Blesa Malpica A L, García de Lorenzo y Mateos A, Robles González A
Hospital Clínico San Carlos, Madrid, España.
Med Intensiva. 2011 Nov;35 Suppl 1:68-71. doi: 10.1016/S0210-5691(11)70014-6.
Patients with polytrauma can be viewed as paradigmatic of the critically-ill patient. These previously healthy patients undergo a life-threatening aggression leading to an organic response that is no different from that in other types of patients. The profile of trauma patients has changed and currently corresponds to patients who are somewhat older, with a higher body mass index and greater comorbidity. Severe injuries lead to intense metabolic stress, posing a risk of malnutrition. Therefore, early nutritional support, preferentially through the enteral route, with appropriate protein intake and glutamine supplementation, provides advantages over other routes and types of nutritional formula. To avoid overnutrition, reduced daily calorie intake can be considered in obese patients and in those with medullary lesions. However, little information on this topic is available in patients with medullary lesions.
多发伤患者可被视为危重症患者的典型代表。这些既往健康的患者遭受危及生命的侵害，引发的机体反应与其他类型患者并无不同。创伤患者的特征已发生变化，目前多为年龄稍大、体重指数较高且合并症较多的患者。严重损伤会导致强烈的代谢应激，存在营养不良的风险。因此，早期营养支持，优先通过肠内途径，保证适当的蛋白质摄入并补充谷氨酰胺，相较于其他途径和类型的营养配方具有优势。为避免营养过剩，肥胖患者和脊髓损伤患者可考虑减少每日热量摄入。然而，关于脊髓损伤患者这一主题的信息较少。
