Early Enteral Nutrition Could Be Associated with Improved Survival Outcome in Cardiac Arrest.

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

Emergency Medicine International Pub Date : 2024-06-08 eCollection Date: 2024-01-01 DOI:10.1155/2024/9372015

Jingwei Duan, Jianjie Ren, Xiaodan Li, Lanfang Du, Baomin Duan, Qingbian Ma

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引用次数: 0

Abstract

Background: Although the latest European and US guidelines recommend that early enteral nutrition (EN) be attempted in critically ill patients, there is still a lack of research on feeding strategies for patients after cardiac arrest (CA). Due to the unique pathophysiology following CA, it remains unknown whether evidence from other diseases can be applied in this condition.

Objective: We aimed to explore the relationship between the timing of EN (within 48 hours or after 48 hours) and clinical outcomes and safety in CA.

Method: From the MIMIC-IV (version 2.2) database, we conducted this retrospective cohort study. A 1 : 1 propensity score matching (PSM) analysis was also conducted to prevent potential interference from confounders. Moreover, adjusted proportional hazards model regression models were used to adjust for prehospital and hospitalization characteristics to verify the independence of the association between early EN initiation and patient outcomes.

Results: Of the initial 1286 patients, 670 were equally assigned to the early EN or delayed EN group after PSM. Patients in the early EN group had improved survival outcomes than those in the delayed EN group within 30 days (HR = 0.779, 95% confidence interval [CI] [0.611-0.994], p = 0.041). Similar results were shown at 90 and 180 days. However, there was no significant difference in neurological outcome between the two groups at 30 days (51% vs. 57%, odds ratio [OR] = 0.786, 95% CI [0.580-1.066], p = 0.070). Patients who underwent early EN had a lower risk of ileus than patients who underwent delayed EN (4% vs. 8%, OR = 0.461, 95% CI [0.233-0.909], p = 0.016). Moreover, patients who underwent early EN had shorter hospital stays.

Conclusion: Early EN could be associated with improved survival outcomes for patients after CA. Further studies are needed to verify it. However, at present, we might consider early EN to be a more suitable feeding strategy for CA.

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早期肠内营养可改善心脏骤停患者的生存结果

背景：尽管最新的欧洲和美国指南建议危重病人尝试早期肠内营养（EN），但目前仍缺乏对心脏骤停（CA）后病人喂养策略的研究。由于心脏骤停后的病理生理学非常独特，因此其他疾病的证据是否适用于这种情况仍是未知数：我们的目的是探讨 EN 的时间（48 小时内或 48 小时后）与 CA 的临床结果和安全性之间的关系：我们从 MIMIC-IV（2.2 版）数据库中进行了这项回顾性队列研究。A 1 :1 的倾向得分匹配（PSM）分析，以防止混杂因素的潜在干扰。此外，我们还使用调整后的比例危险模型回归模型来调整入院前和住院期间的特征，以验证早期EN启动与患者预后之间关系的独立性：在最初的1286名患者中，有670人在PSM后被平均分配到早期EN组或延迟EN组。与延迟EN组相比，早期EN组患者在30天内的生存率更高（HR=0.779，95%置信区间[CI][0.611-0.994]，P=0.041）。90 天和 180 天的结果与此类似。然而，两组患者在30天后的神经功能预后无明显差异（51% vs. 57%，几率比[OR] = 0.786，95% CI [0.580-1.066]，p = 0.070）。早期EN患者发生回肠梗阻的风险低于延迟EN患者（4% vs. 8%，OR = 0.461，95% CI [0.233-0.909]，p = 0.016）。此外，接受早期EN的患者住院时间更短：结论：早期EN可改善CA患者的生存预后。结论：早期EN可能与CA术后患者生存预后的改善有关，这需要进一步的研究来验证。结论：早期EN可能与改善CA患者的生存预后有关，还需要进一步的研究来验证。不过，目前我们可以认为早期EN是更适合CA的喂养策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emergency Medicine International EMERGENCY MEDICINE-

CiteScore

0.10

自引率

0.00%

发文量

187

审稿时长

17 weeks

期刊介绍： Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.