ICU获得性衰弱(acquired weakness in ICU,ICU-AW)是重症患者常见的获得性神经肌肉功能障碍,是ICU较为严重的并发症之一。目前,ICU-AW的发病机制不清楚,临床上尚无有效的药理学方法治疗ICU-AW[1],因此对于ICU-AW的预防就显得极为重要。...ICU获得性衰弱(acquired weakness in ICU,ICU-AW)是重症患者常见的获得性神经肌肉功能障碍,是ICU较为严重的并发症之一。目前,ICU-AW的发病机制不清楚,临床上尚无有效的药理学方法治疗ICU-AW[1],因此对于ICU-AW的预防就显得极为重要。既往ICU医护人员关注点多集中于危重患者的抢救与治疗,较少关注ICU-AW的相关问题。自1993年学者RAMSAY等[2]正式提出ICU-AW的概念后,ICU-AW的预防、评估和治疗逐渐成为国内外学者关注的热点。早期识别ICU-AW,可有效减少并发症、降低致残率、缩短住院时间、提高日常生活质量。展开更多
BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acu...BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.展开更多
文摘ICU获得性衰弱(acquired weakness in ICU,ICU-AW)是重症患者常见的获得性神经肌肉功能障碍,是ICU较为严重的并发症之一。目前,ICU-AW的发病机制不清楚,临床上尚无有效的药理学方法治疗ICU-AW[1],因此对于ICU-AW的预防就显得极为重要。既往ICU医护人员关注点多集中于危重患者的抢救与治疗,较少关注ICU-AW的相关问题。自1993年学者RAMSAY等[2]正式提出ICU-AW的概念后,ICU-AW的预防、评估和治疗逐渐成为国内外学者关注的热点。早期识别ICU-AW,可有效减少并发症、降低致残率、缩短住院时间、提高日常生活质量。
基金funded by the Social Development Project of Jiangsu Provincial Department of Science and Technology(BE2020670)the Social Development Project of Lianyungang Science and Technology(SF2117).
文摘BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.
