【摘要】 目的:观察营养支持对心脏手术后循环衰竭接受体外膜肺氧合(ECMO)辅助病人的耐受性和安全性。方法:回顾性分析2009~2013年间在我院心外科ICU使用ECMO辅助的病人,所有的病人均因为心脏术后发生严重的心功能衰竭接受了VA-ECMO(venoarterial,VA静脉-动脉)辅助治疗,同时采用104.6 k J(25 kcal)/(kg·d)肠内营养(EN)支持,共7 d。营养耐受情况以达到喂养目标的达标率和观察胃潴留量为主。观察其安全性以EN引起的不良反应来评估。结果:共有12例病人进行了ECMO辅助,EN为唯一的营养支持方式,所有病人第1周内营养耐受率超过70%。无一例出现EN引起的严重不良反应。结论:接受ECMO辅助的危重症病人给予EN治疗安全、可行,无严重并发症,第1周内EN耐受率达70%。更多还原

【Abstract】 Objective: Eenteral nutrition( EN) is considered controversial in critically ill patients with severe hemodynamic failure. To evaluate the tolerance and safety of EN in a consecutive group of patients receiving venoarterial( VA) extracorporeal membrane oxygenation( ECMO) for severe hemodynamic failure. Methods: Retrospective observational study was performed in a cardiac surgical intensive care unit( ICU) during last 5 years. All adult patients receiving VA ECMO for severe hemodynamic failure unresponsive to conventional therapies were included. Nutrition support was enteral nutrition protocol. Nutrition tolerance was defined as the ratio of delivered nutrition to target nutrition,expressed as a percentage. Special interest was made to detect possible adverse effects attributable to EN. Results:There were 12 patients treated with ECMO. EN was the only nutrition source. More than 70% nutrition tolerance was achieved within the first week in all cases. No serious adverse events that could be attributable to EN were noted. Conclusion: Early EN is possible and safe in patients with severe hemodynamic failure receiving VA ECMO.更多还原