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含低分子量乳清肽的寡聚体肠内营养对重症监护营养中腹泻的影响

Impact of oligomeric enteral nutrition with low-molecular-weight whey peptides on diarrhea in critical care nutrition.

作者信息

Nakamura Kensuke, Kawakami Tetsuro, Naraba Hiromu, Motoki Maiko, Ikechi Daisuke, Nakano Hidehiko, Mochizuki Masaki, Takahashi Yuji, Hashimoto Hideki

机构信息

Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki 317-0077, Japan.

出版信息

J Clin Biochem Nutr. 2022 Nov;71(3):255-259. doi: 10.3164/jcbn.22-10. Epub 2022 Aug 4.

Abstract

Diarrhea is one of the most common complications associated with enteral nutrition in hospitalized patients. Oligomeric enteral nutrition has been considered to reduce the incidence of diarrhea. We herein introduced and examined the effects of a specific oligomeric enteral nutrition with the low-molecular-weight whey peptides, Peptino‍ in critically ill patients with refractory diarrhea or at high risk of mesenteric ischemia. A retrospective study of a consecutive case series was conducted. Patients were divided into two groups: enteral nutrition products were switched to Peptino‍ (switching group) and Peptino‍ was the initial enteral nutrition product (first initiation group). Sixty-eight patients were administered Peptino‍ in the ICU. Diarrhea occurred in 28.3% of patients in the switching group and 13.3% in the first initiation group. EN failure with gastrointestinal intolerance was observed in 6 patients (8.8%). Diarrhea resolved in 29 out of the 35 patients (82.9%) with diarrhea prior to the switch to Peptino‍. Diarrhea cessation within 24 h of the initiation of Peptino‍ was achieved in 11 patients (31.4%) and within 24-48 h in 12 (34.3%). Mesenteric ischemia was not detected in any patients. In conclusion, Peptino‍ may be effective against diarrhea and gastrointestinal intolerance in critical care nutrition.

摘要

腹泻是住院患者肠内营养最常见的并发症之一。低聚肠内营养被认为可降低腹泻的发生率。我们在此介绍并研究了一种含有低分子量乳清肽的特定低聚肠内营养产品Peptino对患有难治性腹泻或有肠系膜缺血高风险的重症患者的影响。进行了一项连续病例系列的回顾性研究。患者分为两组:将肠内营养产品换为Peptino的组(换药组)和将Peptino作为初始肠内营养产品的组(首次使用组)。68例患者在重症监护病房接受了Peptino治疗。换药组28.3%的患者发生腹泻,首次使用组为13.3%。6例患者(8.8%)出现了伴有胃肠道不耐受的肠内营养失败。在换用Peptino之前腹泻的35例患者中,29例(82.9%)腹泻得到缓解。11例患者(31.4%)在开始使用Peptino后24小时内腹泻停止,12例(34.3%)在24至48小时内腹泻停止。未在任何患者中检测到肠系膜缺血。总之,Peptino在重症监护营养中可能对腹泻和胃肠道不耐受有效。

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