Nutrition intake, muscle thickness, and recovery outcomes for critically ill patients requiring non-invasive forms of respiratory support: A prospective observational study

IF 2.6 3区医学 Q2 CRITICAL CARE MEDICINE Australian Critical Care Pub Date : 2025-01-01 DOI:10.1016/j.aucc.2024.07.078

Elizabeth Viner Smith BND (Hons) , Matthew J. Summers BSc, MDiet , Imogen Asser BHlthMedSc , Rhea Louis BMedSc (Hons) , Kylie Lange BSc Ma&CompSci (Hons) , Emma J. Ridley BNutrDiet, PhD , Lee-anne S. Chapple BMedSc, MNutrDiet, PhD

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Abstract

Background

Use of high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) in the intensive care unit (ICU) is increasing, yet reporting of nutrition intake, muscle thickness, or recovery outcomes in this population is limited.

Objective

The objective of this study was to quantify muscle thickness, nutrition intake, and functional recovery outcomes for patients receiving HFNC/NIV within the ICU.

Methods

A single-centre, prospective, observational study in adult ICU patients recruited within 48 hrs of commencing HFNC/NIV. Change in quadriceps muscle layer thickness using ultrasound (primary outcome) and 24 hr nutrition intake from study inclusion to day 7 (D7), functional capacity (Barthel Index), and quality of life (EuroQol five-dimension five-level utility index) at D90 were assessed. Data are n (%), mean ± standard deviation or median [interquartile range], are compared using paired sample t-test, and a P value of <0.05 was considered significant.

Results

Primary outcome data were available for n = 28/42: 64 ± 13 y, 61% male, body mass index: 29.1 ± 9.0 kg/m², and Acute Physiology and Chronic Health Evaluation II score: 17 ± 5. Quadriceps muscle layer thickness reduced from 2.41 ± 0.87 to 2.12 ± 0.73 cm; mean difference: −0.29 cm (95% confidence interval: -0.44, −0.13). Nutrition intake increased from study inclusion to D7: 1735 ± 1283 to 5448 ± 2858 kJ and 17.4 ± 16.6 to 60.9 ± 36.8g protein. Barthel Index was 87 ± 20 at baseline and 91 ± 15 at D90 (out of 100). Quality of life was impaired at D90: 0.64 ± 0.23 (health = 1.0).

Conclusion

Critically ill patients receiving HFNC/NIV experienced muscle loss and impaired quality of life.

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需要无创呼吸支持的重症患者的营养摄入、肌肉厚度和恢复效果：前瞻性观察研究。

背景：在重症监护病房（ICU）中使用高流量鼻插管（HFNC）和无创通气（NIV）的患者越来越多，但有关这类人群的营养摄入、肌肉厚度或恢复效果的报告却很有限：本研究旨在量化重症监护病房内接受高频无创通气/NIV 患者的肌肉厚度、营养摄入量和功能恢复结果：方法：这是一项单中心、前瞻性、观察性研究，研究对象是在开始接受高频核磁/NIV 治疗 48 小时内入院的成人 ICU 患者。研究评估了使用超声波检查的股四头肌肌层厚度变化（主要结果）、从纳入研究到第 7 天（D7）的 24 小时营养摄入量、功能能力（Barthel 指数）以及第 90 天的生活质量（EuroQol 五维五级效用指数）。数据以n（%）、均数±标准差或中位数[四分位距]表示，采用配对样本t检验进行比较，P值为结果：n = 28/42：64 ± 13 岁，61% 为男性，体重指数：29.1 ± 9.0 千克：股四头肌肌层厚度从 2.41 ± 0.87 厘米减少到 2.12 ± 0.73 厘米；平均差异为-0.29 厘米（95%）：平均差异：-0.29 厘米（95% 置信区间：-0.44，-0.13）。从纳入研究到第7天，营养摄入量有所增加：热量从1735 ± 1283千焦增加到5448 ± 2858千焦，蛋白质从17.4 ± 16.6克增加到60.9 ± 36.8克。巴特尔指数（Barthel Index）基线为 87 ± 20，D90 为 91 ± 15（满分 100）。D90时生活质量受损：0.64 ± 0.23（健康 = 1.0）：结论：接受 HFNC/NIV 治疗的重症患者会出现肌肉萎缩和生活质量下降。

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来源期刊

Australian Critical Care NURSING-NURSING

CiteScore

4.90

自引率

9.10%

发文量

148

审稿时长

>12 weeks

期刊介绍： Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.