临床实践的综合框架:在接受连续脏替代疗法的重症患者中个性化腹腔营养:临床实践的综合框架
Nicola Sinatra1, Antonino Maniaci2, Giuseppe Cuttone3
1Nephrology and Dialysis Unit, "Paolo Borsellino" Hospital, 91025 Marsala, Italy.
Journal of personalized medicine
|November 26, 2025
概括
由于营养损失,接受连续置换疗法 (CRRT) 的重症患者需要专门的腹腔营养 (PN). 通过更高的蛋白质和调整的能量摄入量来优化PN可以改善结果,例如更短的ICU停留时间.
科学领域:
- 密集护理医学 密集护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床营养学 临床营养学
背景情况:
- 接受连续置换疗法 (CRRT) 的重症患者面临着独特的营养挑战.
- CRRT需要专门的肠外营养 (PN) 策略来管理营养的平衡.
研究的目的:
- 综合当前的证据和临床专业知识,为CRRT患者提供全面的营养框架.
- 为接受CRRT的重症患者指导优化亲肠道营养.
主要方法:
- 审查当前的证据和临床专业知识.
- 分析CRRT期间的营养损失 (氨基酸,维生素,微量元素).
- 对蛋白质和能量目标和临床结果的观察性研究的评估.
主要成果:
- CRRT导致每天大量的氨基酸 (14-22g),水溶性维生素和微量元素的损失.
- 需要更高的蛋白质目标 (1.8-2.5 g/kg/day) 来实现正的平衡.
- 能量计算必须考虑酸盐和醇的"隐藏"卡路里.
结论:
- 在CRRT患者中实现营养充足与减少ICU停留,缩短机械通风和改善恢复相关.
- 最佳的营养支持需要基于CRRT参数的动态调整,与肠道营养,代谢监测和多学科合作的整合.
- 未来的研究应该专注于基于证据的指导方针的护理点分析和人工智能驱动的系统.
相关概念视频
Continuous Renal Replacement Therapy
768
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
768
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
165
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
165
Acute Kidney Injury V: Interprofessional Care
284
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
284
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
702
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
702
Chronic Kidney Disease III: Interprofessional Care
326
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
326
Acute Kidney Injury VI: Nursing Management
371
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
371


