澳大利亚和新西兰危重病人住院期间的营养提供：一项多中心、前瞻性观察研究。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2024-11-25 DOI:10.1111/jhn.13385

Emma J. Ridley, Kate Ainscough, Michael Bailey, Rebecca Baskett, Allison Bone, Lewis Campbell, Eleanor Capel, Lee-anne Chapple, Andrew Cheng, Adam M. Deane, Ra'eesa Doola, Suzie Ferrie, Kate Fetterplace, Eileen Gilder, Alisa M. Higgins, Carol L. Hodgson, Victoria King, Andrea P. Marshall, Alistair Nichol, Sandra Peake, Mahesh Ramanan, Ary Serpa Neto, Andrew Udy, Patricia Williams, Jacinta Winderlich, Paul J. Young, NUTRIENT Study Investigators and ANZICS Clinical Trials Group

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引用次数: 0

摘要

背景和目的：接受口服营养的重症患者的能量和蛋白质供应往往低于推荐目标。我们比较了在澳大利亚或新西兰（ANZ）重症监护病房接受口服营养作为唯一营养来源的患者与首次开始肠内营养（EN）或肠外营养（PN）的患者在住院期间（重症监护病房住院期间和住院后）的特征和营养过程：方法：对澳大利亚或新西兰（ANZ）44 家医院的常规营养护理进行多中心观察研究，包括入住 ICU 至少 48 小时的成年患者。将接受口服营养作为唯一营养来源（无论是否有口服营养补充剂）的患者纳入 "口服营养 "组，将在 ICU 首次接受肠内营养和/或肠外营养的患者纳入 "肠内营养/肠外营养组"。主要结果是重症监护室每日能量供给中位数。数据以人数（%）或中位数[四分位距]表示：在登记的 409 名患者中，中位数[IQR]年龄为 64 [51-74] 岁，257 名患者（62%）为男性。与接受 EN/PN 的患者（209 人）相比，接受口服营养的患者（200 人）的 APACHE II 评分、有创通气使用率和住院时间（LOS）均较低。在重症监护室，63 例（31.5%）和 169 例（81%）（P与首先接受 EN/PN 的患者相比，在 ICU 以口服营养作为唯一营养来源的患者的病情严重程度、营养评估率和口服营养补充剂的提供率均较低。重症监护室和病房中所有患者的口服营养定量往往不完整。

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Nutrition delivery during hospitalisation after critical illness in Australia and New Zealand: a multicentre, prospective observational study

Background and Aims

Energy and protein provision for critically ill patients who receive oral nutrition often falls below recommended targets. We compared characteristics and nutrition processes during hospital stay (within and post-intensive care unit [ICU] stay) of those who received oral nutrition as the sole nutrition source to those who first commenced enteral (EN) or parenteral nutrition (PN) within an Australian or New Zealand (ANZ) ICU.

Methods

Multicentre, observational study of routine nutrition care in 44 hospitals across ANZ, including adult patients within ICU admitted for at least 48 h. Those receiving oral nutrition as the sole source of nutrition (with or without oral nutrition supplements) were included in the ‘oral nutrition’ group and those who first received EN and/or PN in the ICU as the ‘EN/PN group’. The primary outcome was median daily energy delivery in ICU. Data are presented as number (%) or median [interquartile range].

Results

Of the 409 patients enroled, median [IQR] age was 64 [51–74] years and 257 patients (62%) were male. APACHE II score, use of invasive ventilation and hospital length of stay (LOS) were all lower in those receiving oral nutrition (n = 200) compared to those receiving EN/PN (n = 209). In ICU, 63 (31.5%) and 169 (81%) (p < 0.001), patients who were receiving oral nutrition and in the EN/PN group received a nutrition assessment, respectively. Oral nutrition supplements were provided for 40 (20%) patients in the oral nutrition group and 31 of 94 (33%) of those receiving oral nutrition in the EN/PN group (p = 0.019). Energy and protein intake in ICU for the oral nutrition group was 716 [597–1069] kcal/day and 37 [19–46] g/day versus 1158 [664–1583] kcal/day and 57 [31–77] g/day for those receiving EN/PN (p = 0.020 energy, p = 0.016 protein). Quantification of oral nutrition was attempted in 78/294 (27%) patients in ICU and completed on 27/78 (36%) occasions. On the ward, attempts were made for 120/273 (44%) patients, with 60/120 (50%) complete.

Conclusion

Patients who received oral nutrition as the sole nutrition source in ICU had lower illness severity, rates of nutrition assessment and provision of oral supplements compared to those who first received EN/PN. Quantification of oral nutrition was often incomplete for all patients in ICU and on the ward.

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.