Provision of protein and energy in relation to measured requirements in intensive care patients
Provision of protein and energy in relation to measured requirements in intensive care patients
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DOI：
10.1016/j.clnu.2011.12.006
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发表时间：
2012-08-01
影响因子：
6.3
通讯作者：
Kondrup, Jens
中科院分区：
文献类型：
--
作者：
Allingstrup, Matilde Jo;Esmailzadeh, Negar;Kondrup, Jens
背景和目的：重症监护患者的营养支持是否充足仍然是一个调查问题。本研究旨在将死亡率与 ICU 患者的能量和蛋白质供应、测量需求和平衡联系起来。设计：对三级转诊医院的 113 名 ICU 患者进行前瞻性观察队列研究。结果：蛋白质和氨基酸供应最低的三分位数患者较早死亡。结果在 Cox 回归分析中得到证实，该分析显示，随着蛋白质供应的增加，死亡风险比显着降低，并且在调整基线预后变量（APACHE II、SOFA 评分和年龄）时也是如此。能量供应、测量的静息能量消耗或能量和氮平衡与死亡率无关。在对入院初始部分进行更详细的分析后，讨论了可能的因果关系。结论：在这些重症 ICU 患者中，较高的蛋白质和氨基酸供应与较低的死亡率相关。对于提供能量或测量的静息能量消耗或能量或氮平衡来说，情况并非如此。提供更多蛋白质可以改善结果的假设应该在随机试验中进行检验。 (c) 2011 年爱思唯尔有限公司和欧洲临床营养与代谢学会。版权所有。
Background & aims: Adequacy of nutritional support in intensive care patients is still a matter of investigation. This study aimed to relate mortality to provision, measured requirements and balances for energy and protein in ICU patients.Design: Prospective observational cohort study of 113 ICU patients in a tertiary referral hospital.Results: Death occurred earlier in the tertile of patients with the lowest provision of protein and amino acids. The results were confirmed in Cox regression analyses which showed a significantly decreased hazard ratio of death with increased protein provision, also when adjusted for baseline prognostic variables (APACHE II, SOFA scores and age). Provision of energy, measured resting energy expenditure or energy and nitrogen balance was not related to mortality. The possible cause-effect relationship is discussed after a more detailed analysis of the initial part of the admission.Conclusion: In these severely ill ICU patients, a higher provision of protein and amino acids was associated with a lower mortality. This was not the case for provision of energy or measured resting energy expenditure or energy or nitrogen balances. The hypothesis that higher provision of protein improves outcome should be tested in a randomised trial. (c) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.