To explore the effects of different nutritional pathways on nutrition metabolism and respiratory muscle strength in critical elderly patients in Intensive Care Unit (ICU) .

Totally 99 critical patients admitted in the ICU of Shandong Provincial Third Hospital between January and September 2017 and were equally randomized into enteral nutrition group (EN group) , parenteral nutrition group (PN group) and enteral nutrition plus parenteral nutrition group (EN+PN group) , which received nutritional support via different pathways. The patients'hemoglobin (Hb) , plasma albumin (ALB) and nitrogen balance were measured 7 days post nutritional support; the maximal inspiratory pressure (PImax) was monitored; and the nutritional status and respiratory muscle strength were compared in the patients receiving nutritional support via different pathways.

After 7 days'nutritional support, EN+PN group showed better Hb (133.52±12.96) g/L, ALB (40.16±4.42) g/L and nitrogen balance (-4.31±1.67) g than PN group and EN group (F=5.602, 4.594, 2.854; P<0.05) . The PImax of EN+PN group was (-34.52±12.96) cmH₂O, which was better than EN group and PN group (F=3.651, P<0.05) .

The combined EN and PN support has better effects on improving the nutritional status and respiratory muscle strength in critical elderly patients as compared to simply using EN or PN, and it also shows better short-term clinical outcomes than simply using EN or PN.

Parenteral nutrition; Intensive care units; Enteral nutrition; Nutrition metabolism; Respiratory muscle strength