Duodenal versus gastric feeding in ventilated blunt trauma patients: A randomized controlled trial
Duodenal versus gastric feeding in ventilated blunt trauma patients: A randomized controlled trial
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DOI：
10.1097/00005373-199906000-00002
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发表时间：
1999-06-01
影响因子：
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通讯作者：
Doig, C
中科院分区：
文献类型：
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作者：
Kortbeek, JB;Haigh, PI;Doig, C
目的：为了评估transpyloric饲料，因为他们黑尔被提议作为一种手段，提供肠内营养更迅速，最大限度地减少发病率在通气trauma patients.Methods：1994年7月至1997年6月，80例成人通气创伤患者参加了一项随机对照试验，十二指肠与胃饲料。结果：43例患者接受胃饲（G），37例患者接受十二指肠饲（D），平均年龄分别为34.7 ± 15.7岁（G）和33.6 ± 17.5岁（D）;年龄差异不显著（NS）。平均损伤严重度评分为30.0 +/- 11（G），33.0 +/- 9.7（D），NS。平均急性生理学和慢性健康评估（APACHE II）评分为18.0 +/- 6.0（G）和18.0 +/- 7.4（D），SS，43例患者中34例为男性（G），37例患者中28例为男性（D），SS，两组之间麻醉剂和麻痹剂的使用无显著差异。能量需求是基础能量消耗的1.4倍，即2，127 +/- 304千卡;，和2，089 +/- 274千卡（D），NS，重症监护室住院时间中位数为7天（范围，3-32天）（G）和10天（范围，3-24天）（D），NS，使用呼吸机的天数中位数为5天（范围，3-15天）（G）和9天（范围，2-13天）（D），NS。住院时间。中位时间为25天（范围，9-88天）（G）和30天（范围，16-47天）（D），NS，记录的发病率无显著差异。肺炎发生率分别为42%（G）和27%（D），NS，连续24 h耐受全强度喂养的时间分别为43.8 h ± 22.6 h（G）和34.3 h ± 7.1 h（D），差异有显著性（p = 0.02）。需要进行更大规模的试验来确定肺炎发病率的差异
Objective: To evaluate transpyloric feeds as they hale been proposed as a means of providing enteric nutrition more rapidly and minimizing morbidity in ventilated trauma patients.Methods: Between July of 1994 and June of 1997, 80 adult ventilated trauma patients were enrolled in a randomized controlled trial of duodenal versus gastric feeds. Feeding was initiated within 72 hours of injury.Results: Forty-three patients received gastric feeds (G), and 37 patients received duodenal feeds (D), Mean age was 34.7 +/- 15.7 years (G) and 33.6 +/- 17.5 years (D); the difference in age was not significant (NS). Mean Injury Severity Score was 30.0 +/- 11 (G), 33.0 +/- 9.7 (D), NS. Mean Acute Physiology and Chronic Health Evaluation (APACHE II) score was 18.0 +/- 6.0 (G) and 18.0 +/- 7.4 (D), SS, Thirty-four of 43 patients were men (G) and 28 of 37 patients were men (D), SS, Use of narcotics and paralytics between the two groups was not significantly different. Energy requirements were 1.4 times basal energy expenditure at 2,127 +/- 304 Kcal ie;, and 2,089 +/- 274 Kcal (D), NS, Intensive care unit length of stay Has a median of 7 days (range, 3-32 days) (G) and 10 days (range, 3-24 days) (D), NS, Number of days on a ventilator was a median of 5 days (range, 3-15 days) (G) and 9 days (range, 2-13 days) (D), NS. Hospital length of stay. was a median of 25 days (range, 9-88 days) (G) and 30 days (range, 16-47 days) (D), NS, Recorded morbidity was not significantly different. Pneumonia rates were 42% (G) and 27% (D), NS, Time to tolerate full-strength feeds for 24 consecutive hours was 43.8 hours +/- 22.6 (G) and 34.3 hours +/- 7.1 (D), difference significant atp = 0.02,Conclusion: Length of stay and ventilator days were not significantly different. A larger trial would be required to determine differences in the rates of pneumonia