重大创伤后入住重症监护病房的患者肠内营养输送：谁有风险，影响是什么？

IF 1.4 Q3 CRITICAL CARE MEDICINE

Journal of the Intensive Care Society Pub Date : 2025-06-29 DOI:10.1177/17511437251349679

Carys Davies, Lina Johansson, Stephen J Brett, Elaine Cole

{"title":"重大创伤后入住重症监护病房的患者肠内营养输送：谁有风险，影响是什么？","authors":"Carys Davies, Lina Johansson, Stephen J Brett, Elaine Cole","doi":"10.1177/17511437251349679","DOIUrl":null,"url":null,"abstract":"Background: Hypermetabolism and enteral nutrition delivery challenges, result in trauma patients, becoming malnourished during their hospital, admission. This study aimed to explore enteral nutrition delivery, predictors of suboptimal delivery and the relationship with clinical outcomes in patients admitted to a critical care unit following major trauma.Methods: An exploration of nutrition related data collected as part of a multicentre prospective major trauma study was conducted. Nutrition related data included anthropometry, nutrition risk screening, feeding route, nutrition products, target volume, nutrition delivery and causes of enteral feeding interruptions. Multivariate logistic regression analysis was used to evaluate the strongest associations with suboptimal nutrition delivery.Results: Of 1036 participants, 71% (n = 732) required enteral nutrition for a mean of 15.7 (7.9) days. Suboptimal nutrition delivery was prevalent throughout the admission. Mean energy target was 23.8 (6.37) versus 15.81 (3.43) kcal/kg/day delivered (p < 0.001). Mean protein target was 1.27 (0.34) versus 0.89 (0.48) g/kg/day delivered (p < 0.001). Factors associated with suboptimal nutrition delivery included male sex (OR, 1.82, 95% CI 1.27-2.60; p < 0.001), traumatic brain injury (OR, 1.67, 95% CI 1.16-2.40; p = 0.006) or high NUTRIC score (OR, 1.17, 95% CI 1.08-1.27; p < 0.001); early enteral nutrition reduced the risk of underfeeding (OR, 0.49, 95% CI 0.30-0.81; p = 0.006). Lower energy and protein delivery were associated with increased days of mechanical ventilation (p < 0.001) and longer length of stay in both the critical care unit and overall hospital stay (p < 0.001).Conclusion: Trauma patients experience inadequate enteral nutrition delivery which potentially negatively impacts clinical outcomes. Additional investigation is required to further understand the barriers and facilitators to adequate nutrition provision in critically ill trauma patients.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251349679"},"PeriodicalIF":1.4000,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206743/pdf/","citationCount":"0","resultStr":"{\"title\":\"Enteral nutrition delivery in patients admitted to a critical care unit following major trauma: Who's at risk and what's the impact?\",\"authors\":\"Carys Davies, Lina Johansson, Stephen J Brett, Elaine Cole\",\"doi\":\"10.1177/17511437251349679\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Hypermetabolism and enteral nutrition delivery challenges, result in trauma patients, becoming malnourished during their hospital, admission. This study aimed to explore enteral nutrition delivery, predictors of suboptimal delivery and the relationship with clinical outcomes in patients admitted to a critical care unit following major trauma.Methods: An exploration of nutrition related data collected as part of a multicentre prospective major trauma study was conducted. Nutrition related data included anthropometry, nutrition risk screening, feeding route, nutrition products, target volume, nutrition delivery and causes of enteral feeding interruptions. Multivariate logistic regression analysis was used to evaluate the strongest associations with suboptimal nutrition delivery.Results: Of 1036 participants, 71% (n = 732) required enteral nutrition for a mean of 15.7 (7.9) days. Suboptimal nutrition delivery was prevalent throughout the admission. Mean energy target was 23.8 (6.37) versus 15.81 (3.43) kcal/kg/day delivered (p < 0.001). Mean protein target was 1.27 (0.34) versus 0.89 (0.48) g/kg/day delivered (p < 0.001). Factors associated with suboptimal nutrition delivery included male sex (OR, 1.82, 95% CI 1.27-2.60; p < 0.001), traumatic brain injury (OR, 1.67, 95% CI 1.16-2.40; p = 0.006) or high NUTRIC score (OR, 1.17, 95% CI 1.08-1.27; p < 0.001); early enteral nutrition reduced the risk of underfeeding (OR, 0.49, 95% CI 0.30-0.81; p = 0.006). Lower energy and protein delivery were associated with increased days of mechanical ventilation (p < 0.001) and longer length of stay in both the critical care unit and overall hospital stay (p < 0.001).Conclusion: Trauma patients experience inadequate enteral nutrition delivery which potentially negatively impacts clinical outcomes. Additional investigation is required to further understand the barriers and facilitators to adequate nutrition provision in critically ill trauma patients.\",\"PeriodicalId\":39161,\"journal\":{\"name\":\"Journal of the Intensive Care Society\",\"volume\":\" \",\"pages\":\"17511437251349679\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-06-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206743/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Intensive Care Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/17511437251349679\",\"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":"Journal of the Intensive Care Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17511437251349679","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：高代谢和肠内营养输送的挑战，导致创伤患者在入院期间营养不良。本研究旨在探讨肠内营养输送、次优输送的预测因素以及与重大创伤后入住重症监护病房的患者临床结局的关系。方法：对一项多中心前瞻性重大创伤研究中收集的营养相关数据进行了探索。营养相关数据包括人体测量、营养风险筛查、喂养途径、营养产品、目标体积、营养输送和肠内喂养中断的原因。多变量logistic回归分析用于评估与次优营养输送的最强关联。结果：在1036名参与者中，71% （n = 732）需要肠内营养，平均15.7（7.9）天。在整个入院过程中，营养输送不理想的情况普遍存在。平均能量目标为23.8 (6.37)vs 15.81 (3.43) kcal/kg/day交付（p p p p = 0.006）或高NUTRIC评分(or, 1.17, 95% CI 1.08-1.27；p = 0.006)。较低的能量和蛋白质输送与机械通气天数增加有关(p)结论：创伤患者肠内营养输送不足，可能对临床结果产生负面影响。需要进一步的调查，以进一步了解障碍和促进充分的营养提供创伤重症患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Enteral nutrition delivery in patients admitted to a critical care unit following major trauma: Who's at risk and what's the impact?

Background: Hypermetabolism and enteral nutrition delivery challenges, result in trauma patients, becoming malnourished during their hospital, admission. This study aimed to explore enteral nutrition delivery, predictors of suboptimal delivery and the relationship with clinical outcomes in patients admitted to a critical care unit following major trauma.

Methods: An exploration of nutrition related data collected as part of a multicentre prospective major trauma study was conducted. Nutrition related data included anthropometry, nutrition risk screening, feeding route, nutrition products, target volume, nutrition delivery and causes of enteral feeding interruptions. Multivariate logistic regression analysis was used to evaluate the strongest associations with suboptimal nutrition delivery.

Results: Of 1036 participants, 71% (n = 732) required enteral nutrition for a mean of 15.7 (7.9) days. Suboptimal nutrition delivery was prevalent throughout the admission. Mean energy target was 23.8 (6.37) versus 15.81 (3.43) kcal/kg/day delivered (p < 0.001). Mean protein target was 1.27 (0.34) versus 0.89 (0.48) g/kg/day delivered (p < 0.001). Factors associated with suboptimal nutrition delivery included male sex (OR, 1.82, 95% CI 1.27-2.60; p < 0.001), traumatic brain injury (OR, 1.67, 95% CI 1.16-2.40; p = 0.006) or high NUTRIC score (OR, 1.17, 95% CI 1.08-1.27; p < 0.001); early enteral nutrition reduced the risk of underfeeding (OR, 0.49, 95% CI 0.30-0.81; p = 0.006). Lower energy and protein delivery were associated with increased days of mechanical ventilation (p < 0.001) and longer length of stay in both the critical care unit and overall hospital stay (p < 0.001).

Conclusion: Trauma patients experience inadequate enteral nutrition delivery which potentially negatively impacts clinical outcomes. Additional investigation is required to further understand the barriers and facilitators to adequate nutrition provision in critically ill trauma patients.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of the Intensive Care Society Nursing-Critical Care Nursing

CiteScore

4.40

自引率

0.00%

发文量

期刊介绍： The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.