Miller Jerad P, Choban Patricia Smith
Mount Carmel Health System, 793 West State Street, Columbus, OH 43222, USA.
Respir Care Clin N Am. 2006 Dec;12(4):593-601. doi: 10.1016/j.rcc.2006.09.002.
Obesity and its many metabolic and physiologic comorbidities are becoming more common. Thus, a strategy to approach the nutritional needs of obese critically ill patients is warranted. The adverse effect of obesity on the respiratory system is well established. The obesity may be an inciting event or merely an additional burden in the obese critically ill patient. A strategy of hypocaloric nutrition support avoids the many detrimental effects of overfeeding and has been considered for all critically ill patients. In the obese patient, the strategy addresses the additional problem of the excessive fat store and has the additional benefit of fat reduction while sparing lean body mass. In the patient with normal renal and hepatic function, hypocaloric nutrition support simplifies care and may improve outcome.
肥胖及其多种代谢和生理合并症正变得越来越普遍。因此，制定一种满足肥胖重症患者营养需求的策略是必要的。肥胖对呼吸系统的不良影响已得到充分证实。肥胖可能是引发事件，也可能仅仅是肥胖重症患者的额外负担。低热卡营养支持策略可避免过度喂养的诸多有害影响，并且已被应用于所有重症患者。对于肥胖患者，该策略解决了脂肪储存过多的额外问题，还有减少脂肪同时保留瘦体重的额外益处。对于肾功能和肝功能正常的患者，低热卡营养支持简化了护理并可能改善预后。
