{"title":"重症监护病房患者的营养处方:这重要吗?","authors":"Amarja Ashok Havaldar, Sumithra Selvam","doi":"10.5005/jp-journals-10071-24755","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The nutritional status of the patients before critical illness and nutrition support given during the critical illness play an important role in the recovery. We aimed to evaluate the nutritional prescription and its effect on ICU mortality.</p><p><strong>Materials and methods: </strong>This was a prospective observational study conducted after institutional ethical committee approval (IEC 94/2018, CTRI/2018/06/014625) in a case-mixed (medical and surgical) ICU. Patients admitted to the ICU were enrolled within 24 hours of admission. The amount of calories and proteins prescribed and received by the patients was collected for 7 days. The primary outcome was ICU mortality.</p><p><strong>Results: </strong>A total of 100 patients were included. The mean age was 48.63 (16.25) years, and 62% were males. The acute physiology and chronic health evaluation (APACHE II), sequential organ failure assessment (SOFA), and modified Nutric (mNUTRIC) scores were comparable between the two groups. The ICU mortality was 30%. The calorie and protein deficits were comparable between survivors and non-survivors. Among the secondary outcomes, a significant time effect (<i>p</i> = 0.013) and interaction effect (<i>p</i> = 0.004) were noted for maximum glucose levels. The glucose variability calculated by coefficient of variation (CV) was significantly higher in non-survivors than survivors (<i>p</i> = 0.031).</p><p><strong>Conclusion: </strong>The calorie and protein deficits did not affect ICU mortality. The maximum glucose variability and CV were significant parameters associated with ICU mortality.</p><p><strong>How to cite this article: </strong>Havaldar AA, Selvam S. Nutritional Prescription in ICU Patients: Does it Matter? Indian J Crit Care Med 2024;28(7):657-661.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 7","pages":"657-661"},"PeriodicalIF":1.5000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234123/pdf/","citationCount":"0","resultStr":"{\"title\":\"Nutritional Prescription in ICU Patients: Does it Matter?\",\"authors\":\"Amarja Ashok Havaldar, Sumithra Selvam\",\"doi\":\"10.5005/jp-journals-10071-24755\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The nutritional status of the patients before critical illness and nutrition support given during the critical illness play an important role in the recovery. We aimed to evaluate the nutritional prescription and its effect on ICU mortality.</p><p><strong>Materials and methods: </strong>This was a prospective observational study conducted after institutional ethical committee approval (IEC 94/2018, CTRI/2018/06/014625) in a case-mixed (medical and surgical) ICU. Patients admitted to the ICU were enrolled within 24 hours of admission. The amount of calories and proteins prescribed and received by the patients was collected for 7 days. The primary outcome was ICU mortality.</p><p><strong>Results: </strong>A total of 100 patients were included. The mean age was 48.63 (16.25) years, and 62% were males. The acute physiology and chronic health evaluation (APACHE II), sequential organ failure assessment (SOFA), and modified Nutric (mNUTRIC) scores were comparable between the two groups. The ICU mortality was 30%. The calorie and protein deficits were comparable between survivors and non-survivors. Among the secondary outcomes, a significant time effect (<i>p</i> = 0.013) and interaction effect (<i>p</i> = 0.004) were noted for maximum glucose levels. The glucose variability calculated by coefficient of variation (CV) was significantly higher in non-survivors than survivors (<i>p</i> = 0.031).</p><p><strong>Conclusion: </strong>The calorie and protein deficits did not affect ICU mortality. The maximum glucose variability and CV were significant parameters associated with ICU mortality.</p><p><strong>How to cite this article: </strong>Havaldar AA, Selvam S. Nutritional Prescription in ICU Patients: Does it Matter? Indian J Crit Care Med 2024;28(7):657-661.</p>\",\"PeriodicalId\":47664,\"journal\":{\"name\":\"Indian Journal of Critical Care Medicine\",\"volume\":\"28 7\",\"pages\":\"657-661\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234123/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/jp-journals-10071-24755\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10071-24755","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:危重病人发病前的营养状况和发病期间的营养支持对其康复起着重要作用。我们旨在评估营养处方及其对重症监护病房死亡率的影响:这是一项前瞻性观察研究,经机构伦理委员会批准(IEC 94/2018,CTRI/2018/06/014625)后在病例混合型(内科和外科)重症监护病房进行。重症监护室收治的患者均在入院 24 小时内登记。研究人员收集了患者在7天内的热量和蛋白质处方量和摄入量。主要结果是重症监护室死亡率:结果:共纳入 100 名患者。平均年龄为 48.63(16.25)岁,男性占 62%。两组患者的急性生理学和慢性健康评估(APACHE II)、序贯器官衰竭评估(SOFA)和改良营养学(mNUTRIC)评分相当。重症监护室死亡率为 30%。存活者和非存活者的卡路里和蛋白质缺乏率相当。在次要结果中,最大血糖水平存在显著的时间效应(p = 0.013)和交互效应(p = 0.004)。用变异系数(CV)计算,非幸存者的血糖变异性明显高于幸存者(p = 0.031):结论:卡路里和蛋白质的缺乏不会影响重症监护病房的死亡率。结论:卡路里和蛋白质的缺乏并不影响重症监护室的死亡率,最大葡萄糖变异性和CV是与重症监护室死亡率相关的重要参数:Havaldar AA, Selvam S. ICU患者的营养处方:重要吗?Indian J Crit Care Med 2024;28(7):657-661.
Nutritional Prescription in ICU Patients: Does it Matter?
Background: The nutritional status of the patients before critical illness and nutrition support given during the critical illness play an important role in the recovery. We aimed to evaluate the nutritional prescription and its effect on ICU mortality.
Materials and methods: This was a prospective observational study conducted after institutional ethical committee approval (IEC 94/2018, CTRI/2018/06/014625) in a case-mixed (medical and surgical) ICU. Patients admitted to the ICU were enrolled within 24 hours of admission. The amount of calories and proteins prescribed and received by the patients was collected for 7 days. The primary outcome was ICU mortality.
Results: A total of 100 patients were included. The mean age was 48.63 (16.25) years, and 62% were males. The acute physiology and chronic health evaluation (APACHE II), sequential organ failure assessment (SOFA), and modified Nutric (mNUTRIC) scores were comparable between the two groups. The ICU mortality was 30%. The calorie and protein deficits were comparable between survivors and non-survivors. Among the secondary outcomes, a significant time effect (p = 0.013) and interaction effect (p = 0.004) were noted for maximum glucose levels. The glucose variability calculated by coefficient of variation (CV) was significantly higher in non-survivors than survivors (p = 0.031).
Conclusion: The calorie and protein deficits did not affect ICU mortality. The maximum glucose variability and CV were significant parameters associated with ICU mortality.
How to cite this article: Havaldar AA, Selvam S. Nutritional Prescription in ICU Patients: Does it Matter? Indian J Crit Care Med 2024;28(7):657-661.
期刊介绍:
Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.