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重症监护病房中危重症患者肠内营养相关性腹泻的发生率。

Incidence of Enteral Nutrition-Related Diarrhea Among Critically Ill Patients in Intensive Care Units.

机构信息

Manar AlElaimat, MSN, RN, Clinical Nurse Specialist, Zarqa Public Hospital, Zarqa, Jordan.

Jafar Alasad Alshraideh, PhD, RN, Professor, School of Nursing, The University of Jordan, Amman, Jordan.

出版信息

Gastroenterol Nurs. 2024;47(4):242-249. doi: 10.1097/SGA.0000000000000808. Epub 2024 Jul 28.

Abstract

Enteral nutrition is a common nutritional modality in intensive care units. Despite its valuable benefits, it has many complications among which diarrhea is the most important. However, the incidence of enteral nutrition-related diarrhea is variable in the literature, with no established baseline in Jordan. The aim of this study was to investigate the incidence of enteral nutrition-related diarrhea in intensive care units of a major public hospital in Jordan. A prospective cohort design was adopted over 4 months. Using a consecutive sampling technique, 84 critically ill patients receiving enteral nutrition were recruited. King's Stool Chart was used. The incidence of enteral nutrition-related diarrhea calculated per patient and per feeding day was 63.1% and 13.2%, respectively. Significant positive associations were found between the incidence of diarrhea with feeding days (r = .356, p = .001) and intensive care unit length of stay (r = .254, p = .020). The same was found for the frequency of diarrhea (r = .633, p = .000; r = .439, p = .000, respectively). Conversely, a significant negative association was found between baseline serum albumin and frequency of diarrhea (r = -.250, p = .037). Enteral nutrition-related diarrhea is prevalent in Jordanian intensive care units, but it should not be a barrier to enteral nutrition delivery. It would be beneficial for intensive care unit nurses to improve their nutritional practices by following a nurse-led enteral nutrition protocol to guide the enteral nutrition practices utilizing multidisciplinary approaches.

摘要

肠内营养是重症监护病房常用的营养方式。尽管它有很多益处,但也有很多并发症,其中腹泻最为重要。然而,肠内营养相关性腹泻的发生率在文献中变化很大,在约旦没有确定的基线。本研究旨在调查约旦一家主要公立医院重症监护病房肠内营养相关性腹泻的发生率。采用前瞻性队列设计,历时 4 个月。采用连续抽样技术,招募了 84 名接受肠内营养的危重患者。使用 King's Stool Chart。患者和喂养日的肠内营养相关性腹泻发生率分别为 63.1%和 13.2%。腹泻发生率与喂养天数(r =.356,p =.001)和重症监护病房住院时间(r =.254,p =.020)呈显著正相关。腹泻频率也存在同样的关系(r =.633,p =.000;r =.439,p =.000)。相反,血清白蛋白基线与腹泻频率呈显著负相关(r = -.250,p =.037)。肠内营养相关性腹泻在约旦重症监护病房很常见,但不应成为肠内营养实施的障碍。重症监护病房护士遵循护士主导的肠内营养方案,采用多学科方法指导肠内营养实践,将有助于改善他们的营养实践。

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