Ruiz-Santana S, Arboleda Sánchez J A, Abilés J
Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
Med Intensiva. 2011 Nov;35 Suppl 1:12-6. doi: 10.1016/S0210-5691(11)70003-1.
Current parameters to assess nutritional status in critically-ill patients are useful to evaluate nutritional status prior to admission to the intensive care unit. However, these parameters are of little utility once the patient's nutritional status has been altered by the acute process and its treatment. Changes in water distribution affect anthropometric variables and biochemical biomarkers, which in turn are affected by synthesis and degradation processes. Increased plasma levels of prealbumin and retinol -proteins with a short half-life- can indicate adequate response to nutritional support, while reduced levels of these proteins indicate further metabolic stress. The parameters used in functional assessment, such as those employed to assess muscular or immune function, are often altered by drugs or the presence of infection or polyneuropathy. However, some parameters can be used to monitor metabolic response and refeeding or can aid prognostic evaluation.
目前用于评估重症患者营养状况的参数，对于评估其进入重症监护病房之前的营养状况很有用。然而，一旦患者的营养状况因急性病程及其治疗而发生改变，这些参数的作用就很小了。水分布的变化会影响人体测量学变量和生化生物标志物，而这些又会受到合成和降解过程的影响。前白蛋白和视黄醇蛋白（半衰期短）的血浆水平升高可表明对营养支持有充分反应，而这些蛋白水平降低则表明存在进一步的代谢应激。功能评估中使用的参数，如用于评估肌肉或免疫功能的参数，常常会因药物、感染或多发性神经病的存在而发生改变。然而，一些参数可用于监测代谢反应和重新喂养，或有助于预后评估。
