Nutritional support for successful weaning in patients undergoing prolonged mechanical ventilation

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作者
Shih-Ching Lo
Kevin Sheng-Kai Ma
Yen-Ru Li
Zi-Yue Li
Cheng-Hung Lin
Hsing-Chun Lin
Shun-Fa Yang
机构
[1] Chung Shan Medical University,Institute of Medicine
[2] Chung Shan Medical University Hospital,Department of Nutrition
[3] Chung Shan Medical University,Department of Nutrition
[4] University of Pennsylvania,Center for Global Health, Perelman School of Medicine
[5] Harvard T.H. Chan School of Public Health,Department of Epidemiology
[6] National Taiwan University,Graduate Institute of Biomedical Electronics and Bioinformatics
[7] Chung Shan Medical University Hospital,Department of Management
[8] Chung Shan Medical University Hospital,Respiratory Care Center
[9] Chung Shan Medical University Hospital,Department of Information Technology
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摘要
Successful weaning from ventilators not only improves the quality of life of patients, but also reduces medical expenses. The aim of this study was to explore the association between nutritional provision and successful ventilator weaning. In this retrospective study data from the Respiratory Care Center of Chung Shan Medical University Hospital between October, 2017 and July, 2019 on patient characteristics, amount of nutrition delivered, and clinical outcomes were retrieved. A total of 280 ventilated patients were enrolled and divided into successful extubation and failed weaning groups. There were 178 males (63.6%) and 102 females (36.4%) with a mean age of 67.3 ± 16.9 years. The successful extubation group consisted of patients who tended towards ideal body weight during the weaning process (BMI 23.9 ± 5.0 versus 22.7 ± 4.8 kg/m2, p < 0.001). Patients from both groups initially received the same nutritional intervention, while patients of successful extubation received significantly more calories and protein after weaning (23.8 ± 7.8 kcal versus 27.8 ± 9.1 kcal, p < 0.001 and 0.97 ± 0.36 g versus 1.14 ± 0.42 g, p < 0.001). Successful weaning was associated with higher survival rate (p = 0.016), shortened hospital stay (p = 0.001), and reduced medical costs (p < 0.001). Overall, nutritional support with high calories and protein was associated with the probability of successful ventilator weaning in patients undergoing prolonged mechanical ventilation. Adequate nutrition is a determinant of successful ventilator weaning.
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