RESUMO
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 rate:89.3% (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.
RESUMO
Objective:To observe the nutritional status and respiratory function of the patients with mechanical ventilation in Intensive Care Unit after high fat and low carbohydrate enteral nutrition treatment.Methods:271 patients with mechanical ventilation in Intensive Care Unit were randomly divided into two groups:study group and control group.The study group was given high fat and low carbohydrate enteral nutrition treatment,while the control group with Enteral Nutritional Suspension.Thealbumin,prealbumin,blood gas analysis(PaC02,Pa0) and RQ,VC02,V02,IgG,CD4,CD4/CD8 were observed.Results:After nutritional support,nutritional status of two groups were improved,but there was no significant difference regarding the serum albumin and prealbumin.The PaO2,VO2,VCO2,RQ,IgG,CD4,CD4/CD8 and the total time of mechanical ventilation were improved,and the study group was superior to the control group.Conclusion:High fat and low carbohydrate enteral nutrition improves the nutritional status and respiratory function of the patients with mechanical ventilation in Intensive Care Unit,and decreases the total time of mechanical ventilation and total medical expenses.
