The effect of enteral nutrition liquid containing slow release starch on clinical efficacy in elderly patients with diabetes under mechanical ventilation / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the clinical therapeutic effect of enteral nutrition (EN) liquid containing slow release starch for treatment of elderly patients with diabetes under mechanical ventilation (MV). Methods Fifty-six senile patients with diabetes treated with MV were admitted to Hangzhou Geriatric Hospital from January 2015 to December 2016, they were divided into an observation group (29 cases) treated with continuous instillation of EN liquid containing slow-release starch (Fresubin diabetes) and a control group (27 cases) treated with instillation of standard EN liquid (TPF) by nasointestinal tubes. After treatment for 14 days, the clinical efficacy was evaluated in the two groups. The levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA1c), serum albumin (ALB), pre-albumin (PA), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and 14-day and 28-day survival rates were observed after treatment in the two groups. Results The blood glucose fluctuation in the observation group was small, while the blood glucose in the control group was significantly elevated necessary to add insulin for treatment. After treatment for 7 days and 14 days, the FBG, 2 h PBG and PaCO2in the observation group were significantly lower than those in the control group [7 days after treatment: FBG (mmol/L) was 8.18±1.91 vs. 8.83±2.08, 2 h PBG (mmol/L) was 9.54±1.86 vs. 9.94±3.01, PaCO2(mmHg, 1 mmHg =0.133 kPa) was 39.0±4.3 vs. 43.0±4.5; 14 days after treatment: FBG (mmol/L) was 7.11±1.01 vs. 9.01±1.22, 2 h PBG (mmol/L) was 8.15±2.35 vs. 10.28±2.77, PaCO2(mmHg): 37.0±3.9 vs. 41.0±4.1], PaO2were significantly higher than those of the control group (mmHg: 7 days after treatment was 81.8±10.1 vs. 76.6±10.7, 14 days after treatment was 92.2±10.0 vs. 77.7±11.2), and the differences were all statistically significant (all P < 0.05). After treatment, the HbA1c in the observation group was lower than that before treatment, and serum ALB and PA were higher than those before treatment, however, there were no statistical significant differences between the two groups (all P > 0.05). The 14-day and 28-day survival rates of the observation group were significantly higher than those of the control group [14 days: 93.1% (27/29) vs. 88.8% (24/27), 28 days: 89.7% (26/29) vs. 85.2% (23/27), all P < 0.05]. Conclusion Using EN preparation containing sustained-release starch for treatment of elderly diabetic patients under MV, their blood glucose levels are stable, the ventilation function and gas exchange of lung are improved, and their survival rates are obviously elevated.