Pei-Chun Chao, Hsien-Hua Liao, Lu-Huan Chou

Background and Objectives: Currently, the optimal energy and protein requirements for critically ill patients to reduce their morbidity and mortality remain unknown. Medical nutrition therapy is essential, especially during the first week of intensive care unit (ICU) treatment, because energy deficiency can affect clinical outcomes.

Methods and Study Design: A retrospective analysis of surgical ICU (SICU) cases was conducted from January to December 2023. Patients aged >18 years who required more than 7 days of hospitalization in the SICU were included and divided into three groups: a low-calorie low-protein (LCLP) group (<20 kcal/kg, <1.0 g/kg protein; n = 19), a standardcalorie standard-protein (SCSP) group (20–25 kcal/kg, 1.0–1.2 g/kg protein; n = 25), and a high-calorie high-protein (HCHP) group (>25 kcal/kg, >1.2 g/kg protein; n = 31).

Results: Significant decreases in Nutritional Risk Index scores (−1.64 ± 1.65, p < 0.001), hemoglobin levels (−1.5 ± 3.07 g/dL, p = 0.048), weight (−2.52 ± 2.58 kg, p < 0.001), and body mass index (p < 0.001) were observed in the LCLP group. Similarly, significant decreases in Acute Physiology and Chronic Health Evaluation II scores were observed in the SCSP (−5.92 ± 5.48, p < 0.001) and HCHP (−5.42 ± 6.76, p < 0.001) groups. By contrast, significant increases in Glasgow Coma Scale scores were observed in the SCSP (+3.56 ± 3.91, p < 0.001) and HCHP (+4.23 ± 4.99, p < 0.001) groups.

Conclusions: During the first week of nutritional therapy in the SICU, adequate energy and protein intake may help improve patient care and clinical outcomes.

趙佩君，廖憲華，周律寰

背景與目的：目前尚不清楚能有效降低重症病患併發症與死亡率的最佳熱量與蛋白質需求量為何，營養治療在加護病房治療的第一週特別關鍵，因為能量不足可能會影響臨床結果。

方法與研究設計：本回溯性分析研究，針對2023年1月至12月間住於外科加護病房(SICU)的病例進行探討。納入年齡超過18歲，且於SICU住院超過7天的病患，並依照第一週熱量與蛋白質攝取量分為三組：低熱量低蛋白組（LCLP組，<20 kcal/kg、蛋白質<1.0 g/kg；n = 19）、標準熱量標準蛋白組（SCSP 組，20–25 kcal/kg、蛋白質1.0–1.2 g/kg；n = 25）、高熱量高蛋白組（HCHP組，>25 kcal/kg、蛋白質>1.2 g/kg；n = 31）。

結果：在LCLP組中觀察到營養風險指數顯著下降（–1.64 ± 1.65，p < 0.001）、血紅素濃度下降（–1.5 ± 3.07 g/dL，p = 0.048）、體重下降（–2.52 ± 2.58 kg，p < 0.001），以及身體質量指數下降（p < 0.001）。同時，SCSP組（–5.92 ± 5.48，p < 0.001）與HCHP組（–5.42 ± 6.76，p < 0.001）的急性生理與慢性健康評估II（APACHE II）分數亦顯著下降。相對地，SCSP組（+3.56 ± 3.91，p < 0.001）與HCHP組（+4.23 ± 4.99，p < 0.001）的格拉斯哥昏迷指數（GCS）分數則顯著上升。

結論：在外科加護病房（SICU）營養治療的第一週期間，提供足夠的熱量與蛋白質攝取可能有助於改善病患的臨床照護與預後。