Nutritional Needs and Intake on Clinical Outcomes in Mechanically Ventilated Critically Ill Elderly Patients
2018年8月31日 更新者:Pi-Hui Hsu、Mackay Memorial Hospital
Clinical Dietitian, Dietetic Service, Mackay Memorial Hospital
The purposes of this study were to investigate the caloric requirement and clinical outcomes in mechanically ventilated critically ill elderly patients and identify those at high nutritional risk who require high protein formula intervention.
研究概览
详细说明
The elderly population is rapidly increasing, but studies on calorie requirement in critically ill elderly patients are few, and indirect calorimetry (IC) is not available in every intensive care unit (ICU).
The aim of this study was to compare IC and Harris-Benedict (HB) predictive equation in different BMI (body mass index) groups.
And to investigate whether the nutrition intake from EN (enteral nutrition) and PN (parenteral nutrition) created a better clinical outcome than EN alone in HNR (high nutritional risk) mechanically ventilated critically ill elderly patients.Inclusion criteria were: age ≧65 years old, APACHE Π score ≧15, mechanical ventilation ≧48 hours and on NG tube feeding.
Nutritional risk was screened by mNUTRIC and GNRI.
Indirect calorimetry and HB equation were used to assess energy requirements.
Patients were randomized 1:1 to two tube feeding regimens: general formula and high protein formula (1.5~2.0 gm/kg BW).
Nutritional intake from EN, the type and amount of intravenous nutrition within 7 days, tolerance to feeding, MVD (Mechanical Ventilation Day), newly diagnosed VAP (Ventilator Associated Pneumonia), ICU and hospital LOS (Length of Stay) and date of death were recorded.
We used SAS version 9.4 for statistical analysis.
Statistically significance was set at α=0.05.
研究类型
介入性
注册 (实际的)
190
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
-
-
-
Taipei、台湾
- Mackay Memorial Hospital
-
-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
65年 及以上 (年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- APACHE Π score ≧ 15
- ≧ 65 years
- on mechanical ventilation ≧48 hours
- received EN
Exclusion Criteria:
- Use of total parenteral nutrition
- Fasting >5 days
- Brain death
- Terminal cancer
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:支持治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:high protein enteral nutrition
supply protein over 1.5 gm/kg body weight
|
supply protein over 1.5 gm/kg body weight
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Determination of the energy requirements in critically ill elderly patients
大体时间:first 5 days in the ICU
|
A total of 177 critically ill elderly patients (≧ 65 years old) underwent IC for measured resting energy expenditure (MREE).
Estimated calorie requirement was calculated by the HB equation, using actual body weight (ABW) and ideal body weight (IBW) separately.
Patients were divided into four BMI groups.
One-way ANOVA and Pearson's correlation coefficient were used for statistical analyses.
|
first 5 days in the ICU
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Higher Enteral Nutrition Intake May Reduce Hospital Mortality
大体时间:first 28 days in the ICU
|
We included patients ≧ 65 years on mechanical ventilation ≧ 48 hours and received EN.
Nutritional status was evaluated by mNUTRIC score.
We calculated the energy and protein requirements as Harris-Benedict equation ╳ 1.0~1.3 and 1.0~2.0
gm/kg body weight respectively.
Nutrition intake from EN and PN was recorded within 7 days.
ICU and hospital mortalities in HNR elderly patients who could achieve more or less 80% of the prescribed nutrition were compared.
|
first 28 days in the ICU
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员:Pi-Hui Hsu、Mackay Memorial Hospital
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Hsu PH, Lee CH, Kuo LK, Kung YC, Chen WJ, Tzeng MS. Higher Energy and Protein Intake from Enteral Nutrition May Reduce Hospital Mortality in Mechanically Ventilated Critically Ill Elderly Patients. International Journal of Gerontology. Available online 26 March 2018. https://doi.org/10.1016/j.ijge.2018.03.001
- Hsu PH, Lee CH, Kuo LK, Kung YC, Chen WJ, Tzeng MS. Determination of the energy requirements in mechanically ventilated critically ill elderly patients in different BMI groups using the Harris-Benedict equation. J Formos Med Assoc. 2018 Apr;117(4):301-307. doi: 10.1016/j.jfma.2017.12.010. Epub 2018 Jan 12.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2014年12月26日
初级完成 (实际的)
2016年6月30日
研究完成 (实际的)
2016年6月30日
研究注册日期
首次提交
2014年12月11日
首先提交符合 QC 标准的
2015年2月26日
首次发布 (估计)
2015年2月27日
研究记录更新
最后更新发布 (实际的)
2018年9月5日
上次提交的符合 QC 标准的更新
2018年8月31日
最后验证
2018年8月1日
更多信息
与本研究相关的术语
其他研究编号
- 14MMHIS229
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.