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重症监护病房收治期间营养治疗对新型冠状病毒肺炎患者重症监护后综合征的影响

Impact of Nutritional Therapy during Intensive Care Unit Admission on Post-Intensive Care Syndrome in Patients with COVID-19.

作者信息

Suganuma Shinya, Nakamura Kensuke, Kato Hideaki, Hemmi Muneaki, Kawabata Keiichiro, Hosozawa Mariko, Muto Yoko, Hori Miyuki, Iba Arisa, Asahi Tomohiro, Kawauchi Akira, Fujitani Shigeki, Hatakeyama Junji, Oshima Taku, Ota Kohei, Kamijo Hiroshi, Iso Hiroyasu

机构信息

Critical Care Medicine, Yokohama City University Hospital, Yokohama, Japan,

Critical Care Medicine, Yokohama City University Hospital, Yokohama, Japan.

出版信息

Ann Nutr Metab. 2025;81(1):41-50. doi: 10.1159/000542298. Epub 2024 Nov 4.

Abstract

INTRODUCTION

Nutritional therapy is an important component of intensive care. We investigated the associations of nutritional therapy in the acute phase of severe COVID-19 with the long-term outcomes of post-intensive care syndrome (PICS) and post-COVID-19 conditions.

METHODS

A questionnaire on the health status after COVID-19 was sent to patients 1 year after infection and PICS was evaluated. Total energy and protein intakes during the first week after admission to the intensive care unit (ICU) were calculated. The primary endpoint was a decrease in quality of life (QOL) defined by EuroQol5-dimensions 5-level (EQ5D5L) <0.8. A multivariable regression analysis was used to examine.

RESULTS

A total of 220 ICU patients were included in this study. Median total energy and protein intakes were 65.1 kcal/kg/week and 3.3 g/kg/week, respectively. Total energy and protein intakes were associated with EQ5D5L scores (energy: unit odds ratio 0.98 [0.97-0.99], p value <0.01; protein: unit odds ratio 0.72 [0.59-0.87], p value <0.01). Insufficient total energy and protein intakes were associated with malaise, arthralgia, myalgia, palpitations, sleep disturbance, and muscle weakness.

CONCLUSIONS

Poor nutrition during the first week after ICU admission was associated with a decreased QOL 1 year after. These nutrition shortages were also associated with an increased risk of developing PICS, post-COVID-19 conditions, which may contribute to decreased QOL.

INTRODUCTION

Nutritional therapy is an important component of intensive care. We investigated the associations of nutritional therapy in the acute phase of severe COVID-19 with the long-term outcomes of post-intensive care syndrome (PICS) and post-COVID-19 conditions.

METHODS

A questionnaire on the health status after COVID-19 was sent to patients 1 year after infection and PICS was evaluated. Total energy and protein intakes during the first week after admission to the intensive care unit (ICU) were calculated. The primary endpoint was a decrease in quality of life (QOL) defined by EuroQol5-dimensions 5-level (EQ5D5L) <0.8. A multivariable regression analysis was used to examine.

RESULTS

A total of 220 ICU patients were included in this study. Median total energy and protein intakes were 65.1 kcal/kg/week and 3.3 g/kg/week, respectively. Total energy and protein intakes were associated with EQ5D5L scores (energy: unit odds ratio 0.98 [0.97-0.99], p value <0.01; protein: unit odds ratio 0.72 [0.59-0.87], p value <0.01). Insufficient total energy and protein intakes were associated with malaise, arthralgia, myalgia, palpitations, sleep disturbance, and muscle weakness.

CONCLUSIONS

Poor nutrition during the first week after ICU admission was associated with a decreased QOL 1 year after. These nutrition shortages were also associated with an increased risk of developing PICS, post-COVID-19 conditions, which may contribute to decreased QOL.

摘要

引言

营养治疗是重症监护的重要组成部分。我们研究了重症新型冠状病毒肺炎(COVID-19)急性期的营养治疗与重症监护后综合征(PICS)及COVID-19后状况的长期结局之间的关联。

方法

在感染后1年向患者发送关于COVID-19后健康状况的问卷,并对PICS进行评估。计算重症监护病房(ICU)入院后第一周的总能量和蛋白质摄入量。主要终点是由欧洲五维健康量表(EQ5D5L)定义的生活质量(QOL)下降<0.8。采用多变量回归分析进行检验。

结果

本研究共纳入220例ICU患者。总能量和蛋白质摄入量的中位数分别为65.1千卡/千克/周和3.3克/千克/周。总能量和蛋白质摄入量与EQ5D5L评分相关(能量:单位比值比0.98[0.97 - 0.99],p值<0.01;蛋白质:单位比值比0.72[0.59 - 0.87],p值<0.01)。总能量和蛋白质摄入不足与不适、关节痛、肌痛、心悸、睡眠障碍和肌肉无力有关。

结论

ICU入院后第一周营养状况不佳与1年后生活质量下降有关。这些营养缺乏也与发生PICS、COVID-19后状况的风险增加有关,这可能导致生活质量下降。

引言

营养治疗是重症监护的重要组成部分。我们研究了重症新型冠状病毒肺炎(COVID-19)急性期的营养治疗与重症监护后综合征(PICS)及COVID-19后状况的长期结局之间的关联。

方法

在感染后1年向患者发送关于COVID-19后健康状况的问卷,并对PICS进行评估。计算重症监护病房(ICU)入院后第一周的总能量和蛋白质摄入量。主要终点是由欧洲五维健康量表(EQ5D5L)定义的生活质量(QOL)下降<0.8。采用多变量回归分析进行检验。

结果

本研究共纳入220例ICU患者。总能量和蛋白质摄入量的中位数分别为65.1千卡/千克/周和3.3克/千克/周。总能量和蛋白质摄入量与EQ5D5L评分相关(能量:单位比值比0.98[0.97 - 0.99],p值<0.01;蛋白质:单位比值比0.72[0.59 - 0.87],p值<0.01)。总能量和蛋白质摄入不足与不适、关节痛、肌痛、心悸、睡眠障碍和肌肉无力有关。

结论

ICU入院后第一周营养状况不佳与1年后生活质量下降有关。这些营养缺乏也与发生PICS、COVID-19后状况的风险增加有关,这可能导致生活质量下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21c3/11797927/75f5a499fc5f/anm-2025-0081-0001-542298_F01.jpg

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