Comparison of the nutritional indicators of critically Ill patients on extracorporeal membrane oxygen (ECMO)

신 나미, 하 숙연, 조 윤수
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Abstract

Purpose: This study aimed at investigating the nutritional status, nutritional support, and nutritional indicators of critically ill patients on extracorporeal membrane oxygen (ECMO) in intensive care units (ICU). Methods: This descriptive study obtained data from the medical records of 37 patients who were treated using ECMO at a university hospital in Korea. The patients were admitted to the Korea University Anam Hospital ICU with acute or serious damage to vital organs from January 1, 2014 to June 30, 2016. Results: Although 32 patients (86.5%) were at a high risk of malnutrition, 26 patients (70.3%) were considered normal in terms of nutritional status by the nutritionist at the beginning of their ICU stay. However, after two weeks, nine patients had passed away and only one patient maintained normal status. Parenteral nutrition was started first but took 4.25 ± 6.95 days till initiation. Only eight patients (21.6%) were able to meet their requirement for both calories and protein. The group provided with adequate calorie and protein showed significantly longer use of the ECMO and respirator and longer ICU and total hospital stay than their counterparts. Normal levels of serum albumin and protein of the group at low-risk for malnutrition on the day of initiation of ECMO, which were significantly higher than the high-risk group, declined by the last day of ECMO leading to a lack of significant differences between the two groups. Conclusion: Considering that the nutritional indicators of patients deteriorated as the days on ECMO increased, more aggressive nutritional management to ensure adequate nutritional support should be emphasized from the beginning and throughout the ICU stay.
重症患者体外膜氧(ECMO)营养指标的比较
目的:探讨重症监护病房(ICU)重症患者体外膜氧(ECMO)的营养状况、营养支持及营养指标。方法:本描述性研究获得了韩国某大学医院37例采用体外膜肺栓塞治疗患者的病历资料。患者于2014年1月1日至2016年6月30日因重要器官急重度损伤入住高丽大学安岩医院ICU。结果:32例(86.5%)患者存在营养不良高危,26例(70.3%)患者在ICU入住时营养学家认为营养状况正常。然而,两周后,9名患者去世,只有1名患者保持正常状态。首先开始肠外营养,但需要4.25±6.95天才能开始。只有8名患者(21.6%)能够满足他们对卡路里和蛋白质的需求。提供足够的卡路里和蛋白质的组比对照组使用ECMO和呼吸机的时间更长,ICU和总住院时间更长。营养不良低风险组在ECMO开始当天血清白蛋白和蛋白的正常水平显著高于高危组,但在ECMO最后一天有所下降,两组间无显著差异。结论:考虑到患者的营养指标随着ECMO天数的增加而恶化,应从开始到整个ICU住院期间都强调更积极的营养管理,以确保足够的营养支持。
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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