危急疾病中的巨量营养素过量:过多是好事吗?
Maria Alcaide1,2, 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
概括
避免在重症患者的疾病早期过度食. 根据耐受性和疾病阶段量身定制营养可以优化恢复并最大限度地减少代谢并发症.
科学领域:
- 关键护理医学 关键护理医学
- 营养科学 营养科学
- 代谢途径 代谢途径
背景情况:
- 传统的重症监护营养专注于预防营养不良.
- 新出现的证据表明,在重症监护室 (ICU) 患者中,早期的巨量营养素过量可能会造成潜在的危害.
研究的目的:
- 审查宏观营养素毒性的机制.
- 识别不耐受性的临床和生化标志物.
- 为量身定制的营养物质提供概述指南推的策略.
主要方法:
- 最近随机对照试验 (RCT) 的综述.
- 对宏观营养素毒性机制的证据分析.
- 综合目前的指导方针建议.
主要成果:
- 在ICU中早期补充宏观营养素的管理可能不会带来任何好处和潜在的危害.
- 过多的能量,蛋白质,碳水化合物或脂质可以恶化线粒体功能障碍,高血糖,肝硬化和免疫功能.
- 生物标志物的开发对于重症成人精准营养至关重要.
结论:
- 建议采用分阶段,基于耐受性的营养方法.
- 在急性代谢过程中避免过度食是必不可少的.
- 在康复阶段支持营养需求增加至关重要.
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