Increasing Enteral Protein Intake in Critically Ill Trauma and Surgical Patients.
Increasing Enteral Protein Intake in Critically Ill Trauma and Surgical Patients.
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增加危重创伤和手术患者的肠内蛋白质摄入量。
DOI：
10.1002/ncp.10256
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Araujo-Lino,JoseCruz
中科院分区：
文献类型：
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作者：
O'Keefe,GrantE;Shelton,Marilyn;Qiu,Qian;Araujo-Lino,JoseCruz
背景已发表的指南建议为外科危重患者提供至少2 g/kg/d的蛋白质。使用标准肠内配方可能难以达到该摄入水平，因此需要补充蛋白质或氨基酸。在此，我们报告我们的方法，肠内蛋白补充剂及其与尿氮排泄和血清transthyretin concentration.MethodsThis的关系是一个回顾性队列研究中，我们回顾了危重创伤和手术患者治疗补充肠内蛋白根据协议，旨在提供总的2克/千克/天的蛋白质。我们在入院后2周内收集了详细的营养数据，并在出院时获得了额外的数据，以确定热量和蛋白质摄入以及并发症。我们还比较了这些患者和对照组谁没有收到补充protein. ResultsFifty-three受试者早期蛋白质补充之间的尿氮排泄和甲状腺素运载蛋白浓度。在重症监护室第4天，配方奶粉和蛋白质补充剂均提供了约1.2 g/kg/d的蛋白质。这导致第14天的中位总蛋白质摄入量为2.2 g/kg/d。1例患者发生急性肾损伤，1例患者发生3次呕吐。到第三周，血清甲状腺素运载蛋白浓度增加到中位数为21毫克/分升相比，13毫克/分升的受试者不接受早期supplementation.ConclusionIt是安全的，提供补充蛋白质肠内危重手术和创伤患者，并达到2克/公斤/天的蛋白质摄入量在第一周的疾病。
BackgroundPublished guidelines recommend providing at least 2 g/kg/d of protein for critically ill surgical patients. It may be difficult to achieve this level of intake using standard enteral formulas, thus necessitating protein or amino acid supplementation. Herein, we report our approach to enteral protein supplementation and its relationship with urinary nitrogen excretion and serum transthyretin concentrations.MethodsThis was a retrospective cohort study in which we reviewed critically ill trauma and surgical patients treated with supplemental enteral protein according to a protocol aiming to deliver a total of 2 g/kg/d of protein. We collected detailed nutrition data over a 2‐week period after admission and obtained additional data through discharge to determine caloric and protein intake as well as complications. We also compared urine nitrogen excretion and transthyretin concentrations between these patients and a control group who did not receive supplemental protein.ResultsFifty‐three subjects received early protein supplementation. Formula and protein supplement each provided ≈1.2 g/kg/d of protein by intensive care unit day 4. This resulted in a median total protein intake of 2.2 g/kg/d through day 14. One patient developed acute kidney injury, and 1 patient had 3 episodes of vomiting. By the third week, serum transthyretin concentrations increased to a median of 21 mg/dL compared with 13 mg/dL in subjects not receiving early supplementation.ConclusionIt is safe to deliver supplemental protein enterally to critically ill surgical and trauma patients and reach 2 g/kg/d of protein intake during the first week of illness.