Chidester J C, Spangler A A
Reid Hospital & Health Care Services, Richmond, Ind 47374, USA.
J Am Diet Assoc. 1997 Jan;97(1):23-8; quiz 29-30. doi: 10.1016/S0002-8223(97)00011-4.
Actual fluid intake in the institutionalized elderly was compared with three established standards to determine adequacy of fluid intake.
Consecutive 3-day food and fluid intake was observed directly and analyzed by computer for water content. Number and frequency of medications and Minimum Data Set (MDS) information about cognitive skills, physical locomotion, and ability to understand were obtained from medical records. Recommended fluid intake was determined using three established standards for two age groups: 65 through 85 years and 86 through 100 years. The standards were 30 mL/kg body weight (standard 1); 1 mL/kcal energy consumed (standard 2); and 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, and 15 mL for remaining kg (standard 3).
SUBJECTS/SETTING: Data were collected in one nursing home. Subjects were 40 residents who were free from acute illness and infection and/or were not receiving enteral feedings.
Fluid intake and MDS data were collected. Data about medications were obtained after preliminary data collection observations.
A two-tailed t test was used to compare actual fluid intake with recommended fluid intake. Interaction effect of age on fluid intake was analyzed using multiple analysis of variance. Correlations were used to evaluate relationships among fluid intake, number and frequency of medications, age, weight, and MDS data.
This population received adequate or more than adequate fluid according to the standards of 30 mL/kg body weight or 1 mL/kcal energy consumed, but inadequate fluid according to standard 3, which adjusted for extremes of underweight or overweight. Age was not a factor in adequacy of fluid intake. Positive correlations existed between fluid obtained from nonmeal feedings and number and frequency of medications.
When the standard of 30 mL/kg body weight is used, underweight residents have unrealistically low fluid recommendations. Standard 3, which adjusts for extremes in body weight, is more reasonable for patients whether they are of normal weight, underweight, or overweight. This standard more closely supports other recommendations of 1,500 to 2,000 mL fluid intake per day. Number and frequency of medications influences the amount of fluid residents obtain during nonmeal feedings.
将机构养老老年人的实际液体摄入量与三个既定标准进行比较，以确定液体摄入是否充足。
连续3天直接观察食物和液体摄入量，并通过计算机分析其含水量。从医疗记录中获取用药数量和频率以及关于认知技能、身体活动能力和理解能力的最低数据集（MDS）信息。使用两个年龄组（65至85岁和86至100岁）的三个既定标准确定推荐液体摄入量。标准分别为：30毫升/千克体重（标准1）；每消耗1千卡能量摄入1毫升（标准2）；前10千克体重为100毫升/千克，接下来10千克体重为50毫升/千克，其余体重为15毫升/千克（标准3）。
研究对象/地点：在一家养老院收集数据。研究对象为40名居民，他们没有急性疾病和感染，且未接受肠内喂养。
收集液体摄入量和MDS数据。在初步数据收集观察后获取用药数据。
使用双侧t检验比较实际液体摄入量与推荐液体摄入量。使用多因素方差分析分析年龄对液体摄入量的交互作用。使用相关性分析评估液体摄入量、用药数量和频率、年龄、体重以及MDS数据之间的关系。
根据30毫升/千克体重或每消耗1千卡能量摄入1毫升的标准，该人群的液体摄入量充足或超过充足水平，但根据针对体重过轻或超重极端情况进行调整的标准3，液体摄入量不足。年龄不是液体摄入充足与否的因素。非餐时摄入的液体量与用药数量和频率之间存在正相关。
当使用30毫升/千克体重的标准时，体重过轻的居民的液体推荐量低得不切实际。针对体重极端情况进行调整的标准3对正常体重、体重过轻或超重的患者更为合理。该标准更接近每天摄入1500至2000毫升液体的其他建议。用药数量和频率会影响居民非餐时的液体摄入量。
