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首页> 外文期刊>Proceedings of the Nutrition Society >Providing optimal nutritional support on the intensive care unit: key challenges and practical solutions.
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Providing optimal nutritional support on the intensive care unit: key challenges and practical solutions.

机译：在重症监护病房提供最佳的营养支持：关键挑战和实际解决方案。

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Many patients in the intensive care unit are malnourished or unable to eat. Feeding them correctly has the potential to reduce morbidity and even mortality but is a very complex procedure. The inflammatory response induced by surgery, trauma or sepsis will alter metabolism, change the ability to utilise nutrients and can lead to rapid loss of lean mass. Both overfeeding and underfeeding macronutrients can be harmful but generally it would seem optimal to give less during metabolic stress and immobility and increase in recovery. Physical intolerance of feeding such as diarrhoea or delayed gastric emptying is common in the intensive care unit. Diarrhoea can be treated with fibre or peptide feeds and anti-diarrhoeal drugs; however, the use of probiotics is controversial. Gastric dysfunction problems can often be overcome with prokinetic drugs or small bowel feeding tubes. New feeds with nutrients such as n-3 fatty acids that have the potential to attenuate excessive inflammatory responses show great promise in favourably improving metabolism and substrate utilisation. The importance of changing nutrient provision according to metabolic and physical tolerance cannot be understated and although expert groups have produced many guidelines on nutritional support of the critically ill, correct interpretation and implementation can be difficult without a dedicated nutrition health care professional such as a dietitian or a multidisciplinary nutritional support team.
机译：重症监护病房的许多患者营养不良或无法进食。正确喂养它们有可能降低发病率，甚至降低死亡率，但是这是一个非常复杂的过程。手术，创伤或败血症引起的炎症反应将改变新陈代谢，改变营养利用能力，并可能导致瘦体重的快速丧失。过量摄取和不足摄取大量营养素均可能有害，但通常看来最佳的做法是在代谢压力和不动时减少摄入量，并增加恢复。在重症监护病房中，腹泻或胃排空延迟等喂养对身体的不耐受是常见的。腹泻可以用纤维或多肽饲料和止泻药治疗;但是，使用益生菌存在争议。胃功能障碍的问题通常可以通过服用促运动药或小肠饲管来解决。新型营养素饲料，如 n -3脂肪酸，具有减轻过度炎症反应的潜力，在改善代谢和底物利用率方面显示出巨大的希望。不能低估根据代谢和身体耐受性改变营养供应的重要性，尽管专家组已经制定了许多有关重症患者营养支持的指南，但是如果没有专职的营养保健专业人员（例如营养师或多学科的营养支持团队。

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