关键护理中的蛋白质输送-最近的试验告诉我们什么?
Michelle Carmen Paulus1, Arthur Raymond Hubert van Zanten1
1Department of Intensive Care Medicine & Research, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands; Division of Human Nutrition and Health, Nutritional Biology, Wageningen University & Research, HELIX (Building 124), Stippeneng 4, 6708 WE Wageningen, The Netherlands.
Critical care clinics
|February 28, 2025
概括
为优化重症监护室 (ICU) 患者的蛋白质摄入量,需要避免低剂量和过量剂量. 根据患者类型量身定制营养和逐渐增加蛋白质是恢复的关键.
科学领域:
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
- 代谢研究的研究.
背景情况:
- 对于重症监护室 (ICU) 和ICU后患者来说,最佳的蛋白质摄入仍然是一个挑战.
- 精确的蛋白质输送至关重要,但实际摄入量往往不同于处方剂量,风险低或过量 (<1.0 g/kg或>1.6 g/kg).
- 新出现的证据强调了患者表型和内型为个性化营养目标的重要性.
研究的目的:
- 审查确定ICU和ICU后人群最佳蛋白质摄入量的复杂性.
- 强调需要精确的蛋白质输送和个性化的营养策略.
- 发现当前知识的差距,特别是对于ICU后的患者.
主要方法:
- 对当前指导方针的文献综述和对重症患者蛋白质代谢的研究.
- 分析影响蛋白质摄入精度和患者反应的因素.
- 讨论营养治疗中的表型和内型等新兴概念.
主要成果:
- 对于ICU患者来说,最佳蛋白质摄入量是一个狭窄的范围,需要仔细监测,以避免补充不足或过量的有害影响.
- 在ICU的最初4-5天内,蛋白质摄入量的逐渐增加对患者的康复至关重要.
- 对于ICU后阶段的最佳蛋白质标存在显著的知识差距,需要进一步研究.
结论:
- 确定ICU和ICU后患者的最佳蛋白质摄入量是复杂的,需要在处方和实际摄入量之间保持平衡.
- 个性化的营养策略,由表型和内型决定,对于优化蛋白质疗法至关重要.
- 迫切需要进一步的研究,以建立基于证据的蛋白质摄入指南,以改善ICU后患者的长期结果.
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