PDF(Pubmed)
Abstract：
Within intensive care units (ICU), the administration of peptide-based formulas (PBF) may confer nutritional advantages for critically ill patients identified with heightened nutritional risk. This investigation aimed to ascertain the efficacy of PBF in comparison to standard polymeric formulas (SPF) among this patient cohort. A double-blind, randomized controlled trial was conducted across three ICUs, encompassing 63 adult patients characterized by elevated modified Nutrition Risk in Critically Ill (mNUTRIC) scores. Enrollment occurred promptly subsequent to ICU admission, with participants allocated to receive either PBF or SPF. Primary outcome was the duration to achieve caloric targets. Secondary outcomes involved the evaluation of mean daily gastric residual volume, mechanical ventilation period, infection rates within the ICU, length of hospitalization, mortality rates, nutritional status and inflammatory markers, specifically serum albumin and interleukin-6 levels. Patients in the PBF group reached their caloric targets more expeditiously compared to the SPF group (2.06 ± 0.43 days versus 2.39 ± 0.79 days; p = 0.03). No significant differences were discernible between the groups regarding gastric residual volume, duration of mechanical ventilation, ICU length of stay, mortality, or infection rates. Both cohorts exhibited minimal adverse effects and were devoid of any instances of abdominal distension. While not reaching statistical significance, the observed trends in albumin and interleukin-6 levels suggest a potential advantage of PBF utilization. The implementation of PBF enabled swifter attainment of caloric goals in ICU patients at high nutritional risk without adversely impacting other clinical parameters. Given its favorable tolerance profile and potential immunomodulatory properties, PBF may be considered a valuable nutritional intervention in this setting.Thai Clinical Trials Registry TCTR20220221006. Registered 21 February 2022, https://www.thaiclinicaltrials.org/show/TCTR20220221006 .
摘要：
在重症监护病房(ICU)内，对于营养风险升高的危重患者,给予基于肽的配方(PBF)可能具有营养优势.该研究旨在确定PBF与该患者队列中的标准聚合物配方(SPF)相比的功效。双盲，在三个ICU中进行了随机对照试验，包括63名成人患者，其特征是危重症（mNUTRIC）评分的改良营养风险升高。入住ICU后立即进行登记，参与者被分配接收PBF或SPF。主要结果是达到热量目标的持续时间。次要结局包括平均每日胃残留量的评估，机械通气期,ICU内的感染率，住院时间,死亡率,营养状况和炎症标志物，特别是血清白蛋白和白细胞介素-6水平。与SPF组相比，PBF组患者更快达到其热量目标（2.06±0.43天对2.39±0.79天；p=0.03）。两组之间在胃残留量方面没有明显差异，机械通气的持续时间，ICU住院时间,死亡率,或感染率。两组均表现出最小的不良反应，并且没有任何腹胀的情况。虽然没有达到统计意义，观察到的白蛋白和白细胞介素-6水平的趋势表明PBF利用的潜在优势.PBF的实施使处于高营养风险的ICU患者能够更快地实现热量目标，而不会对其他临床参数产生不利影响。鉴于其良好的耐受性和潜在的免疫调节特性，在这种情况下，PBF可能被认为是一种有价值的营养干预措施。泰国临床试验注册TCTR20220221006。2022年2月21日注册，https://www。thaiclinicaltrials.org/show/TCTR20220221006。
