Guoji laonian yixue zazhi (Jan 2024)

Clinical Value of Permissive Hypocaloric Nutritional Support inElderly Critically Ill Patients

  • Qing Wang,
  • Rong Li,
  • Rong Zhang,
  • Yajun Han,
  • Yan Liu

DOI
https://doi.org/10.3969/j.issn.1674-7593.2024.01.012
Journal volume & issue
Vol. 45, no. 1
pp. 64 – 68

Abstract

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Objective To investigate the value of permissive hypocaloric nutrition support in the treatment of elderly critically ill patients. Methods A total of 126 eligible elderly critically ill patients admitted to Xijing Hospital from January to June 2018 were selected as the study subjects.They were divided into standard calorie group,test group A and test group B according to a random number table,42 cases for each group.Patients started early nutritional support within 24 to 48 h of admission.After 7 days,the caloric intake increased to 30 kcal/(kg·d) in the standard calorie group,15 kcal/(kg·d) in test group A,and 9 kcal/(kg·d) in test group B.Nutrition-related parameters(albumin,prealbumin,and nitrogen balance),acute gastrointestinal injury(AGI) grade,sequential organ failure assessment(SOFA) score,complications, and clinical outcomes were compared between the groups. Results After treatment,the nutritional indexes of test group A and test group B were higher than those of standard calorie group(P<0.05),and the nutritional indexes of test group A were higher than those of the test group B(P<0.05).The AGI grade score and SOFA score of test group A and test group B were lower than those of the standard calorie group(P<0.05),and the AGI score and SOFA score of test group A were lower than those of test group B(P<0.05).The incidence of each complication in test group A was less than that in the standard calorie group and test group B(P<0.05).The mortality after 2 and 4 weeks of treatment in group A and 4 weeks of treatment in group B were lower than those in the standard calorie group(P<0.05),and the mortality after 2 and 4 weeks of treatment in group A was lower than that in group B(P<0.05). Conclusion Allowing low calorie nutrition support has important clinical significance for elderly critically ill patients.Adopting 15 kcal/(kg·d) calorie level can improve the nutritional status of elderly critically ill patients,protect gastrointestinal function,and effectively control complications and mortality.

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