| Objective:Through the survey of Jiangsu province intensive care physicians cognitive status of nutrition support therapy in ICU patients,we found out the deficiencies of our province's critical physicians on cognitive support in patients with critical care.In order to further improve our province intensive physician on cognition and practice of nutrition support treatment ability for our province to provide the basis for improving the status of nutritional support and treatment of critically ill patients in our province.Methods:On the basis of consulting the literature and consultation with experts,guided by the 2016 American Society of Critical Care Medicine and the Association of Parenteral and Enteral Nutrition jointly modified formulation of the "adult critically ill patients nutritional support treatment and assessment guidelines recommend the program" as a guide,homemade(severe nutritional support of patients with status questionnaire)questionnaire,using the questionnaire as the research tools,on-site survey of critical care physicians in Jiangsu area,and the results of statistical analysis.Results:A total of 43 general hospitals participated in the survey involving major medical institutions in the Jiangsu area.A total of 350 critical ill physicians participated in the questionnaire survey,and 308 questionnaires were effectively recovered.298 of the respondents(96.8%)believe that doctors should do nutritional risk assessment,but only 105(34.2%)physicians choose system score;282(91.6%)doctors think early nutritional support,219(75.3%)physicians preferred enteral nutrition;242(78.6%)doctors thought that the target heat card should be set at(25-30ka/kg*d)and 102(33.1%)physicians chose early nutritional support target protein as(1.2-2.0g/kg*d);186(60.4%)doctors choose to elevate the bed 30-45 degrees;all physicians were monitoring gastric retention,when gastric residual volume is more than 500m1,82(26.6%)physicians choose to stop enteral nutrition.For patients with recurrent gastric retention,199(66.10%)doctors chose jejunal tube for enteral nutrition support treatment.There were 113(36.7)physicians who chose to place the nasal tube manually.For patients after gastrointestinal surgery,the number of enteral nutrition,enteral parenteral nutrition and enteral nutrition plus intestinal outside were respectively 109(35.4%),109(35.4%),90(29.2%),And for gastrointestinal postoperative jejunal catheterization,99(32.1%)physicians opted for nutritional support within 48 hours.Conclusions:Critical care physicians in Jiangsu Province have recognized the role of nutritional support in critically ill patients,but improvements are still needed in nutritional risk screening,assessment of nutritional intake goals and clinical implementation.Objective Through the investigation of Jiangsu province intensive care physicians 'cognitive status of nutrition support therapy in ICU patients,we found out the problems and deficiencies of our critical physicians about cognitive nutrition support on patients with critical care.This survey can provide the theoretical basis for physicians to further improve their cognition and practice of critical nutrition support of our province.Methods Guided by "adult critically ill patients nutritional support treatment and assessment guidelines recommend the program" made by American Society of Critical Care Medicine and the Association of Parenteral and Enteral Nutrition in 2016.and combined with the opinions of three experts,a questionnaire was prepared(see attached table 1).Using the questionnaire as a research tool,an on-the-spot anonymous questionnaire survey was conducted on cardiologists in Jiangsu Province.The results were statistically analyzed to analyze the current cognitive status of critical care physicians in their nutritional support treatment.Results(1)A total of 43 general hospitals participated in the survey,A total of 350 critical ill physicians participated in the questionnaire survey,and 308 questionnaires were effectively recovered.(2)Nutritional risk assessment Cognitive situation:96.8%(n = 298)of the physicians considered the nutritional risk assessment should be performed,but only 34.2%(n = 105)of whom opted for systematic tools score;(3)early nutritional support therapy Target cognitive status:78.6%(n = 242)of the physicians thought that the target heat card should be set at(2 5-30ka/kg*d),42.5%of whom(n = 131)chose early nutrition support target protein as(1.2-2.0g/kg*d).(4)Cognition of nutritional support in patients after gastrointestinal surgery:The proportion of enteral nutrition,parenteral nutrition and enteral nutrition plus parenteral support were respectively 35.4%(n = 109),35.4%(n = 109),and 29.2%(n = 90).Only 99(32.1%)physicians opted for nutritional support within 48 hours for gastrointestinal postoperative jejunal catheter patientsConclusions Critical care physicians in Jiangsu Province have recognized the role of nutritional support in critically ill patients,but there are cognitive deficits in their implementation,especially in nutritional risk assessment.Early calorie and protein target setting,and early nutritional support in patients after gastrointestinal surgery are still to be further improved.ObjectiveOur study was aimed to analyze the value of postoperative early enteral nutrition in treatment of patients with upper enteron perforation.MethodsClinical data of upper enteron perforation patients received operation treatment at our hospital from 2015 to 2017 were analyzed.Patients were divided into two groups by whether received postoperative early enteral nutrition(EEN)treatment,Group A:EEN;Group B:no EEN.ResultsA total of 72 patients were analyzed,Group A 32 cases,Group B 40 cases.The Group A patients had shorter postoperative hospital stays than that of Group B patients(12.5 + 3.5 vs 15.6+5.2;t=2.888,P<0.01).After one week treatment,Group A patients had low levels of CRP,IL-6,endotoxin and D-lactate than these of Group B patients(P<0.05).Meanwhile,the Group A patients had higher levels of hemoglobin,albumin and prealbumin than these of Group B patients,the difference was statistically significant(P<0.05).ConclusionFor upper enteron perforation patients,the postoperative early enteral nutrition can improve the nutriture,intestinal barrier function and systemic inflammatory response. |
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