Novel protocol combining physical and nutrition therapies, Intensive Goal-directed REhabilitation with Electrical muscle stimulation and Nutrition (IGREEN) care bundle.
Novel protocol combining physical and nutrition therapies, Intensive Goal-directed REhabilitation with Electrical muscle stimulation and Nutrition (IGREEN) care bundle.
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结合物理和营养疗法的新型方案，即电刺激肌肉和营养强化目标导向康复（IGREEN）综合护理措施。
DOI：
10.1186/s13054-021-03827-8
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发表时间：
2021-12-04
期刊：
影响因子：
--
通讯作者：
Nakamura K
中科院分区：
文献类型：
--
作者：
Nakano H;Naraba H;Hashimoto H;Mochizuki M;Takahashi Y;Sonoo T;Ogawa Y;Matsuishi Y;Shimojo N;Inoue Y;Nakamura K
尽管康复与营养相结合对于预防重症监护病房（ICU）获得性肌无力可能很重要，但尚未有关于这种结合的规范化干预的报道。在此我们制定了一种原创的联合方案并评估了其疗效。
在这项单中心历史对照研究中，我们纳入了入住ICU的成年患者。对照组患者接受标准护理，而干预组患者接受基于方案的干预。采用ICU活动量表来设定早期活动的目标，当患者无法站立时采用神经肌肉电刺激。对营养状况进行评估以用于营养治疗，干预组将目标热量供给设定为20或30千卡/千克/天，目标蛋白质供给设定为1.8克/千克/天。主要终点是通过计算机断层扫描评估10天内股肌体积的减少情况。
分析纳入了对照组的45名患者和干预组的56名患者。干预组股肌体积损失明显更低（11.6%对14.5%，p = 0.03）。绝对风险差异为2.9%（95%置信区间0.1 - 5.6%）。干预组在第10天更早实现坐到床边的早期活动（p = 0.03），平均热量供给（20.1对16.8千卡/千克/天，p = 0.01）和平均蛋白质供给（1.4对0.8克/千克/天，p < 0.01）也更高。
这种规范化的干预，结合了早期活动和高蛋白营养，有助于实现治疗目标并预防股肌体积损失。
本研究已在大学医院医学信息网络 - 临床试验注册中心注册（UMIN000040290，注册日期：2020年5月7日）。
网络版包含补充材料，可在10.1186/s13054 - 021 - 03827 - 8获取。
Although the combination of rehabilitation and nutrition may be important for the prevention of intensive care unit (ICU)-acquired weakness, a protocolized intervention of this combination has not yet been reported. We herein developed an original combined protocol and evaluated its efficacy. In this single-center historical control study, we enrolled adult patients admitted to the ICU. Patients in the control group received standard care, while those in the intervention group received the protocol-based intervention. The ICU mobility scale was used to set goals for early mobilization and a neuromuscular electrical stimulation was employed when patients were unable to stand. The nutritional status was assessed for nutritional therapy, and target calorie delivery was set at 20 or 30 kcal/kg/day and target protein delivery at 1.8 g/kg/day in the intervention group. The primary endpoint was a decrease in femoral muscle volume in 10 days assessed by computed tomography. Forty-five patients in the control group and 56 in the intervention group were included in the analysis. Femoral muscle volume loss was significantly lower in the intervention group (11.6 vs 14.5%, p = 0.03). The absolute risk difference was 2.9% (95% CI 0.1–5.6%). Early mobilization to a sitting position by day 10 was achieved earlier (p = 0.03), and mean calorie delivery (20.1 vs. 16.8 kcal/kg/day, p = 0.01) and mean protein delivery (1.4 vs. 0.8 g/kg/day, p < 0.01) were higher in the intervention group. The protocolized intervention, combining early mobilization and high-protein nutrition, contributed to the achievement of treatment goals and prevention of femoral muscle volume loss. The present study is registered at the University Hospital Medical Information Network-clinical trials registry (UMIN000040290, Registration date: May 7, 2020). The online version contains supplementary material available at 10.1186/s13054-021-03827-8.
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影响因子：
1.7
作者：
Karatzanos E;Gerovasili V;Zervakis D;Tripodaki ES;Apostolou K;Vasileiadis I;Papadopoulos E;Mitsiou G;Tsimpouki D;Routsi C;Nanas S
通讯作者：
Nanas S
DOI：
10.1177/014860717700100111
发表时间：
1977-01-01
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
Blackburn, G L;Bistrian, B R;Smith, M F
通讯作者：
Smith, M F
影响因子：
3.4
作者：
KONSTANTINIDES, FN;KONSTANTINIDES, NN;CERRA, FB
通讯作者：
CERRA, FB
影响因子：
76.2
作者：
Hermans, Greet;Casaer, Michael P.;Vanhorebeek, Ilse
通讯作者：
Vanhorebeek, Ilse
DOI：
10.1186/cc13720
发表时间：
2014-02-10
期刊：
Critical care (London, England)
影响因子：
--
作者：
Elke G;Wang M;Weiler N;Day AG;Heyland DK
通讯作者：
Heyland DK