University of Michigan Hospitals and Health Centers, Pharmacy Services, UHB2D301, 1500 E. Med. Center Drive, Ann Arbor, MI 48109-0008, USA.
Nutr Clin Pract. 2010 Feb;25(1):32-49. doi: 10.1177/0884533609357565.
Critically ill patients who are subjected to high stress or with severe injury can rapidly break down their body protein and energy stores. Unless adequate nutrition is provided, malnutrition and protein wasting may occur, which can negatively affect patient outcome. Enteral nutrition (EN) is the mainstay of nutrition support therapy in patients with a functional gastrointestinal (GI) tract who cannot take adequate oral nutrition. EN in critically ill patients provides the benefits of maintaining gut functionality, integrity, and immunity as well as decreasing infectious complications. However, the ability to provide timely and adequate EN to critically ill patients is often hindered by GI motility disorders and complications associated with EN. This paper reviews the GI complications and intolerances associated with EN in critically ill patients and provides recommendations for their prevention and treatment. It also addresses the role of commonly used medications in the intensive care unit and their impact on GI motility and EN delivery.
危重症患者如果承受高强度压力或遭受严重损伤，其体内的蛋白质和能量储备会迅速被消耗殆尽。如果不能提供充足的营养，患者可能会发生营养不良和蛋白质流失，从而对患者的预后产生负面影响。对于存在胃肠道（GI）功能障碍而无法摄入足够经口营养的患者，肠内营养（EN）是营养支持治疗的主要方法。EN 可为危重症患者带来诸多益处，包括维持肠道功能、完整性和免疫力，降低感染性并发症的风险。然而，危重症患者往往因胃肠道动力障碍和与 EN 相关的并发症而无法及时、充分地接受 EN。本文回顾了与危重症患者 EN 相关的胃肠道并发症和不耐受情况，并就其预防和治疗提供了相关建议。此外，本文还探讨了 ICU 中常用药物的作用及其对胃肠道动力和 EN 输送的影响。
