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外科重症监护病房接受连续肾脏替代治疗的急性肾损伤患者的营养供给现状及营养支持对临床结局的影响。

Current status of nutritional provision and effects of nutritional support on the clinical outcomes of acute kidney injury requiring continuous renal replacement therapy in the surgical intensive care unit.

机构信息

Division of Trauma Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.

Division of Trauma Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea. Email:

出版信息

Asia Pac J Clin Nutr. 2023 Sep;32(3):321-329. doi: 10.6133/apjcn.202309_32(3).0003.

Abstract

BACKGROUND AND OBJECTIVES

Patients with acute kidney injury requiring continuous renal replacement therapy are at high risk of malnutrition. Nutritional support is an important part of treatment for patients with critical illness admitted to the intensive care unit. We aimed to investigate the status of nutritional provision and the effects of nutritional support on clinical outcomes.

METHODS AND STUDY DESIGN

Our institution's medical records (from January 1, 2020, to December 31, 2021) were analyzed in this retrospective cohort study. We included 43 patients aged >18 years who received continuous renal replacement therapy for acute kidney injury in the surgical intensive care unit.

RESULTS

The demographic characteristics were similar between the survivor and non-survivor groups. The protein supply per body weight (0.88 ± 0.37 g/kg vs. 0.47 ± 0.53 g/kg, p = 0.029) and the proportion of patients who met the target protein level (58.9 ± 24.9% vs. 30.8 ± 34.9%, p = 0.022) were significantly higher in the survivor group. Approximately 79.1% of the patients had a high malnutrition risk with a modified Nutrition Risk in the Critically Ill score of ≥5. The lengths of hospital and intensive care unit stays were longer in the high nutritional risk group compared with that in the low nutritional risk group, but the result was not significant.

CONCLUSIONS

The nutritional amount provided in patients with critical illness is significantly lesser than the recommended amount. Ensuring proper nutritional support can improve the clinical outcomes.

摘要

背景与目的

需要连续性肾脏替代治疗的急性肾损伤患者存在发生营养不良的高风险。营养支持是危重症患者治疗的重要组成部分,这些患者收入重症监护病房。本研究旨在调查营养供给状况以及营养支持对临床结局的影响。

方法和研究设计

本回顾性队列研究分析了我院(2020 年 1 月 1 日至 2021 年 12 月 31 日)的病历资料。共纳入 43 例年龄>18 岁、在外科重症监护病房接受连续性肾脏替代治疗的急性肾损伤患者。

结果

幸存者组和非幸存者组的人口统计学特征相似。幸存者组的每公斤体重提供的蛋白质(0.88±0.37 g/kg 比 0.47±0.53 g/kg,p=0.029)和达到目标蛋白水平的患者比例(58.9±24.9%比 30.8±34.9%,p=0.022)均显著更高。约 79.1%的患者存在高营养风险,改良重症患者营养风险评分≥5。与低营养风险组相比,高营养风险组的住院和重症监护病房住院时间更长,但差异无统计学意义。

结论

危重症患者提供的营养量明显低于推荐量。确保适当的营养支持可以改善临床结局。

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