不同剂量早期肠内营养方案对使用血管活性药物的老年重症患者的影响OA
Effect of different doses of early enteral nutrition regimens on elderly crit-ically ill patients receiving vasoactive drugs
目的 探讨不同剂量早期肠内营养(EEN)方案对使用血管活性药物的老年重症患者的影响.方法 选取2024年1 月至 2025 年 4 月上饶市人民医院收治的 132 例液体复苏后使用血管活性药物控制休克,同时开始给予 EEN的老年重症患者,采用随机数字表法分为低能量摄入组和高能量摄入组,每组各 66 例,低能量摄入组脱落共 4 例.低能量摄入组给予目标能量的 25%～70%,高能量摄入组给与目标能量 70%以上.比较两组患者 EEN耐受性、ICU住院时间、住院费用、90 d全因死亡率、血管活性药物与EEN联用时间、开始EEN后去甲肾上腺素(NE)等效剂量 12、24 h 最大剂量变化[μg/min、μg/(kg·min)].结果 使用血管活性药物[中位数 NE 0.15 μg/(kg·min)]的老年危重症患者开始 EEN.低能量摄入组不耐受性低于高能量摄入组、血管活性药物与 EEN 联用时间短于高能量摄入组、差异有统计学意义(P＜0.05).两组 NE 等效及体重校正 NE 等效最大剂量(12、24 h 剂量)、ICU 住院时间、住院费用、90 d 全因死亡率比较,差异无统计学意义(P＞0.05).结 论 使用血管活性药物[中位数NE 0.15 μg/(kg·min)]的老年重症患者,休克控制后可开始 EEN,低能量摄入不仅提高耐受性,还能缩短血管活性药物与 EEN联用时间.
Objective To explore the effects of different doses of early enteral nutrition(EEN)regimens on elderly critically ill patients using vasoactive drugs.Methods A total of 132 elderly critically ill patients admitted to Shangrao People's Hos-pital from January 2024 to April 2025,who were treated with vasoactive drugs to control shock after fluid resuscitation and began to receive EEN at the same time,were divided into a low-energy intake group and a high-energy intake group by the random number table method,with 66 cases in each group,a total of 4 patients in the low-energy intake group dropped out.The low-energy intake group was given 25%-70%of the target energy,while the high-energy intake group was given more than 70%of the target energy.The tolerance of EEN,ICU hospitalization time,hospitalization cost,90-day all-cause mortality rate,the duration of vasoactive drug and EEN combination use,the equivalent dose of norepinephrine(NE)at 12 and 24 hours after starting EEN,and the maximum dose change(μg/min,μg/[kg·min])were compared between the two groups.Results For elderly critically ill patients receiving vasoactive drugs(with a median NE of 0.15 μg/[kg·min]),early extubation was initiated.The intolerance rate in the low-energy intake group was lower than that in the high-energy intake group,the duration of combined use of vasoactive drugs and EEN was shorter than that in the high-energy intake group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in the NE equiva-lent and weight correction NE equivalent maximum doses(doses for 12 and 24 hours),ICU hospitalization time,hospitalization cost,and 90-day all-cause mortality between the two groups(P＞0.05).Conclusion For elderly critically ill patients who received vasoactive drugs(with a median NE of 0.15 μg/[kg·min]),after shock control,EEN can be initiated.Low energy intake not only improves tolerance but also shortens the duration of the combined use of vasoactive drugs and EEN.
周琴;李博;邱永军;徐粼;甘露
江西省上饶市人民医院药学部,江西 上饶 334000江西省上饶市人民医院药学部,江西 上饶 334000江西省上饶市人民医院药学部,江西 上饶 334000江西省上饶市人民医院急诊科,江西 上饶 334000江西省上饶市人民医院急诊科,江西 上饶 334000
医药卫生
血管活性药物老年重症患者早期肠内营养耐受性营养方案
Vasoactive drugsElderly critically ill pa-tientsEarly enteral nutritionToleranceNutrition regimens
《中国当代医药》 2026 (15)
92-96,5
2024年江西省医院药学专项研究基金(2024-ZXYJ13)上饶市科技计划项目(20242CZDX31).
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