基于容量的喂养策略对机械通气患者的影响

戚桂艳; 宋燕秋; 刘文悦; 卢清龙; 马增香

doi:10.13201/j.issn.1009-5918.2020.10.005

基于容量的喂养策略对机械通气患者的影响

- 沧州市人民医院医专肿瘤院区重症医学科(河北沧州, 061000)

详细信息

通讯作者: 马增香,E-mail:czmzxiang@163.com

中图分类号: R631.2

收稿日期: 2020-07-12

Effects of volume-based feeding protocol in critically ill patients with mechanical ventilation

- Department of Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, 061000, China

More Information

Corresponding author: MA Zeng-xiang, E-mail: czmzxiang@163.com

Received Date: 12 July 2020

摘要

摘要: 目的:观察基于容量的喂养策略对机械通气患者的影响。方法:前瞻性研究我院2019-06-2020-05期间重症医学科收治的需要接受肠内喂养及机械通气的重症患者,根据随机数字表法将患者分为观察组和对照组。观察组采用基于容量的喂养策略(VBF),通过每日目标喂养容量来调整每小时喂养速率;对照组采用传统的基于速率的喂养策略(RBF),以恒定的每小时输注速率进行喂养。观察两组热量及蛋白质的摄入量、ICU住院时间、总的住院时间、病死率和机械通气的天数。结果:研究期间共120例患者参与本研究,观察组和对照组各60例。观察组中实际摄入的热量占目标热量的百分比明显高于对照组(77.4%vs.53.6%,P<0.01),摄入的蛋白质明显多于对照组(0.78 g/kg vs.0.54 g/kg,P<0.01),机械通气时间明显缩短(6.6 d vs.7.9 d,P<0.01)。但两组间住ICU时间、总住院时间及病死率差异无统计学意义。两组间肠内营养耐受性评分差异也无统计学意义。结论:与基于速率的喂养策略相比,基于容量的喂养策略能显著提高目标热量的供应度,增加蛋白质的摄入量,缩短机械通气时间,无耐受性问题,但可能不影响临床结果。
- 基于容量的喂养 /
- 肠内营养 /
- 重症 /
- 机械通气
Abstract: Objective:To observe the effect of volume-based feeding strategy on critically ill patients with mechanical ventilation. Method:This single-center, randomized prospective study evaluated critically ill patients with mechanical ventilation expected to receive enteral feeding(EN) for ≥ 3 days. Patients were randomly divided into two groups according to different feeding strategies. In the treatment group, volume-based feeding strategies(VBF) were used to adjust hourly feeding rate by targeting daily feeding volumes. Patients in the control group were fed at a constant hourly rate using a traditional rate-based feeding strategy(RBF). Calorie and protein intake, length of ICU stay(LOS-ICU), total length of stay, mortality, and days on mechanical ventilation were observed in both groups. Result:A total of 120 patients were enrolled, including 60 in the treatment group and 60 in the control group. The percentage of actual calories accepted in the treatment group was significantly higher than that in the control group(77.4% vs. 53.6%, P<0.01), protein intake was significantly higher than that in the control group(0.78 g/kg vs. 0.54 g/kg, P<0.01), and mechanical ventilation duration was significantly shortened(6.6 d vs. 7.9 d, P<0.01). However, there were no significant differences in length of ICU stay, total length of hospital stay or mortality between the two groups. There was no significant difference in enteral nutrition tolerance score between the two groups.Conclusion:Compared to rate-based feeding strategy, volume-based feeding strategy significantly improved calorie and protein intake, reduced mechanical ventilation duration without tolerability issues, and may not affect the clinical outcome.
- volume-based feeding /
- enteral nutritional /
- intensive care /
- mechanical ventilation

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