Anker S D, John M, Pedersen P U, Raguso C, Cicoira M, Dardai E, Laviano A, Ponikowski P, Schols A M W J, Becker H F, Böhm M, Brunkhorst F M, Vogelmeier C
Division of Applied Cachexia Research, Department of Cardiology, Charité-Universitätsmedizin Berlin, CVK, Berlin, Germany.
Clin Nutr. 2006 Apr;25(2):311-8. doi: 10.1016/j.clnu.2006.01.017. Epub 2006 May 11.
These guidelines are intended to give evidence-based recommendations for the use of enteral nutrition (EN) in patients with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD). They were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publications since 1985. They have been discussed and accepted in a consensus conference. EN by means of oral nutritional supplements (ONS) or tube feeding (TF) enables nutritional intake to be maintained or increased when normal oral intake is inadequate. No data are yet available concerning the effects of EN on cachexia in CHF patients. However, EN is recommended to stop or reverse weight loss on the basis of physiological plausibility. In COPD patients, EN in combination with exercise and anabolic pharmacotherapy has the potential to improve nutritional status and function. Frequent small amounts of ONS are preferred in order to avoid postprandial dyspnoea and satiety as well as to improve compliance.
本指南旨在为慢性心力衰竭(CHF)和慢性阻塞性肺疾病(COPD)患者肠内营养(EN)的使用提供循证建议。该指南由一个跨学科专家组按照官方认可的标准制定,基于1985年以来的所有相关出版物。它们在一次共识会议上进行了讨论并获得通过。当正常经口摄入量不足时,通过口服营养补充剂(ONS)或管饲(TF)进行肠内营养可维持或增加营养摄入。目前尚无关于肠内营养对CHF患者恶病质影响的数据。然而,基于生理合理性,建议采用肠内营养来阻止或扭转体重下降。在COPD患者中,肠内营养与运动及合成代谢药物治疗相结合有可能改善营养状况和功能。为避免餐后呼吸困难和饱腹感并提高依从性,建议频繁少量使用口服营养补充剂。