当代推理为提供肠道营养在严重病情的成年人.
Jayshil J Patel1, Robert G Martindale2, Stephen A McClave3
1Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI.
建议在严重疾病的急性阶段进行限制性肠道营养. 高剂量的蛋白质并不优越,可能会伤害危急病的成年人,特别是急性损伤的成年人.
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
- 重症监护病房 (ICU) 的管理人员.
背景情况:
- 早期的肠道营养是管理严重病情的成年人的基石.
- 在历史上,指导方针建议在ICU入院72小时内进行全肠营养.
研究的目的:
- 对重症成人肠道营养和蛋白质输送的理由,时间,剂量和监测进行审查.
- 综合证据的最佳营养策略在危急疾病的不同阶段.
主要方法:
- 在Medline系统搜索相关研究,系统评论,元分析和指导方针.
- 分析临床前和当代临床文献.
主要成果:
- 在急性阶段,限制性肠道营养可以保护肠道的完整性,支持微生物群,并调节免疫失调.
- 与限制剂量相比,全剂量肠道营养可能导致更糟糕的结果.
- 高剂量的蛋白质不会改善结果,在某些重症患者中可能有害.
结论:
- 当代证据支持在严重疾病的急性阶段限制肠道营养.
- 高剂量蛋白质不优于标准剂量,并且与特定患者群体的不良结果有关,包括急性损伤患者.
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