Critical care 24 × 7: But, why is critical nutrition interrupted?
Critical care 24 × 7: But, why is critical nutrition interrupted?
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重症监护24×7：但是，为什么重症营养会中断呢？
DOI：
10.4103/0972-5229.128704
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发表时间：
2014-03
期刊：
影响因子：
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通讯作者：
Bhuvaneshwari S
中科院分区：
文献类型：
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作者：
Ramakrishnan N;Daphnee DK;Ranganathan L;Bhuvaneshwari S
充分的营养支持对于预防和治疗危重患者的营养不良至关重要。尽管打算提供适当的肠内营养（EN），但由于中断，满足全部营养需求可能是一个挑战。本研究旨在确定EN中断的原因和持续时间。2010年9月至2011年1月入住三级医院多学科重症监护室（CCU）并接受EN治疗>24 h的患者纳入本观察性前瞻性研究。共纳入327例患者，共计857患者-天。记录EN中断的原因和持续时间，并将其分为四组-CCU内的操作，CCU外的操作，胃肠道（GI）症状和其他。CCU内操作占55.9%，胃肠道症状占24.2%。尽管通常认为CCU外的操作是中断的最常见原因，但这仅占18.4%;通气相关操作是最常见的原因（40.25%），其次是鼻胃管抽吸（15.28%）。虽然胃肠道出血通常被认为是暂停肠内喂养的原因，但在我们的研究中，它是最不常见的原因之一（1%）。2-6 h的中断更常见（43%），其中大部分（67.1%）与“CCU内操作”有关。了解EN中断的原因将有助于修改方案，并最大限度地减少CCU手术期间的中断，以达到营养目标。
Adequate nutritional support is crucial in prevention and treatment of malnutrition in critically ill-patients. Despite the intention to provide appropriate enteral nutrition (EN), meeting the full nutritional requirements can be a challenge due to interruptions. This study was undertaken to determine the cause and duration of interruptions in EN. Patients admitted to a multidisciplinary critical care unit (CCU) of a tertiary care hospital from September 2010 to January 2011 and who received EN for a period >24 h were included in this observational, prospective study. A total of 327 patients were included, for a total of 857 patient-days. Reasons and duration of EN interruptions were recorded and categorized under four groups-procedures inside CCU, procedures outside CCU, gastrointestinal (GI) symptoms and others. Procedure inside CCU accounted for 55.9% of the interruptions while GI symptoms for 24.2%. Although it is commonly perceived that procedures outside CCU are the most common reason for interruption, this contributed only to 18.4% individually; ventilation-related procedures were the most frequent cause (40.25%), followed by nasogastric tube aspirations (15.28%). Although GI bleed is often considered a reason to hold enteral feed, it was one of the least common reasons (1%) in our study. Interruption of 2-6 h was more frequent (43%) and most of this (67.1%) was related to “procedures inside CCU”. Awareness of reasons for EN interruptions will aid to modify protocol and minimize interruptions during procedures in CCU to reach nutrition goals.