一个关于关键疾病中必需微量营养素的更新
Kristine W A Koekkoek1, Mette M Berger2
1Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
Current opinion in critical care
|June 12, 2023
概括
危急病患者的微量营养素水平往往较低,增加了免疫防御需求. 补充试验显示,对维生素D和铁等特定营养素有好处,但不建议高剂量单一治疗.
科学领域:
- 关键护理医学 关键护理医学
- 营养生物化学 营养生物化学
- 免疫学 免疫学 免疫学
背景情况:
- 危急病患者表现出低微量营养素水平,影响抗氧化剂和免疫功能.
- 危急疾病中的炎症反应使微量营养素度的解释变得复杂.
- 对于胺,维生素C和维生素D,,和铁,更高的需求和缺乏是常见的.
研究的目的:
- 审查最近关于重症患者微量营养素状况和补充剂的研究结果.
- 在危急疾病的背景下分析微量营养素在免疫防御和抗氧化过程中的作用.
- 评估各种补充方法的有效性和安全性.
主要方法:
- 对重症患者微量营养素补充的观察性和随机对照试验的审查.
- 微量营养素度与炎症反应和生物流体损失相关的分析.
- 评估与特定微量营养素缺乏和干预相关的临床结果.
主要成果:
- 危急疾病中微量营养素水平较低需要仔细解释,考虑到炎症和损失.
- 胺,维生素C和维生素D,,和铁缺乏是常见的,特别是在需要持续置换疗法 (CRRT) 的患者中.
- 缺乏ICU患者的维生素D补充改善了结果;高剂量注射不建议. 静脉注射铁对缺铁性贫血是安全有效的.
结论:
- 在危急疾病中,微量营养素的需求增加,以支持免疫力.
- 监测特定的微量营养素对于长期住院的ICU患者至关重要.
- 与中等剂量的必需微量营养素的联合治疗比高剂量单一治疗更可取.
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