Therapeutic effects of high fat and low carbohydrate enteral nutrition in patients with chronic obstructive pulmonary disease under mechanical ventilation / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the clinical effect of high fat and low carbohydrate enteral nutrition (EN) for treatment of patients with chronic obstructive pulmonary disease (COPD) under mechanical ventilation (MV). Methods Fifty-six COPD patients with MV admitted to the Department of Intensive Care Unit of Traditional Chinese Medicine Hospital of Zhuji from May 2014 to July 2017 were enrolled, and they were randomly divided into an experimental group administered with high fat and low carbohydrate EN (28 cases) and a control group administered with high carbohydrate and low fat EN (28 cases ), the therapeutic course being two weeks in both groups. After two weeks of treatment, the pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of oxygen (PaO2), every minute ventilation volume (VE), oxygen consumption volume (VO2), carbon dioxide production volume (VCO2), total peripheral blood lymphocyte count (TLC), immunoglobulins (IgA, IgG, IgM), MV time, weaning success rate and survival rate were detected and compared between the two groups. Results Two weeks after nutritional support treatment, PaCO2, PaO2, VCO2, VO2, VE, TLC were all significantly improved in experimental group compared with those in control group [PaCO2(mmHg, 1 mmHg = 0.133 kPa) 48.37±10.22 vs. 55.34±9.87, PaO2(mmHg) 73.45±14.68 vs. 67.43±7.38, VCO2(mL) 264±22 vs. 287±30, VO2(mL) 316±35 vs. 344±22, VE (L/min) 10.0±1.6 vs. 11.6±1.9, TLC (×109/L) 1.62±0.73 vs. 1.21±0.21, all P < 0.05], MV time was significantly shorter in experiment group than that in control group (days 6.89±1.15 vs. 8.78±1.29), weaning success rate and survival rate were significantly higher in experiment group than those in control group [weaning success rate 67.9% (19/28) vs. 42.9% (12/28), survival rate89.3% (25/28) vs. 78.6% (22/28), both P < 0.05]. Conclusion High fat and low carbohydrate EN can improve the ventilation and immune indexes in COPD patients with MV, shorten the MV time and increase the weaning success rate and survival rate.