| Objective Methods and their nutritional effects of early nutritional support in patients with mechanical ventilated in ICU are retrospectively analyzed.The current situation on early nutrition of patients with mechanical ventilation isinvestigated.The plan about early nutritional support for patients with mechanical ventilation is discussed.This work will provide a basis on nutritional support for patients with mechanical ventilation.Methods Using the convenience sample way,193 patients with mechanical ventilation and early nutritional support were retrospectively studied in a Grade A of Level ⅲ hospital ICU from September 2014 and August 2016.Among them,90 cases were treated with enteral nutrition only,and 103 cases were treated with enteral and parenteral nutrition.The various information of the two groups patient is collected,the specific information is as follows.The general demographic data including age and sex,disease information,disease and treatment related data including APACHE II score,hospitalization time,tracheal intubation days,mechanical ventilation time,and 28 day mortality rate.The nutritional information including the NRS2002 score,serum prealbumin(PA)and albumin(ALP),the first week of nutritional support,the change value of these data after a week and complications during nutritional support.The cost of two groups of patients,including one week’s nutritional support and 28 days’ hospitalization expenses.Results There was no difference in the general demographic data,disease information and APACHE II score between the two groups(P>0.05).There was no significant difference in NR2002 score,serum prealbumin,hemoglobin and total protein between the two groups when entering the ICU section(P>0.05).The nutritional calories of patients with enteral and extra parenteral nutrition support were higher than those of the complete enteral nutrition group(P<0.05).Especially,the nutritional calories in second days and third days were obviously higher than those in the enteral nutrition group(P<0.01).After one week of treatment,the NR2002 score was statistically significant(P<0.05)。The serum prealbumin of mixed nutrition group were significantly better than those of the enteral nutrition group(P<0.05),and in the comparison of complications,the former had the lower incidence rate on complications in the skin,gastric retention and refeeding syndrome,and the difference was statistically significant(P<0.05).The incidence of diarrhea was significantly different(P<0.01).In the treatment of disease,the number of endotracheal intubation days and the time of mechanical ventilation of mixed nutrition group were less than that of the simple enteral nutrition group,the difference was statistically significant(P<0.05),but there was no difference between the two groups in the days of hospitalization and the mortality rate of 28 days,the difference was not statistically significant(P>0.05).In terms of cost,the one week nutritional cost of the patients that the enteral and enteral mixing group was higher than that in the simple enteral nutrition group(P<0.05),but there was no difference between the two groups at the cost of 28 days treatment(P>0.05).Conclusion Patients with mechanical ventilation were given enteral and parenteral nutrition,and their nutritional calorie was less affected by disease factors.The nutrition effect of mixed nutrition is better thanenteral nutrition for patients’ with mechanical ventilation.The patients’ nutrition state isimproved,the time of mechanical ventilation is shorten,the burden of the digestive tract is reduced and complications is reduced and other adverse reactions do not increase by using enteral and parenteral nutrition.Although the priceof parenteral nutrition agents is high,the one week nutrition cost and the total cost of treatment is not increase for the mixture of enteral and external nutrition.Therefore,enteral and parenteral nutrition is a recommended nutritional support for patients with mechanical ventilation. |
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