Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan.
Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan.
Nutrients. 2022 Oct 20;14(20):4395. doi: 10.3390/nu14204395.
Prolonged mechanical ventilation (PMV) is associated with poor outcomes and a high economic cost. The association between protein intake and PMV has rarely been investigated in previous studies. This study aimed to investigate the impact of protein intake on weaning from mechanical ventilation. Patients with the PMV (mechanical ventilation ≥6 h/day for ≥21 days) at our hospital between December 2020 and April 2022 were included in this study. Demographic data, nutrition records, laboratory data, weaning conditions, and survival data were retrieved from the patient’s electronic medical records. A total of 172 patients were eligible for analysis. The patients were divided into two groups: weaning success (n = 109) and weaning failure (n = 63). Patients with daily protein intake greater than 1.2 g/kg/day had significant shorter median days of ventilator use than those with less daily protein intake (36.5 vs. 114 days, respectively, p < 0.0001). Daily protein intake ≥1.065 g/kg/day (odds ratio: 4.97, p = 0.033), daily protein intake ≥1.2 g/kg/day (odds ratio: 89.07, p = 0.001), improvement of serum albumin (odds ratio: 3.68, p = 0.027), and BMI (odds ratio: 1.235, p = 0.014) were independent predictor for successful weaning. The serum creatinine level in the 4th week remained similar in patients with daily protein intake either >1.065 g/kg/day or >1.2 g/kg/day (p = 0.5219 and p = 0.7796, respectively). Higher protein intake may have benefits in weaning in patients with PMV and had no negative impact on renal function.
长时间机械通气（PMV）与不良预后和高经济成本相关。在之前的研究中，很少有研究调查蛋白质摄入与 PMV 之间的关系。本研究旨在调查蛋白质摄入对机械通气撤机的影响。
我们医院在 2020 年 12 月至 2022 年 4 月期间收治的 PMV 患者（机械通气≥6 小时/天且≥21 天）纳入本研究。从患者的电子病历中检索人口统计学数据、营养记录、实验室数据、撤机条件和生存数据。共有 172 名患者符合分析条件。将患者分为两组：撤机成功组（n = 109）和撤机失败组（n = 63）。每日蛋白质摄入量大于 1.2 g/kg/d 的患者呼吸机使用中位数天数明显短于每日蛋白质摄入量较少的患者（分别为 36.5 天和 114 天，p < 0.0001）。每日蛋白质摄入量≥1.065 g/kg/d（比值比：4.97，p = 0.033）、每日蛋白质摄入量≥1.2 g/kg/d（比值比：89.07，p = 0.001）、血清白蛋白改善（比值比：3.68，p = 0.027）和 BMI（比值比：1.235，p = 0.014）是撤机成功的独立预测因素。第 4 周时，每日蛋白质摄入量≥1.065 g/kg/d 或≥1.2 g/kg/d 的患者血清肌酐水平相似（p = 0.5219 和 p = 0.7796）。较高的蛋白质摄入可能对 PMV 患者撤机有益，且对肾功能无不良影响。
