烧伤患者营养支持中断的单中心观察性研究
Interrupted Nutrition Support in Patients With Burn Injuries: A Single-Centre Observational Study.
作者信息
Coutris Nancy, Gawaziuk Justin P, Cristall Nora, Logsetty Sarvesh
机构信息
Health Sciences Centre, Winnipeg, Manitoba, Canada.
Manitoba Firefighter's Burn Program, Health Sciences Centre, Winnipeg, Manitoba, Canada.
出版信息
Plast Surg (Oakv). 2019 Nov;27(4):334-339. doi: 10.1177/2292550319880917. Epub 2019 Oct 23.
BACKGROUND
Enteral nutrition (EN) is essential to meet the increased metabolic requirements of burn-injured patients. However, feeds are often suspended for care. This study examines the interruptions in EN (IEN).
OBJECTIVE
To determine the frequency and duration of IEN and whether these interruptions are predictable or unpredictable.
DESIGN
This retrospective chart review of 27 adult burn patients examined age, sex, body mass index, percentage of total body surface area, length of hospital stay, predicted energy requirements from equations and indirect calorimetry, EN start time, time EN reached goal rate, and interruptions to EN.
RESULTS
Predictable interruptions accounted for 74.5% (frequency) and 81.6% (duration) of total interruptions. The most frequent and time-consuming interruptions were perioperative period, extubation, and tests/procedures (predictable) versus high gastric residual volume, emesis/nausea, and feeding tube displacement (unpredictable).
CONCLUSIONS
Most IEN were due to predictable events. Based on these findings, compensating for predictable interruptions to meet nutritional requirements in burn patients is recommended.
背景
肠内营养（EN）对于满足烧伤患者增加的代谢需求至关重要。然而，喂养常常因护理而中断。本研究调查了肠内营养中断（IEN）情况。
目的
确定IEN的频率和持续时间，以及这些中断是可预测的还是不可预测的。
设计
这项对27名成年烧伤患者的回顾性病历审查研究了年龄、性别、体重指数、体表面积百分比、住院时间、根据公式和间接测热法得出的预计能量需求、EN开始时间、EN达到目标速率的时间以及EN中断情况。
结果
可预测的中断分别占总中断次数的74.5%（频率）和总中断持续时间的81.6%。最频繁且耗时的中断是围手术期、拔管和检查/操作（可预测），而高胃残余量、呕吐/恶心和喂养管移位（不可预测）则相对较少。
结论
大多数IEN是由可预测事件导致的。基于这些发现，建议对可预测的中断进行补偿，以满足烧伤患者的营养需求。
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