临床药师对危重症患者营养支持治疗的药学监护

Pharmaceutical Care for Critically Ill Patients with Nutritional Support Treatment by Clinical Pharmacists

目的:探讨伴胃肠道反应的危重症患者营养支持治疗方案的合理性及临床疗效。方法:在1例不明原因肺部感染的危重症患者进行营养支持治疗的过程中,临床药师协助医师明确合理的营养支持策略,及时优化营养治疗方案,结合患者病情进展,监测反映营养治疗效果的指标,动态评估营养治疗效果及所有可能发生的与药物相关的不良反应。结果:患者经过治疗,胃肠道反应逐渐减轻,恶心呕吐症状好转,安全地由全肠外营养过渡至肠内营养,营养状态恢复良好,转出重症加强护理病房。结论:临床药师通过参与患者的治疗过程,实施药学监护,优化用药方案,确保了营养药物的合理应用,提高了营养支持治疗的效果。

OBJECTIVE: To explore the rationality and clinical efficacy of nutritional support treatment for critically ill patients with gastrointestinal reaction. METHODS: In the process of nutritional support treatment for a patient with unexplained pulmonary infection, the clinical pharmacists assisted the clinicians to determine a reasonable nutritional support strategy and optimized the nutritional treatment regimen. Combined with the patient’s progress, the clinical pharmacists monitored the indicators that reflect the effects of nutritional therapy, dynamically assessed the effects of nutritional therapy and all possible drug-related adverse drug reactions. RESULTS: After treatment, the gastrointestinal reaction of the patient gradually decreased, nausea and vomiting symptoms had been improved, the transition from total parenteral nutrition to enteral nutrition was safely performed, the nutritional status recovered well, and the patient was transferred out of ICU. CONCLUSIONS: By participating into the patient’s treatment process, clinical pharmacists implement the pharmaceutical care and optimize the drug use programs to ensure the rational application of nutritional drugs and improve the effectiveness of nutritional support treatment.