Rush University Medical Center, Chicago, Illinois 60612, USA.
Curr Opin Clin Nutr Metab Care. 2011 Mar;14(2):182-5. doi: 10.1097/MCO.0b013e3283428e65.
Malnutrition can lead to serious complications in the ICU. Less than half of patients admitted to ICU require ventilation and for many, their optimal route of feeding is oral medical nutrition therapy, rather than enteral or parenteral nutrition. Inadequate oral intake is a prevalent and often difficult problem within this population, as increased calorie deficits are common in the ICU and associated with worse outcomes.
Consuming less than 75% of daily calorie requirements in the hospital setting is associated with worse outcomes. Unfortunately, oral intake is often inadequate. Little is known about the consequences of inadequate oral intake in the ICU; however, data have described worse outcomes with large calorie deficits from enteral and parenteral nutrition. Whether or not these data can be extrapolated to patients in the ICU with poor oral intake remains uncertain.
Despite evidence-based guidelines directing the delivery of nutrition support in the ICU, there is limited research focused on oral intake during this time of hospitalization. Future research is needed to determine the long-term associations of inadequate versus adequate oral intake in the ICU.
营养不良可导致 ICU 患者出现严重并发症。入住 ICU 的患者中，不足半数需要通气治疗，而对于许多患者而言，其最佳的喂养途径是口服医学营养疗法，而非肠内或肠外营养。在这部分人群中，摄入不足是一个普遍且常常难以解决的问题，因为 ICU 中热量亏空较为常见，且与较差的预后相关。
在住院期间，每日热量摄入不足 75%与较差的预后相关。遗憾的是，口服摄入往往不足。关于 ICU 中摄入不足的后果知之甚少；然而，数据表明，肠内和肠外营养的热量亏空较大与较差的结局相关。这些数据是否可以外推至 ICU 中存在经口摄入不佳的患者，尚不确定。
尽管有循证指南指导 ICU 中营养支持的实施，但针对住院期间经口摄入的研究有限。需要开展未来的研究，以确定 ICU 中摄入不足与充足的经口摄入的长期关联。
