2015-06-30 肠外营养在ICU的应用.ppt

Casaer M P, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults[J]. N Engl J Med, 2011, 365(6): 506-517. Casaer M P, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults[J]. N Engl J Med, 2011, 365(6): 506-517. 2013年发表在《Lancet》 2中心、随机、对照 背景：ICU患者推荐的EN常常不能达到营养目标，如果采用SPN将入ICU后第4-8天的能量目标100%满足，是否对临床结局有益？ 对象：如ICU后3天内EN达不到60%目标能量的患者 SPN组：n=153，第4-8天平均获取能量28kCal/kg/day EN组：n=152，第4-8天平均获取能量20kCal/kg/day 主要结局：第8-28天的院内感染发生率 Heidegger C P, Berger M M, Graf S, et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial[J]. The Lancet, 2013, 381(9864): 385-393. 能源供应与危重患者补充肠外营养的最优化。一项随机临床对照试验 主要结局：SPN组免于感染的患者比例显著高于EN组 Heidegger C P, Berger M M, Graf S, et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial[J]. The Lancet, 2013, 381(9864): 385-393. 其它次要临床结局 Heidegger C P, Berger M M, Graf S, et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial[J]. The Lancet, 2013, 381(9864): 385-393. Doig G S, Simpson F, Sweetman E A, et al. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial[J]. JAmA, 2013, 309(20): 2130-2138. 重症患者的早期的肠外营养伴随着短期的相对禁忌症早期肠内营养 Doig G S, Simpson F, Sweetman E A, et al. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial[J]. JAmA, 2013, 309(20): 2130-2138. Doig G S, Simpson F, Sweetman E A, et al. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial[J]. JAmA, 2013, 309(20): 2130-2138. (Singer P, Anbar R, Cohen J，等。严格