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[转载]早期高蛋白摄入可能降低肌肉减少的ICU患者的病死率

已有 1716 次阅读 2017-3-7 09:33 |个人分类:ICU文献|系统分类:论文交流| 营养

摘要:

  1. 一项回顾研究提示肌肉量减少的患者入ICU后短期内给予高蛋白营养支持可能减少死亡风险,而在肌肉含量正常的患者无效。

  2. 在2017年佛罗里达奥兰多的2017年营养周学会上,来自VU University Medical Center in Amsterdam的Dr. Looijaard分享了这个研究。

  3. 肌肉含量减少的定义:第三腰椎的肌肉面积男性小于170cm2,女性小于110cm2。63%的ICU患者存在肌肉含量减少,此类患者6个月病死率是45.3%,相较而言肌肉含量正常患者病死率是18.5%。

comment:

营养支持没有适合所有人的统一标准,我们需要审视患者找到他们具体的营养支持需要。



NEW YORK (Reuters Health) from medscape

Delivering high protein nutrition shortly after admission to intensive care may reduce the mortality risk for patients with low muscle mass, a retrospective study suggests.

“We found protein intake over days 2 to 4 to be significantly associated with 28-day and hospital mortality in patients admitted with low muscle mass (e.g. low protein reserves) who could be adequately fed, but not in patients admitted with normal muscle mass,” said the study’s lead author Dr. Willem Looijaard at VU University Medical Center in Amsterdam.

Dr. Looijaard presented the findings in Orlando, Florida February 20 during Clinical Nutrition Week 2017, where the study was nominated for a Harry M. Vars Award.

He and his colleagues reviewed data on 221 ICU patients who were well fed at 80-120% of their estimated required energy.

Sixty-three percent of the patients had low muscle mass, defined as a muscle area at the third lumbar vertebra of less than 110 cm2 for women and less than 170 cm2 for men. Those patients had a six-month mortality rate of 45.3%, compared to 18.5% in patients with normal muscle mass.

Patients with low muscle mass who had a high protein diet of 1.2g/kg or more after admission appear to have been less likely to die at six months (hazard ratio 0.49; P= 0.011).

The same did not hold for patients with normal muscle mass, however.

“The finding that the provision of protein was associated with mortality in patients admitted with low muscle mass, but not in patients with normal muscle mass, really shows us that one size does not fit all and we really need to look at our patients and try to figure out their personalized nutritional needs,” Dr. Looijaard told Reuters Health.

SOURCE: http://bit.ly/2lrguRj

Clinical Nutrition Week 2017.






https://blog.sciencenet.cn/blog-3306730-1037985.html


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