Primo Martín David, Izaola Olatz, López Gómez Juan José, Torres Torres Beatriz, Gómez Hoyos Emilia, Ortolá Buigues Ana, Delgado Esther, de Luis Daniel
Centro de Investigación de Endocrinología y Nutrición. Facultad de Medicina. Servicio de Endocrinología y Nutrición. Hospital Universitario Río Hortega.
Nutr Hosp. 2021 Apr 19;38(2):221-227. doi: 10.20960/nh.03457.
Objectives: in routine clinical practice many disorders are found that can disrupt the sequence of reactions in digestion and absorption, leading to malnutrition and requiring the use of oral nutritional supplements (ONS). The objective of our study was to evaluate in a real world setting the use of and compliance with a peptide-based ONS in malnourished adult patients with intestinal compromise after more than 14 days of parenteral nutrition. Material and methods: the study was carried out in 44 malnourished patients who required total parenteral nutrition for at least 14 days without using the oral route during their hospital stay. All patients were administered, on an outpatient basis, 1 brick per day of Vital 1.5® for 12 weeks. At the beginning of treatment and after the intervention period evaluated, the following variables were collected: weight, height, body mass index (BMI), global subjective assessment test, nutritional biochemistry, 3-day nutritional survey, adverse effects generated by the formula, and completion rate. Results: 44 patients were enrolled. Mean age was 70.4 ± 10.4 years (20 women & 24 men). After the intervention the following parameters had increased: BMI (0.51 ± 0.1 kg/m2; p = 0.02), weight (1.4 ± 0.3 kg; p = 0.03), prealbumin (3.5 ± 4.1 mg/dl; p = 0.01), albumin (1.3 ± 0.1 mg/dl; p = 0.03), and transferrin (71.5 ± 24.1 mg/dl; p = 0.02). Dietary intake of the ONS represented 14.4 % of the diet's total caloric intake at 3 months, 17.5 % of carbohydrates, 12.9 % of proteins, and 12.3 % of fats. Mean compliance was 87.7 ± 7.2 % of the prescribed intakes. In relation to the nutritional situation, at the beginning of the study, 52.3 % (n = 23) of patients were in the global subjective assessment test in category B (moderate malnutrition or nutritional risk), and 47.7 % (n = 21) in category C (severe malnutrition). After the intervention, 75 % of patients were in category A (n = 33), 13.6 % (n = 6) in category B, and 11.4 % (n = 5) in category C. Conclusions: the use of a peptide-based ONS with short-chain triglycerides in outpatients showed a beneficial effect on biochemical and anthropometric parameters, and improved the nutritional status of patients with high compliance and good tolerance rates.
在常规临床实践中,发现许多疾病会扰乱消化和吸收反应的顺序,导致营养不良,需要使用口服营养补充剂(ONS)。我们研究的目的是在现实环境中评估一种基于肽的ONS在接受肠外营养超过14天的营养不良成年肠功能受损患者中的使用情况和依从性。材料与方法:该研究在44名营养不良患者中进行,这些患者在住院期间需要全肠外营养至少14天且未使用口服途径。所有患者在门诊每天服用1块Vital 1.5®,持续12周。在治疗开始时和评估的干预期结束后,收集以下变量:体重、身高、体重指数(BMI)、整体主观评估测试、营养生物化学、3天营养调查、配方产生的不良反应以及完成率。结果:纳入44名患者。平均年龄为70.4±10.4岁(20名女性和24名男性)。干预后,以下参数有所增加:BMI(0.51±0.1kg/m²;p = 0.02)、体重(±0.3kg;p = 0.03)、前白蛋白(3.5±4.1mg/dl;p = 0.01)、白蛋白(1.3±0.1mg/dl;p = 0.03)和转铁蛋白(71.5±24.1mg/dl;p = 0.02)。三个月时,ONS的饮食摄入量占饮食总热量摄入的14.4%,碳水化合物的17.5%,蛋白质的12.9%,脂肪的12.3%。平均依从性为规定摄入量的87.7±7.2%。关于营养状况,在研究开始时,52.3%(n = 23)的患者在整体主观评估测试中处于B类(中度营养不良或营养风险),47.7%(n = 21)处于C类(重度营养不良)。干预后,75%的患者处于A类(n = 33),13.6%(n = 6)处于B类,11.4%(n = 5)处于C类。结论:门诊患者使用含短链甘油三酯的基于肽的ONS对生化和人体测量参数显示出有益效果,并改善了依从性高且耐受性好的患者的营养状况。