Study of optimization nutrition support in critically ill patients / 重庆医学

ABSTRACT

Objective To assess whether the delivery of 100% of the nutritional target from days 4 to 8 in the ICU with enteral nutrition plus supplemental parenteral nutrition(SPN) could optimize clinical outcome .Methods A total of 300 critically ill patients who had received less than 60% of their energy target from enteral nutrition(EN) were randomized to treatment group(n=150) and control group (n=150) .After using the stochastic indicator method after day 3 of admission to the ICU ,one received EN and the other received EN plus SPN during days 4 to 8 ,then we calculated energy targets with indirect calorimetry repeatedly .Results The mean energy delivery between day 4 and 8 was 28 kcal? kg -1 ? d-1 for the EN plus SPN group ,compared with 20 kcal?kg -1 ?d-1 for the EN group .Between days 9 and 28 ,the EN plus SPN group had a lower incidence of nosocomial infection com‐pared with EN group (P0 .05) .Conclusion Individually optimized nutritional supplementation with enteral nutrition plus supplemen‐tal parenteral nutrition starting 4 days after ICU admission could reduce nosocomial infections and should be considered as a strate‐gy to improve clinical outcome in patients in the ICU for whom EN is insufficient .