[重症监护病房收治的 COVID-19 患者营养支持的演变]
[Evolution of nutrition support in patients with COVID-19 disease admitted in the Intensive Care Unit].
作者信息
López-Gómez Juan J, Lastra-González Paula, Gómez-Hoyos Emilia, Ortolá-Buigues Ana, Jiménez-Sahagún Rebeca, Cuadrado-Clemente Laura, Benito-Sendín-Plaar Katia, Cuenca-Becerril Sara, Portugal-Rodríguez Esther, De Luis Román Daniel A
机构信息
Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, España.
出版信息
Endocrinol Diabetes Nutr. 2022 Dec;69(10):802-809. doi: 10.1016/j.endinu.2021.10.011. Epub 2022 Jan 7.
INTRODUCTION
Nutritional support in patients with COVID-19 can influence the mean stay and complications in the patient in Intensive Care Unit (ICU).
AIMS
To evaluate the selection of enteral nutritional treatment in the COVID-19 patient admitted to the ICU. To know the development of dysphagia and its treatment. To evaluate the adjustment to the requirements and its relationship with the patient's complications.
MATERIAL AND METHODS
One-center longitudinal retrospective study in 71 patients admitted to the ICU with COVID-19 infection and complete enteral nutrition between March and April 2020. Clinical variables were collected: length of stay in ICU, mean stay and rate of complications; and estimated anthropometric variables.
RESULTS
The mean age was 61.84 (13.68) years. Among the patients analyzed, 33 (46.5%) died. The median stay in the ICU was 20 (15.75-32) days and the mean stay was 37 (26.75-63) days.The type of formula most prescribed was normoprotein 24 (35.3%) and diabetes-specific 23 (33.8%). Depending on the prescribed formula, there was no difference in mean stay (p = 0.39) or death rate (p = 0.35). The percentage of achievement of the estimated protein requirements was 50% (34.38-68.76).At discharge, 8 (21%) of the patients had dysphagia. A relationship was observed between the mean ICU stay and the probability of developing dysphagia (OR: 1.035 (1.004-1.07); p = 0.02).
CONCLUSIONS
In the patient with COVID-19 disease admitted to the ICU, only half of the necessary protein requirements were reached. The presence of dysphagia at discharge was related to the length of time the patient was in the ICU.
引言
新型冠状病毒肺炎（COVID-19）患者的营养支持会影响其在重症监护病房（ICU）的平均住院时间及并发症情况。
目的
评估入住ICU的COVID-19患者肠内营养治疗的选择。了解吞咽困难的发展情况及其治疗方法。评估营养需求的调整情况及其与患者并发症的关系。
材料与方法
对2020年3月至4月间71例因COVID-19感染入住ICU并接受完全肠内营养的患者进行单中心纵向回顾性研究。收集临床变量：ICU住院时间、平均住院时间和并发症发生率；以及估计的人体测量变量。
结果
平均年龄为61.84（13.68）岁。在分析的患者中，33例（46.5%）死亡。ICU的中位住院时间为20（15.75 - 32）天，平均住院时间为37（26.75 - 63）天。最常开具的配方类型为标准蛋白配方24例（35.3%）和糖尿病专用配方23例（33.8%）。根据开具的配方不同，平均住院时间（p = 0.39）或死亡率（p = 0.35）无差异。估计蛋白质需求的达成率为50%（34.38 - 68.76）。出院时，8例（21%）患者存在吞咽困难。观察到ICU平均住院时间与发生吞咽困难的概率之间存在关联（比值比：1.035（1.004 - 1.07）；p = 0.02）。
结论
入住ICU的COVID-19患者仅达到了所需蛋白质需求的一半。出院时吞咽困难的出现与患者在ICU的停留时间有关。
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