Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Department of Nursing, HungKuang University, Taichung 43302, Taiwan.
Nutrients. 2020 Nov 15;12(11):3518. doi: 10.3390/nu12113518.
Although energy intake might be associated with clinical outcomes in critically ill patients, it remains unclear whether full or trophic feeding is suitable for critically ill patients with high or low nutrition risk. We conducted a prospective study to determine which feeding energy intakes were associated with clinical outcomes in critically ill patients with high or low nutrition risk. This was an investigator-initiated, single center, single blind, randomized controlled trial. Critically ill patients were allocated to either high or low nutrition risk based on their Nutrition Risk in the Critically Ill score, and then randomized to receive either the full or the trophic feeding. The feeding procedure was administered for six days. No significant differences were observed in in-hospital, 14-day and 28-day mortalities, the length of ventilator dependency, or ICU and hospital stay among the four groups. There were no associations between energy and protein intakes and in-hospital, 14-day and 28-day mortalities in any of the four groups. However, protein intake was positively associated with the length of hospital stay and ventilator dependency in patients with low nutrition risk receiving trophic feeding. Full or trophic feeding in critically ill patients showed no associations with clinical outcomes, regardless of nutrition risk.
尽管能量摄入可能与危重症患者的临床结局相关，但目前仍不清楚高或低营养风险的危重症患者是全量喂养还是营养支持更合适。我们进行了一项前瞻性研究，旨在确定高或低营养风险的危重症患者的哪种能量摄入与临床结局相关。这是一项由研究者发起、单中心、单盲、随机对照试验。根据危重症患者营养风险评分（Nutrition Risk in the Critically Ill score），将危重症患者分为高或低营养风险组，然后随机分为全量喂养或营养支持组。喂养程序持续六天。四组患者在院内、14 天和 28 天死亡率、呼吸机依赖时间、ICU 和住院时间方面无显著差异。在四组患者中，能量和蛋白质摄入与院内、14 天和 28 天死亡率均无关联。然而，在接受营养支持的低营养风险患者中，蛋白质摄入与住院时间和呼吸机依赖时间呈正相关。无论营养风险如何，危重症患者的全量或营养支持喂养与临床结局均无关联。
