyed-Rafi

机构信息

Student Research Committee, Tabriz University of Medical Sciences Tabriz, Iran.

Nutrition Research Center, School of Nutrition, Tabriz University of Medical Sciences Tabriz, Iran.

出版信息

Int J Burns Trauma. 2019 Jun 15;9(3):59-65. eCollection 2019.

Abstract

UNLABELLED

Propose: Nutritional requirements are often escalated following major trauma. Underfeeding and adverse outcomes were seen in critically ill trauma patients. The aim of the study was to quantify actual amount of calories and protein intakes, and extent to which those clinical factors may affect adequate intake.

MATERIAL AND METHODS

An observational study carried out in a medical intensive care unit (ICU) of Tabriz University of medical science during April 2017 and December 2018. A total of 85 adult trauma patients with a 7 days ICU length of stay and who received Enteral nutrition (EN) were included in this study. The data on estimated and actual intake of energy and protein, severity of illness (i.e., Acute Physiology and Chronic Health Evaluation II (APACHE II), The Glasgow Coma Scale (GCS) and markers of nutritional status (i.e., serum albumin level and body mass index) were recorded.

RESULTS

In this study, sixty-six patients (77%) were underfed in terms of energy and 19 patients (23%) had adequate energy intake. Logistic regression showed that only GCS possibly predict energy status. For every one-unit additional decrease in GCS scores, the odds of being underfed in terms of energy were increased by 1.32 times, after controlling for other factors (95% CI, 1.07 to 1.75, -value = 0.044). No association was observed between nutritional status and clinical outcomes.

CONCLUSIONS

The definite nutritional intake did not coverage the calculated requirements during ICU stay. The current study proposed that there was an inverse association between some clinically important factors (APACHE II score, intubation time) and mean energy intake. Nutritional support was not associated with any complications.

摘要

未标注

建议:重大创伤后营养需求通常会增加。重症创伤患者存在营养不足及不良后果。本研究的目的是量化热量和蛋白质的实际摄入量,以及这些临床因素可能影响充足摄入量的程度。

材料与方法

于2017年4月至2018年12月在大不里士医科大学的医学重症监护病房(ICU)进行一项观察性研究。本研究纳入了85例入住ICU 7天且接受肠内营养(EN)的成年创伤患者。记录能量和蛋白质的估计摄入量与实际摄入量、疾病严重程度(即急性生理与慢性健康状况评分系统II(APACHE II)、格拉斯哥昏迷量表(GCS))以及营养状况指标(即血清白蛋白水平和体重指数)的数据。

结果

在本研究中,66例患者(77%)能量摄入不足,19例患者(23%)能量摄入充足。逻辑回归显示,只有GCS可能预测能量状态。在控制其他因素后,GCS评分每额外降低1个单位,能量摄入不足的几率增加1.32倍(95%可信区间,1.07至1.75,P值 = 0.044)。未观察到营养状况与临床结局之间存在关联。

结论

在ICU住院期间,确切的营养摄入量未达到计算出的需求量。本研究表明,一些临床重要因素(APACHE II评分、插管时间)与平均能量摄入量之间存在负相关。营养支持与任何并发症均无关联。

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