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一项观察性研究,旨在评估机械通气的危重症患者肠内营养供给与营养生物标志物之间的关系。

Observational study to assess the relationship between enteral nutrition delivery and nutritional biomarkers among mechanically ventilated critically ill patients.

作者信息

Zaher S

机构信息

Clinical Nutrition Department, Faculty of Applied Medical Sciences, Taibah University, Saudi Arabia.

出版信息

Saudi J Biol Sci. 2022 Dec;29(12):103466. doi: 10.1016/j.sjbs.2022.103466. Epub 2022 Sep 28.

Abstract

BACKGROUND

Biochemical assessment is considered a useful tool in assessing the patient's nutritional status and intake. However, during critical illness, nutritional biomarkers, such as albumin, and haemoglobin (HB) may reflect the severity of acute illness. The aim of this study is to assess the relationship between energy and protein delivery with the change in albumin, HB, "mean corpuscular volume"(MCV), and "mean corpuscular haemoglobin concentration" (MCHC) levels in critically ill patients.

METHOD

In this prospective observational study we monitored the intake of energy and protein in a group critically ill patients for 6 consecutive days. Biochemical data including albumin, HB, MCV and MCHC was measured on admission and on day 6 of the follow-up. The variation in the biomarkers between admission and day 6 was calculated as the follow-up reading minus the reading obtained upon admission to (Intensive Care Unit) ICU.

RESULTS

This study included 43 patients. There was a significant difference in the albumin and HB levels between admission and follow up readings. No statistical association was recorded between the intake and the changes in albumin, MCV and MCHC level during ICU stay. The results showed a significant association between the intake of energy (R = 0.393), and protein (R = 0.385), with the increase in HB level during hospitalisation.

CONCLUSION

Overall, this study showed that most nutritional biomarkers were not influenced by nutritional therapy during the acute phase of illness. These findings may directly undermine the usefulness of the serial measurements of these biomarkers in the early phase of ICU admission.

摘要

背景

生化评估被认为是评估患者营养状况和摄入量的有用工具。然而,在危重病期间,营养生物标志物,如白蛋白和血红蛋白(HB),可能反映急性疾病的严重程度。本研究的目的是评估危重病患者能量和蛋白质供应与白蛋白、HB、“平均红细胞体积”(MCV)和“平均红细胞血红蛋白浓度”(MCHC)水平变化之间的关系。

方法

在这项前瞻性观察研究中,我们连续6天监测一组危重病患者的能量和蛋白质摄入量。在入院时和随访的第6天测量包括白蛋白、HB、MCV和MCHC在内的生化数据。入院至第6天生物标志物的变化计算为随访读数减去入住重症监护病房(ICU)时获得的读数。

结果

本研究纳入43例患者。入院时和随访读数之间的白蛋白和HB水平存在显著差异。在ICU住院期间,摄入量与白蛋白、MCV和MCHC水平的变化之间未记录到统计学关联。结果显示,能量摄入量(R = 0.393)和蛋白质摄入量(R = 0.385)与住院期间HB水平的升高之间存在显著关联。

结论

总体而言,本研究表明,在疾病急性期,大多数营养生物标志物不受营养治疗的影响。这些发现可能直接削弱在ICU入院早期对这些生物标志物进行系列测量的有用性。

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