{"id":6845,"date":"2023-02-01T09:42:00","date_gmt":"2023-02-01T04:42:00","guid":{"rendered":"https:\/\/www.serenepharma.com\/?p=6845"},"modified":"2023-02-08T09:45:20","modified_gmt":"2023-02-08T04:45:20","slug":"intensiv-terapiya-bolimida-covid-19-bilan-kasallangan-bemorlarga-qoshimcha-oziqlantirishni-istamaslik-muallif-devid-uayld","status":"publish","type":"post","link":"https:\/\/www.serenepharma.com\/uz\/gazetauz\/intensiv-terapiya-bolimida-covid-19-bilan-kasallangan-bemorlarga-qoshimcha-oziqlantirishni-istamaslik-muallif-devid-uayld\/","title":{"rendered":"Intensiv terapiya bo\u2019limida COVID-19 bilan kasallangan bemorlarga qo\u2019shimcha oziqlantirishni istamaslik Muallif: Devid Uayld"},"content":{"rendered":"\n

Ilova: https:\/\/www.pharmacypracticenews.com\/Online-First\/Article\/05-22\/Reluctance-to-Prescribe-Supplemental-Nutrition-to-COVID-19-ICU-Patients\/67144<\/p>\n\n\n

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\u0410merika parenteral va enteral oziqlantirish jamiyati (ASPEN) 2022 ilmiy-amaliy konferentsiyasida o\u2019tkazilgan so\u2019rovnoma natijalariga ko\u2019ra, og\u2019ir kasal bo\u2019lgan Covid-19 bemorlariga erta enteral oziqlantirish va parenteral oziqlantirish berilishining afzalliklariga qaramay, ko\u2019plab shifokorlar buni bajarishni istamaydilar.<\/p>\n\n\n\n

Sent-Luisdagi Barnes-Jewish kasalxonasi shifokori, klinik oziqlantirish bo\u2019yicha ilmiy xodim Bet Teylor va uning hamkasblari Covid-19 intensiv terapiya bo\u2019limidagi 199 shifokor va dietologlardan so\u2019rovnoma o\u2019tkazilishi natijalariga ko\u2019ra, so\u2019ralganlarning 9%i bemorlarining energiya va oqsilga bo\u2019lgan ehtiyojini o\u2019z vaqtida ta\u2019minlanganliklari aniqlandi.<\/p>\n\n\n\n

Biroq bu oziqlantirish yetishmovchiligi \u201cbemorlarning oziq moddalarini o\u2019zlashtirmasligi natijasi emas, balki ularni to\u2019liq oziqlantirilmaganligi sababli kelib chiqgan\u201d- deydi doktor Teylor.<\/p>\n\n\n\n

Masalan, respondentlarning 75%i bemorlarning oziqlantirishdagi ehtiyojlarini kasalliklarini kechishi noaniq bo\u2019lganligi sababli qoniqtira olinmaganligini ta\u2019kidlab o\u2019tdilar. Hattoki holati \u201cstabil\u201d hisoblangan va vaqtida oziqlantirish bilan qo\u2019llab quvvatlangan bemorlarda ham, to\u2019satdan ahvollarining yomonlashuvi aniqlanib, bu esa energiya va oqsil yetishmovchiligiga olib kelgan. Ularning so\u2019zlariga qaraganda: bunday holat ro\u2019y berganida, oziqlantirishni bemorning holatiga mos ravishda korrektsiya qilish o\u2019rniga, enteral oziqlantirishdan voz kechish istagi tug\u2019iladi.<\/p>\n\n\n\n

Parenteral oziqlantirishdan foydalanishni xoxlamaslikning aksariyati natijalarning yomonlashuviga olib kelishidan havotirlik bilan bog\u2019liq. Doktor Teylorning so\u2019zlariga qaraganda, Covid-19 dan avvalgi davrda o\u2019tkazilgan yirik randomizatsiyalangan nazorat ostida o\u2019tkazilgan tadqiqotlar natijasi intensiv terapiya bo\u2019limidagi bemorlardda erta enteral va parenteral oziqlantirish orasida infektsiya, sepsis va boshqa asoratlar havfi o\u2019rtasida deyarli farq bo\u2019lmaganligini ko\u2019rsatdi (Lancet 2018;391[10116]:133-143).<\/p>\n\n\n\n

\u201cParenteral oziqlantirishdan foydalanish bilan bog\u2019liq havf va foyda bilan bog\u2019liq jiddiy noto\u2019g\u2019ri fikrlar va shaxsiy qarashlar mavjud, masalan: giperglikemiya havfi, biz bunday holatlarni me\u2019yoridan ortiq kaloriyani bermaslik va glikemiyani erta nazorat qilish bilan uddalaymiz\u201d.<\/p>\n\n\n\n

Biz bunday noto\u2019g\u2019i fikrlar va qarashlarga qarshi kurashishimiz va erta enteral oziqlantirish va qo\u2019shimcha parenteral oziqlantirishni qo\u2019llab quvvatlashimiz kerak \u2013 deydi doktor Teylor.<\/p>\n\n\n\n

U, \u201cCovid-19 Intensiv terapiya bo\u2019limida bemorlarning oziqlantirishni qo\u2019llab quvvatlashda uslubiy yondoshuv\u201d va \u201coptimal parvarish qilish uchun oziqlantirishni boshqarish bo\u2019yicha yangilangan ko\u2019rsatmalar\u201d zarur ekanligini ta\u2019kidladi.<\/p>\n\n\n\n

Doktor Teylor davom etayotgan pandemiya bosimini hisobga olgan holda bu oson ish emasligini tan oldi. \u201cCovid-19 pandemiyasi boshlangandan beri zarbalarga dosh berdik va shu bilan birga intensiv terapiya bo\u2019limida Covid-19 bemorlarini qanday qilib yaxshi davolashni ham o\u2019rganishimiz kerak edi\u201d-deydi u.<\/p>\n\n\n\n

O\u2019sha dastlabki kunlarda doktor Teylor va uning hamkasblari Covid-19 kasallari intensiv terapiya bo\u2019limiga qabul qilingandan so\u2019ng darhol oziqlantirish kerakligini tushunishdi. \u201cBu virusli kasallikda kasallik jarayoni uzoq kechishini hisobga olib, qo\u2019shimcha parenteral oziqlantirishni erta boshlash haqida o\u2019ylashimiz kerak\u201d- deydi u.<\/p>\n\n\n\n

Darhaqiqat, 2020 yilning boshida e\u2019lon qilingan tavsiyalar (J Parenter Enteral Nutr 2020;44[7]:1174-1184) \u2013 va shu vaqtdan beri yangilanayotgan ma\u2019lumotlar intensiv terapiya bo\u2019limiga tushgan bemorga enteral oziqlantirishni 24-36 soatda boshlashni, agar bemor enteral oziqlantirishni ko\u2019tara olmasa, darhol parenteral oziqlantirishga o\u2019tkazishni qat\u2019iy tavsiya etadilar. Ushbu ko\u2019rsatmalar intensiv terapiya bo\u2019limi bemorlari orasida erta oziqlantirishning muhimligini aks ettiradi, ushbu strategiya kechiktirilgan oziqlantirishga nisbatan o\u2019lim havfini 55%ga kamaytiradi (Crit Care Med 2018;46[7]:1049-1056).<\/p>\n","protected":false},"excerpt":{"rendered":"

Ilova: https:\/\/www.pharmacypracticenews.com\/Online-First\/Article\/05-22\/Reluctance-to-Prescribe-Supplemental-Nutrition-to-COVID-19-ICU-Patients\/67144 \u0410merika parenteral va enteral oziqlantirish jamiyati (ASPEN) 2022 ilmiy-amaliy konferentsiyasida o\u2019tkazilgan so\u2019rovnoma natijalariga ko\u2019ra, og\u2019ir kasal bo\u2019lgan Covid-19 bemorlariga erta enteral oziqlantirish va parenteral oziqlantirish berilishining afzalliklariga qaramay, ko\u2019plab shifokorlar buni bajarishni istamaydilar. Sent-Luisdagi Barnes-Jewish kasalxonasi shifokori, klinik oziqlantirish bo\u2019yicha ilmiy xodim Bet Teylor va uning hamkasblari Covid-19 intensiv terapiya bo\u2019limidagi 199 shifokor…<\/p>\n","protected":false},"author":1,"featured_media":6801,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"rs_blank_template":"","rs_page_bg_color":"","slide_template_v7":"","inline_featured_image":false,"footnotes":""},"categories":[141],"tags":[172],"class_list":["post-6845","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gazetauz","tag-reanimatsiya"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t