在重症监护室的瘦身量损失及其恢复:一个叙事审查
Arved Weimann1, Andreas Edel2, Lennart Lücke2,3
1Clinical Nutrition Unit, Department of General, Visceral and Oncological Surgery, St. George Hospital, Leipzig, Germany.
概括
在重症患者中保持瘦肉量 (LM) 是具有挑战性的. 序列生物电阻分析 (BIA) 用于无脂肪质量监测和性别特定的营养指导是恢复的关键.
科学领域:
- 临床营养学 临床营养学
- 密集护理医学 密集护理医学
- 身体组成分析 身体成分分析
背景情况:
- 瘦身量 (LM) 的保存和恢复是临床营养中的关键挑战.
- 在养不响应和过度养或营养不良的风险之间存在困境.
- 后重症监护综合征 (PICS) 强调了需要在ICU之外继续进行营养治疗.
研究的目的:
- 审查当前关于在重症患者中管理瘦身质量的文献.
- 确定在ICU和ICU后阶段评估身体组成和营养监测的最佳方法.
- 探索未来的研究方向,以优化营养治疗和瘦肉质恢复.
主要方法:
- 综合文献综述最近关于重症患者身体组成和营养的研究.
- 评估各种身体成分评估技术,包括计算机断层扫描 (CT),生物电阻分析 (BIA) 和超声波.
- 以人体成分指标为指导的能源和蛋白质输送策略的分析.
主要成果:
- 无脂肪质量测量的连续BIA是监测的可行和有前途的方法.
- 性别特定的无脂肪质量,而不是总体体重,应该指导能量和蛋白质供应,得到间接热量计的支持.
- 综合营养策略比单独的干预措施更有效的LM恢复.
结论:
- 特定时间点的身体成分监测 (特别是串行BIA) 应该整合到日常ICU护理中.
- 营养治疗和监测必须延伸到ICU后期,以解决PICS.
- 未来的研究应该专注于用于"准备食"评估的机器学习,微量营养素,性饮食, ω-3 脂肪酸和激素治疗.
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