Mostra el registre complet de l'element
Martínez Romero, G; Pérez Ruixo, Juan José; Jiménez Torres, N. Víctor | |||
Aquest document és un/a article, creat/da en: 2002 | |||
|
|||
|
|||
The aim of this study is to identify patients subpopulations
with similar caloric and proteic needs (CPN) and
developing and assessing the utility of standarized formulations
of total parenteral nutrition (TPN) with equivalents
supplies to the average patients needs of each
identified subpopulation. CPN of one hundred metabolically
stables adults patients in treatment with TPN were
evaluated consecutively. Caloric supplies were calculated
with the Harris-Benedict equation, with the Long corrections
and proteics supplies were evaluated according
to stress level. The identification of patients
subpopulation according to the CPN was made through
the cluster analysis with partitioning around mediods
algorithm. We considered the formulation with equivalent
supplies to the average needs of each subpopulation
was adequated to the patients caloric-proteic requirements
when their...
[Llegir més ...]
[-]
The aim of this study is to identify patients subpopulations
with similar caloric and proteic needs (CPN) and
developing and assessing the utility of standarized formulations
of total parenteral nutrition (TPN) with equivalents
supplies to the average patients needs of each
identified subpopulation. CPN of one hundred metabolically
stables adults patients in treatment with TPN were
evaluated consecutively. Caloric supplies were calculated
with the Harris-Benedict equation, with the Long corrections
and proteics supplies were evaluated according
to stress level. The identification of patients
subpopulation according to the CPN was made through
the cluster analysis with partitioning around mediods
algorithm. We considered the formulation with equivalent
supplies to the average needs of each subpopulation
was adequated to the patients caloric-proteic requirements
when their difference was lower than 20%. The
percentage of patients who received adequated supplies
were compared between the subpopulations identified.
In case of two subpopulations, glucose, lipids and
amino acid needs are: 275 (CI 95%: 265-285) g, 83 (CI
95%: 78-88) g and 89 (CI 95%: 86-92) g in subpopulation
1 (N = 35), and 195 (CI 95%: 187-203) g, 58 (CI
95%: 56-61) g and 74 (CI 95%: 72-77) g in subpopulation
2 (N = 65), respectively. In case of three subpopulations,
in subpopulation 1 (N = 19), glucose, lipids and
amino acid needs are: 295 (CI 95%: 283-306) g, 91 (CI
95%: 84-97) g and 91 (CI 95%: 86-95); 234 (CI 95%:
227-240) g, 67 (CI 95%: 64-70) g and 84 (CI 95%: 82-86)
g to the subpopulation 2 (N = 45) and 172 (CI 95%: 165-
179) g, 55 (CI 95%: 52-57) g, and 68 (CI 95%: 64-71) g
to the subpopulation 3 (N = 36) respectively. In general,
caloric and proteic supplies are equal to the patients needs,
but there was a tendendy to overfeeding in patients
with lower CPN. The utilization of one, two or three formulations with equivalent supplies to the average needs
of each subpopulation was adequated to the patients in
the 45% (CI 95%: 36%-55%), 75% (CI 95%: 65%-
83%) and 82% (CI 95%: 74%-89%), respectively.
Therefore, the development of three normalized formulations
of total parenteral nutrition allows to satisfy the
patients nutritional needs at least the 74% of the patients.La disponibilidad de formulaciones parenterales normalizadas
en relación a los aportes de nutrientes, plantea
la problemática de su idoneidad en relación a las necesidades
nutritivas de los pacientes. El objetivo de este
trabajo es identificar subpoblaciones de pacientes con
necesidades calórico-proteicas similares y valorar su
adecuación a formulaciones normalizadas. Con este fin,
se evaluaron, de forma prospectiva las necesidades calórico-
proteicas de 100 pacientes adultos metabólicamente
estables en tratamiento con nutrición parenteral total.
Los aportes calóricos se estudiaron por Harris-Benedict
(con corrección de Long) y los aportes proteicos se calcularon
en función del grado de estrés. Las necesidades
calórico-proteicas se analizaron mediante un análisis de
cluster mediante el algoritmo de partición alrededor de
los mediodes. Se consideró que cuando la formulación
de nutrición parenteral contenía aportes equivalentes a
± 20% de las necesidades medias de cada subpoblación
era adecuada para satisfacer los requerimientos calórico-
proteicos de los pacientes. El porcentaje de pacientes,
en función del número de subpoblaciones identificadas,
que recibirían aportes adecuados a sus requerimientos
se tomó como variable de estudio comparativo.
En el caso de dos subpoblaciones, para la subpoblación
1 (N = 35), las necesidades de glucosa, lípidos y aminoácidos
son: 275 (IC 95%: 265-285) g, 83 (IC 95%: 78-
88) g y 89 (IC 95%: 86-92) y para la subpoblación 2 (N =
65), 195 (IC 95%: 187-203) g, 58 (IC 95%: 56-61) g y 74
(IC 95%: 72-77) g, respectivamente. En el caso de tres subpoblaciones,
estas mismas necesidades de nutrientes
son para la subpoblación 1 (N = 19): 295 (IC 95%: 283-
306) g, 91 (IC 95%: 84-97) g y 91 (IC 95%: 86-95); para
la subpoblación 2 (N = 45), 234 (IC 95%: 227-240) g, 67
(IC 95%: 64-70) g, y 84 (IC 95%: 82-86) g; y para la
subpoblación 3 (N = 36): 172 (IC 95%: 165-179) g, 55
(IC 95%: 52-57) g y 68 (IC 95%: 64-71) g, respectivamente.
La utilización de una, dos o tres formulaciones,
que contengan aportes equivalentes a ± 20% de las necesidades
medias de cada subpoblación, satisfacen los requerimientos
de glucosa, lípidos y proteínas en el 45%
(IC 95%: 36% a 55%), 74% (IC 95%: 65% a 83) y 82%
(IC 95%: 74% a 89%) de los pacientes, respectivamente.
En suma, el desarrollo de tres formulaciones normalizadas
de nutrición parenteral permite satisfacer las necesidades
nutricionales de al menos el 74% de los
pacientes adultos metabólicamente estables subsidiarios
de nutrición parenteral total.
|
|||
Veure al catàleg Trobes |