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Deep vein of Early Nutrition in ARDS


Early,[link widoczny dla zalogowanych], that is within the ventilation start using 24 ~ 48h. ④ A group was given TPN therapy, to maintain total caloric intake of 8317 ~ 1617kJ / (kg · d.). The standard weight of 65 patients, for example, the formula for the 200g / L fat. $ L5OOmL, 70g / L amino acid 1000mL, 250g / L glucose 1000mL, insulin 32U, 100g / L potassium chloride 30mL, Glutamine 100mL, fat-soluble vitamins 2, two water-soluble vitamins, trace elements 20mL, Anderson United States 1 branch, along with added under aseptic 3L bag, the central venous 24h average rate input, to give half the amount of the first day, without adverse reaction, the whole amount of verdict the next day, and the other peripherally amount of sodium chloride intravenous medication, supplement, to be stable condition, after eating may be the gradual reduction of their own. B group to the suspension in the enteral nutrition,[link widoczny dla zalogowanych], gastrointestinal pump pump start 2000Kcal / d, a gradual transition to 4000Kcal / d or injected from the liquid food within the stomach; ⑤ corticosteroids, vitamin C and other symptomatic treatment. While monitoring ECG,[link widoczny dla zalogowanych], oxygen, central venous pressure, urine output, blood gas analysis, blood, electrolytes, glucose, observation of consciousness,[link widoczny dla zalogowanych], pupil larvae L, nutritional status, periodic review of chest radiograph, positive symptomatic treatment. 1.6 measurement data statistically as mean ± standard deviation (x ± S), said statistical software used for statistical analysis SPSS10.0. Between groups and t test were used. 2 results of clinical efficacy 2.1 A group of 36 patients had 19 cases of successful offline 1, 6 2 offline success, the success rate of 69.4% of the total off-line,[link widoczny dla zalogowanych], the average duration of mechanical ventilation (5.1 ± 1.9) d, mortality of 30.6%; B group 39 cases had successful offline l3 cases 1, 7 2 off-line success, the success rate of 51.2% of total off-line, the average duration of mechanical ventilation ( 8.6 Soil 2.I) d, mortality of 48.8%. There were significant differences between the two groups, P <0.05. 2.2 A group of deep venous adverse reactions can be carried out smoothly nutrition and found no adverse reaction; B group were diarrhea, bloating or stomach reflux of gastric contents within the phenomenon. 3 patients with ARDS is often accompanied by serious discussion of the negative nitrogen balance. Although enteral nutrition support can provide energy, but mechanical ventilation in the treatment of ARDS patients with high metabolic reactions, metabolic disorders and is characterized by negative nitrogen balance J, the result of long duration large consumption of energy and nutrient intake, leading to malnutrition, of diseased tissue repair, causing respiratory muscle fatigue, low immunity, concurrent infection, electrolyte imbalance, anemia, and even mechanical ventilation to remove the difficulties of multiple organ failure appears to increase mortality. Deep vein parenteral nutrition can improve the negative nitrogen balance, increased protein synthesis, maintain and improve the body's organs, respiratory muscle strength and function, improve quality and endurance of respiratory muscles, increase body resistance to infection and shorten the duration of mechanical ventilation on the reduction of concurrency disease and reduce the mortality has important clinical value. Our results show that, A group of nitrogen balance than the control group, can achieve nitrogen balance, protein synthesis efficiency also significantly improved significantly higher. Nitrogen balance improved due to increased protein synthesis, decomposition decreased. In respiratory failure / dysfunction in patients with TPN can greatly reduce the percentage of ventilator-dependent. The results show that, A group of patients in the treatment of ARDS, mechanical ventilation to remove earlier, mortality was significantly lower, the difference was significant (P <0.05), while the negative nitrogen balance is also improving. Therefore, the status of TPN therapy in ARDS important and should as a routine treatment. Respiratory dysfunction in patients sensitive to the excess calories, excess production caused by increased CO, oxygen consumption increased, PaO: reduce, increase respiratory insufficiency, pulmonary edema fluid also increased too much, so keep the blood circulating relatively reasonable quantity and quality, in the blood hemodynamics, plasma osmotic pressure, coagulation function of the liquid under the monitoring of input, especially important to prevent disease progression.