Refeeding syndrome influences outcome of anorexia nervosa patients in intensive care unit an observational study 英文参考文献.docVIP

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Refeeding syndrome influences outcome of anorexia nervosa patients in intensive care unit an observational study 英文参考文献.doc

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Refeeding syndrome influences outcome of anorexia nervosa patients in intensive care unit an observational study 英文参考文献

Vignaudetal.CriticalCare,2010,14:R172 /content/14/5/R172 RESEARCH OpenAccess Refeedingsyndromeinfluencesoutcomeof anorexianervosapatientsinintensivecareunit: anobservationalstudy MarieVignaud1,2,Jean-MichelConstantin1,2*,MarcRuivard2,3,MicheleVillemeyre-Plane4,2,EmmanuelFutier1, Jean-EtienneBazin1,DjillaliAnnane5,fortheAZUREAgroup(AnorexieReaStudyGroup)1 Abstract Introduction:Dataontheepidemiologyandmanagementofanorexianervosa(AN)intheintensivecareunit (ICU)arescarce.Theaimofthisstudywastoevaluatetheprevalenceandassociatedmorbidityandmortalityof ANinFrenchICUs. Methods:Werandomlyselected30ICUsthroughoutFrance.Thereafter,weretrospectivelyanalyzedallpatients withANadmittedtoanyofthese30ICUsbetweenMay2006andMay2008.Weconsidereddemographicdata, diagnosisatadmissionandcomplicationsoccurringduringthestay,focusingonrefeedingsyndromeand managementofrefeeding. Results:Elevenofthe30ICUsparticipatedintheretrospectivestudy,featuring68patients,including62women. Averagebodymassindexattheadmissionwas12±3kg/m2.Twentyoneweremechanicallyventilated,mainly forneurologicalreasons.Thereportedaveragecalorieintakewas22.3±13kcal/kg/24h.Majordiagnosesat admissionweremetabolicproblems,refeedingsurveyandvoluntarydrugintoxicationandinfection.Themost commoncomplicationsweremetabolic,hematological,hepatic,andinfectiousevents,ofwhich10%occurred duringrefeeding.Sevenpatientsdevelopedrefeedingsyndrome.Atdayone,theaveragecalorieintakewashigher forpatientswhodevelopedrefeedingsyndrome(23.2±5Kcal/kg/j;n=7)versuspatientswithoutrefeeding syndrome(14.1±3Kcal/kg/j;n=61)P=0.02.Sevenpatientsdied,twofromacuterespiratorydistresssyndrome andfivefrommultiorgan-failureassociatedwithmajorhydroelectrolyticproblems. Conclusions:ThefrequencyofANinICUpatientsisverylowandthecrudemortalityinthisgroupisabout10%. Preventionandearly-detectionofrefeedingsyndromeisthekeypoint. Introduction are two types of AN. The pure restrictive form, with The American Psychiatric Association definition of physicalhyperactivity,accountsf