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本文引用的文献

1
Permissive Underfeeding or Standard Enteral Feeding in Critically Ill Adults.危重症成人患者的允许性低喂养或标准肠内喂养。
N Engl J Med. 2015 Jun 18;372(25):2398-408. doi: 10.1056/NEJMoa1502826. Epub 2015 May 20.
2
Metabolic and nutritional support of critically ill patients: consensus and controversies.危重症患者的代谢与营养支持:共识与争议
Crit Care. 2015 Jan 29;19(1):35. doi: 10.1186/s13054-015-0737-8.
3
The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies.2013年加拿大重症监护营养指南:当前建议及实施策略的更新
Nutr Clin Pract. 2014 Feb;29(1):29-43. doi: 10.1177/0884533613510948. Epub 2013 Dec 2.
4
Why patients in critical care do not receive adequate enteral nutrition? A review of the literature.为什么重症监护病房的患者不能得到足够的肠内营养?文献复习。
J Crit Care. 2012 Dec;27(6):702-13. doi: 10.1016/j.jcrc.2012.07.019. Epub 2012 Oct 17.
5
Optimal protein and energy nutrition decreases mortality in mechanically ventilated, critically ill patients: a prospective observational cohort study.最佳蛋白质和能量营养可降低机械通气危重症患者的死亡率:一项前瞻性观察性队列研究。
JPEN J Parenter Enteral Nutr. 2012 Jan;36(1):60-8. doi: 10.1177/0148607111415109. Epub 2011 Dec 13.
6
Nutritional status and dietary intake of acute care patients: results from the Nutrition Care Day Survey 2010.急危重症患者的营养状况和膳食摄入:来自 2010 年营养护理日调查的结果。
Clin Nutr. 2012 Feb;31(1):41-7. doi: 10.1016/j.clnu.2011.08.002. Epub 2011 Sep 8.
7
The tight calorie control study (TICACOS): a prospective, randomized, controlled pilot study of nutritional support in critically ill patients.紧卡热量控制研究(TICACOS):一项前瞻性、随机、对照的危重患者营养支持的初步研究。
Intensive Care Med. 2011 Apr;37(4):601-9. doi: 10.1007/s00134-011-2146-z. Epub 2011 Feb 22.
8
ESPEN Guidelines on Parenteral Nutrition: intensive care.欧洲临床营养与代谢学会(ESPEN)肠外营养指南:重症监护
Clin Nutr. 2009 Aug;28(4):387-400. doi: 10.1016/j.clnu.2009.04.024. Epub 2009 Jun 7.
9
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).《成人危重症患者营养支持治疗的提供与评估指南:危重症医学会(SCCM)和美国肠外肠内营养学会(A.S.P.E.N.)》
JPEN J Parenter Enteral Nutr. 2009 May-Jun;33(3):277-316. doi: 10.1177/0148607109335234.
10
Pathophysiologic response to severe burn injury.对严重烧伤损伤的病理生理反应。
Ann Surg. 2008 Sep;248(3):387-401. doi: 10.1097/SLA.0b013e3181856241.

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.

PMID:31333896
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6627791/
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。