重篤な病気におけるマクロ栄養素過剰: 過剰摂取は良いことですか?

Maria Alcaide^1,2, Zudin Puthucheary¹, John R Prowle¹

¹Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London.

Current opinion in critical care

|February 17, 2026

まとめ

重症患者の病気の初期段階での過度の栄養摂取は避けるべきです. 耐性および病気の段階に基づいて栄養を調整することで,回復を最適化し,代謝合併症を最小限に抑えることができます.

科学分野:

クリティカルケア医療は,重症治療薬です.
栄養科学とは,栄養科学である.
メタボリック経路は

背景:

伝統的なクリニックケア栄養は,栄養不良の予防に重点を置いていました.
新興の証拠は,集中治療室 (ICU) の患者の早期マクロニュートリエント過剰による潜在的な害を示しています.

研究の目的:

マクロ栄養素の毒性のメカニズムを見直す.
耐性不良の臨床的および生化学的マーカーを特定する.
ガイドラインで推奨される戦略を概説し,栄養素の提供に合わせる.

主な方法:

最近のランダム化対照試験 (RCT) のレビュー.
マクロ栄養素の毒性メカニズムに関する証拠の分析.
現在のガイドラインの推奨事項の要約.

主要な成果:

早期のICUでのマクロ栄養素補充投与は,利益と潜在的な害を提供しない可能性があります.
過剰なエネルギー,タンパク質,炭水化物,または脂質は,ミトコンドリア機能不全,高血糖症,肝臓ステアトーシス,および免疫機能を悪化させる可能性があります.
バイオマーカーの開発は,重症成人における精密栄養に不可欠です.

結論:

段階的,耐性に基づく栄養アプローチが推奨されています.
急性代謝期間の過食を避けるのは不可欠です.
回復期に栄養需要を増やすためのサポートは極めて重要です.

キーワード:

集中治療栄養栄養についてマクロ栄養素の毒性についてメタボリック不耐性です.ミトコンドリアの機能障害酸化ストレスによるストレスです.

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