[1]姚德贞,王丽杰,关文贺.危重病儿ECMO肠内营养支持治疗研究进展[J].肠外与肠内营养杂志,2024,(02):118-123.[doi:DOI : 10.16151/j.1007-810x.2024.02.009]
 YAO De-zhen,WANG Li-jie,GUAN Wen-he.Research progress on enteral nutrition in pediatric extracorporeal membrane oxy‐genation[J].PARENTERAL & ENTERAL NUTRITION,2024,(02):118-123.[doi:DOI : 10.16151/j.1007-810x.2024.02.009]
点击复制

危重病儿ECMO肠内营养支持治疗研究进展()
分享到:

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年02期
页码:
118-123
栏目:
综述
出版日期:
2024-04-10

文章信息/Info

Title:
Research progress on enteral nutrition in pediatric extracorporeal membrane oxy‐genation
作者:
姚德贞王丽杰关文贺
中国医科大学附属盛京医院儿科重症监护病房,辽宁沈阳 110004
Author(s):
YAO De-zhen WANG Li-jie GUAN Wen-he
Department of Pediatric Intensive Care Unit, Shengjing Hospital of China medical university ,Shengyang 110004, Liaoning, China
关键词:
危重症 体外膜肺氧合 肠内营养 能量和蛋白供应
Keywords:
Intensive care Extracorporeal membrane oxygenation Enteral nutrition Energy and proteinprovision
分类号:
R459.3
DOI:
DOI : 10.16151/j.1007-810x.2024.02.009
文献标志码:
A
摘要:
体外膜肺氧合(ECMO)支持已经越来越多地应用于儿科重症监护病房,然而,对于这些病儿最佳的营养支持方案仍没有达成共识。营养不良在接受ECMO支持的危重病儿中很常见,营养不良的发生常常导致不良预后,故营养支持治疗是ECMO治疗过程中需要引起重视的一部分。本文基于国内外对危重及ECMO病儿营养支持治疗方面的最新指南,整理目前关于ECMO病儿营养支持的各个方面的临床研究,提出对该类病儿营养支持过程中的建议和未来研究方向。
Abstract:
Extracorporeal membrane oxygenation (ECMO) has been increasingly applied in pediatric intensivecare units, however, there is still no consensus on the optimal nutritional support for these children. Malnutrition iscommon in critically ill children receiving ECMO, and often leads to poor clinical outcomes. Therefore, nutritionalsupport is an important component of ECMO treatment. This study was based on the latest guidelines on nutritionaltherapy for critically ill and ECMO children. We summarized the current clinical research on various aspects ofnutritional therapy for ECMO children, and proposed suggestions and future research directions for the nutritionaltherapy in such children.

参考文献/References:


[1] Hamilton M, Thornton SW, Tracy ET, et al. Quality improvementstrategies in pediatric ECMO. Semin Pediatr Surg. 2023, 32(4):151337.
[2] 国家心血管疾病医疗质量控制中心专家委员会体外循环与体外生命支持专家工作组. 2022年中国体外生命支持医疗质量控制报告. 中国循环杂志,2023,38(6):613-620.
[3] Kurundkar AR, Killingsworth CR, McIlwain RB, et al.Extracorporeal membrane oxygenation causes loss of intestinalepithelial barrier in the newborn piglet. Pediatr Res, 2010,68(2):128-133.
[4] 胡梦珑,戚继荣. 儿童体外膜肺氧合治疗期间营养支持研究进展. 临床小儿外科杂志,2021,20(11):1076-1081.
[5] Koning NJ, Vonk AB, van Barneveld LJ, et al. Pulsatile flowduring cardiopulmonary bypass preserves postoperativemicrocirculatory perfusion irrespective of systemichemodynamics. J Appl Physiol (1985),2012,112(10):1727-1734.
[6] Gambra-Arzoz M, Alonso-Cadenas JA, Jiménez-Legido M, et al.Nutrition Risk in Hospitalized Pediatric Patients: HigherComplication Rate and Higher Costs Related to Malnutrition.Nutr Clin Pract,2020,35(1):157-163.
[7] Costa CAD, Tonial CT, Garcia PCR. Association betweennutritional status and outcomes in critically-ill pediatric patients -a systematic review.J Pediatr (Rio J), 2016, 92(3): 223-229.
[8] 钱素云,陆国平,等 . 危重症儿童营养评估及支持治疗指南(2018,中国,标准版). 中国循证儿科杂志,2018,13(1):1-29.
[9] Lee AE, Munoz E, Al Dabbous T, et al. Extracorporeal LifeSupport Organization Guidelines for the Provision andAssessment of Nutritional Support in the Neonatal and PediatricECMO Patient. ASAIO J, 2022, 68(7): 875-880.
[10] 姚德贞,王丽杰.PICU危重病儿营养管理现状单中心调查.肠外与肠内营养,2022,29(2):69-74.
[11] Mehta NM, Skillman HE, Irving SY, et al. Guidelines for theprovision and assessment of Nutrition Support Therapy in thepediatric critically ill patient: Society of Critical Care Medicineand American Society for Parenteral and Enteral Nutrition. JParenter Enter Nutr,2017,41(5):706–742.
[12] Anton-Martin P, Papacostas M, Lee E, et al. Underweight StatusIs an Independent Predictor of In-Hospital Mortality in PediatricPatients on Extracorporeal Membrane Oxygenation. JPEN JParenter Enteral Nutr, 2018,42(1):104-111.
[13] Beser OF, Cokugras FC, Erkan T, et al. Evaluation ofmalnutrition development risk in hospitalized children. Nutrition,2018 ,48:40-47.
[14] Singer P, Blaser AR, Berger MM, et al. ESPEN guideline onclinical nutrition in the intensive care unit. Clin Nutr,2019,38(1):48-79.
[15] Hummell AC, Cummings M. Role of the nutrition-focusedphysical examination in identifying malnutrition and itseffectiveness. Nutr Clin Pract, 2022,37(1):41-49.
[16] Adab-Jorge A: Nutrition management of the critically ill pediatricpatient: Minimizing barriers to optimal nutrition support. ICAN,2013,5: 222–230.
[17] Pereira DS, da Silva VM, Luz GD, et al. Nutrition risk prevalenceand screening tools’ validity in pediatric patients: A systematicreview. JPEN J Parenter Enteral Nutr. 2023,47(2):184-206.
[18] Ventura JC, Silveira TT, Bechard L, et al. Nutritional screeningtool for critically ill children: a systematic review. Nutr Rev,2022,80(6):1392-1418.
[19] Ong C, Mok YH, Tan ZH, et al. Nutritional practices andadequacy in children supported on extracorporeal membraneoxygenation. Clin Nutr ESPEN,2018,26:21-26.
[20] Ariagno K, Armstrong L, Smallwood C, et al. Protein deliveryduring the first week of pediatric ECMO: Impact on outcomes.Crit Care Med,2016,44:196.
[21] MacGowan L, Smith E, Elliott-Hammond C, et al. Adequacy ofnutrition support during extracorporeal membrane oxygenation.Clin Nutr,2019,38(1):324-331.
[22] Brisard L, Bailly A, Le Thuaut A, et al. Impact of early nutritionroute in patients receiving extracorporeal membrane oxygenation:A retrospective cohort study. JPEN J Parenter Enteral Nutr, 2022,46(3):526-537.
[23] 王 瑜,时皎皎,常 硕,等.成人体外膜肺氧合支持病人的营养支持治疗研究进展.肠外与肠内营养,2022,29(5):304-309.
[24] Duan JY, Zheng WH, Zhou H, et al. Energy delivery guided byindirect calorimetry in critically ill patients: a systematic reviewand meta-analysis. Crit Care,2021,25(1):88.
[25] Elke G, Hartl WH, Kreymann KG, et al. Clinical Nutrition inCritical Care Medicine - Guideline of the German Society forNutritional Medicine (DGEM). Clin Nutr ESPEN, 2019, 33:220-275.
[26] De Waele E, Jonckheer J, Pen JJ, et al. Energy expenditure ofpatients on ECMO: A prospective pilot study. Acta AnaesthesiolScand, 2019,63(3):360-364.
[27] Wollersheim T, Frank S, Müller MC, et al. Measuring EnergyExpenditure in extracorporeal lung support Patients (MEEP) -Protocol, feasibility and pilot trial. Clin Nutr, 2018,37(1):301-307.
[28] Mtaweh H, Soto Aguero MJ, Campbell M, et al. Systematicreview of factors associated with energy expenditure in thecritically ill. Clin Nutr ESPEN, 2019, 33:111-124.
[29] Briassoulis G, Briassouli E, Ilia S, et al. External Validation ofEquations to Estimate Resting Energy Expenditure in CriticallyIll Children and Adolescents with and without Malnutrition: ACross-Sectional Study. Nutrients, 2022,14(19):4149.
[30] Kyle UG, Earthman CP, Pichard C, et al. Body compositionduring growth in children: limitations and perspectives ofbioelectrical impedance analysis. Eur J Clin Nutr, 2015, 69(12):1298-1305.
[31] Rosendale RP, Bartok CJ. Air-displacement plethysmography forthe measurement of body composition in children aged 6-48months. Pediatr Res, 2012,71(3):299-304.
[32] Yanchis D, So S, Patterson C, et al. Assessment of bodycomposition in pediatric intestinal failure: A comparison study.JPEN J Parenter Enteral Nutr, 2023,47(7):920-929.
[33] 张丹丹,朱秋爽,刘金晓,等.相同能量和蛋白质下不同膳食碳水化合物/脂肪比例对寿命影响代谢组学分析.中国公共卫生,2021,37(12):1778-1782.
[34] Keshen TH, Miller RG, Jahoor F, et al. Stable isotopicquantitation of protein metabolism and energy expenditure inneonates on- and post-extracorporeal life support. J Pediatr Surg,1997,32(7):958-962.
[35] Reintam Blaser A, Starkopf J, Alhazzani W, et al. ESICMWorking Group on Gastrointestinal Function. Early enteralnutrition in critically ill patients: ESICM clinical practiceguidelines. Intensive Care Med, 2017,43(3):380-398.
[36] Page A, Flower L, Prowle J, et al. Novel methods to identify andmeasure catabolism. Curr Opin Crit Care, 2021,27(4):361-366.
[37] Pelekhaty S, Galvagno SM, Hochberg E,et al. Nitrogen BalanceDuring Venovenous Extracorporeal Membrane OxygenationSupport: Preliminary Results of a Prospective, ObservationalStudy. JPEN J Parenter Enteral Nutr, 2020,44(3):548-553.
[38] Berger MM, Shenkin A, Schweinlin A, et al. ESPENmicronutrient guideline. Clin Nutr, 2022,41(6):1357-1424.
[39] Lindberg BR, Videm V, Dahl T, et al. Influence of the ECMOcircuit on the concentration of nutritional supplements. Sci Rep,2020, 10(1):19275.
[40] Estensen K, Shekar K, Robins E, et al. Macro- and micronutrientdisposition in an ex vivo model of extracorporeal membraneoxygenation. Intensive Care Med Exp, 2014,2(1):29.
[41] Valla Frédéric V, Bost Muriel , Roche Sylvain , et al. MultipleMicronutrient Plasma Level Changes Are Related to OxidativeStress Intensity in Critically Ill Children. Pediatr Crit Care Med,2018, 19: e455-e463.
[42] Kaplan MC, Heath TS. Evaluation of Calcium Homeostasis andDietary Supplementation for Pediatric and Neonatal PatientsReceiving Extracorporeal Membrane Oxygenation Support. JPediatr Pharmacol Ther, 2019,24(1):27-33.
[43] 曹佳颖,张育才,崔 云. 儿童体外膜肺氧合期间的营养管理策略. 中华儿科杂志,2021,59(11):985-988.
[44] Amrein K, Papinutti A, Mathew E, et al. Vitamin D and criticalillness: what endocrinology can learn from intensive care andvice versa. Endocr Connect, 2018,7(12):R304-R315.
[45] Stoppe C, Lee ZY, Ortiz L, et al. The potential role of intravenousvitamin C monotherapy in critical illness. JPEN J ParenterEnteral Nutr, 2022, 46(5):972-976.
[46] Pérez G, González E, Zamora L, et al. Early Enteral Nutrition andGastrointestinal Complications in Pediatric Patients onExtracorporeal Membrane Oxygenation. J Pediatr GastroenterolNutr, 2022, 74(1):110-115.
[47] Kim S, Jeong SK, Hwang J, et al. Early enteral nutrition andfactors related to in-hospital mortality in people on extracorporealmembrane oxygenation. Nutrition, 2021,89(1):111222.
[48] Talebi S, Zeraattalab-Motlagh S, Vajdi M, et al. Early vs delayedenteral nutrition or parenteral nutrition in hospitalized patients:An umbrella review of systematic reviews and meta-analyses ofrandomized trials. Nutr Clin Pract, 2023,38(3):564-579.
[49] Dresen E, Naidoo O, Hill A, et al. Medical nutrition therapy inpatients receiving ECMO: Evidence-based guidance for clinicalpractice. JPEN J Parenter Enteral Nutr, 2023,47(2):220-235.
[50] Panchal AK, Manzi J, Connolly S, et al. Safety of EnteralFeedings in Critically Ill Children Receiving Vasoactive Agents.JPEN J Parenter Enteral Nutr,2016, 40(2):236-241.
[51] Lu GY, Xu H, Li JH, et al. Safety and outcome of early enteralnutrition in patients receiving extracorporeal membraneoxygenation. Clin Nutr, 2023,42(9):1711-1714.
[52] Lee ZY, Ibrahim NA, Mohd-Yusof BN. Prevalence and durationof reasons for enteral nutrition feeding interruption in a tertiaryintensive care unit. Nutrition, 2018,53:26-33.
[53] Yasuda H, Kondo N, Yamamoto R, et al. Monitoring of gastricresidual volume during enteral nutrition. Cochrane Database SystRev, 2021,9(9):CD013335.
[54] 亚洲急危重症协会中国腹腔重症协作组.重症病人胃肠功能障碍肠内营养专家共识(2021 版). 中华消化外科杂志, 2021, 20(11):14.
[55] Al-Dorzi HM, Arabi YM. Enteral Nutrition Safety WithAdvanced Treatments: Extracorporeal Membrane Oxygenation,Prone Positioning, and Infusion of Neuromuscular Blockers. NutrClin Pract, 2021,36(1):88-97.
[56] Hunt MF, Pierre AS, Zhou X, et al. Nutritional Support inPostcardiotomy Shock Extracorporeal Membrane OxygenationPatients: A Prospective, Observational Study. J Surg Res, 2019,244(1):257-264.
[57] Holyk A, Belden V, Sirimaturos M, et al. Volume-Based FeedingEnhances Enteral Delivery by Maximizing the Optimal Rate ofEnteral Feeding (FEED MORE). JPEN J Parenter Enteral Nutr,2020,44(6):1038-1046.
[58] Zivick E, Kilgallon K, Cheifetz IM. Challenges of NutritionSupport in Pediatric Patients Requiring Extracorporeal MembraneOxygenation. ASAIO J. 2024 Feb 1;70(2):81-85.

相似文献/References:

[1]解好好.高能量密度肠内营养:有益或有害?[J].肠外与肠内营养杂志,2019,(01):20.[doi:10.16151/j.1007-810x.2019.01.009]
[2]冯筱青,白 倩,李 利,等.等热卡情况下不同蛋白供给对于重症病人临床结局的影响[J].肠外与肠内营养杂志,2019,(04):198.[doi:DOI : 10.16151/j.1007-810x.2019.04.002]
 FENG Xiao-qing,BAI Qian,LI Li,et al.Effects of different protein supplies on clinical outcomes in severe patients with the same calorie[J].PARENTERAL & ENTERAL NUTRITION,2019,(02):198.[doi:DOI : 10.16151/j.1007-810x.2019.04.002]
[3]蒋小芝,王华伟,赵浩天 综述,等.骨骼肌超声在急危重症病人营养状态 评估中的应用骨骼肌超声在急危重症病人营养状态[J].肠外与肠内营养杂志,2019,(06):372.[doi:10.16151/j.1007-810x.2019.06.012]
 JIANG Xiao-zhi,WANG Hua-wei,ZHAO Hao-tian reviewing,et al.Application of skeletal muscle ultoassound in the assessment of ntritional status of critical patients[J].PARENTERAL & ENTERAL NUTRITION,2019,(02):372.[doi:10.16151/j.1007-810x.2019.06.012]
[4]任宏生.美国重症医学临床实践观察[J].肠外与肠内营养杂志,2020,(01):5.[doi:10.16151/j.1007-810x.2020.01.002]
[5]叶向红,宫雪梅,王慧君,等.早期肠内营养耐受性分级干预在重症病人中 的应用[J].肠外与肠内营养杂志,2020,(02):89.[doi:10.16151/j.1007-810x.2020.02.006]
 YE Xiang-hong,GONG Xue-mei,WANG Hui-jun,et al.The application of improved grading management on early enteral nutrition tolerance in critically ill patients[J].PARENTERAL & ENTERAL NUTRITION,2020,(02):89.[doi:10.16151/j.1007-810x.2020.02.006]
[6]高恒妙,钱素云.危重症儿童肠内营养时应关注的重点问题[J].肠外与肠内营养杂志,2020,(06):321.[doi:10.16151/j.1007-810x.2020.06.001]
[7]叶向红,宫雪梅,薛阳阳.早期肠内营养护理方案对重症病人热卡达标率及喂养不耐受的 前后对照研究[J].肠外与肠内营养杂志,2021,(04):230.[doi:10.16151/j.1007-810x.2021.04.009]
 YE Xiang-hong,GONG Xue-mei,XUE Yang-yang.The effects of a nurse-driven feeding protocol on target reaching rate and feeding tolerance in critically ill patients: A before and after study[J].PARENTERAL & ENTERAL NUTRITION,2021,(02):230.[doi:10.16151/j.1007-810x.2021.04.009]
[8]高 月,李梦璇,陈松林,等.益生菌对危重症病人预后影响的 Meta 分析[J].肠外与肠内营养杂志,2022,(03):139.[doi:DOI : 10.16151/j.1007-810x.2022.03.003]
 GAO Yue,LI Meng-xuan,CHEN Song-ling,et al.Effects of probiotics on the outcome of critically ill adult patients: a Metaanalysis[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):139.[doi:DOI : 10.16151/j.1007-810x.2022.03.003]
[9]江 洁,罗 倩,朱宝华,等.床旁超声胃窦双径法预估胃残余量指导老年重症病人肠内营养实施的临床研究[J].肠外与肠内营养杂志,2022,(05):280.[doi:10.16151/j.1007-810x.2022.05.005]
 JIANG Jie,LUO Qian,ZHU Bao-hua,et al.Prediction of gastric residual volume by bedside ultrasound to guide the implementation of enteral nutrition in elderly critically ill patients[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):280.[doi:10.16151/j.1007-810x.2022.05.005]
[10]王 瑜,时皎皎,常 硕,等.成人体外膜肺氧合支持病人的营养支持治疗研究进展[J].肠外与肠内营养杂志,2022,(05):304.[doi:10.16151/j.1007-810x.2022.05.009]
 WANG Yu,SHI Jiao-jiao,CHANG Shuo,et al.Progress of nutritional therapy in adult patients supported by extracorporeal membrane oxygenation[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):304.[doi:10.16151/j.1007-810x.2022.05.009]

备注/Memo

备注/Memo:
作者简介 :姚德贞,住院医师,医学硕士,主要从事危重症营养的临床研究。E-mail:ydz.1996@qq.com通讯作者 :王丽杰,E-mail:wlj682002@163.com
更新日期/Last Update: 1900-01-01