Wang Tsae-Jyy, Wu Shu-Fang Vivienne, Liang Shu Yuan, Tung Heng-Hsin, Lin Yu-Ping
Department of Nursing, National Taipei University of Nursing and Health Sciences, ROC.
Hu Li Za Zhi. 2012 Aug;59(4):18-23. doi: 10.6224/JN.59.3.18.
Nutritional support provides critically ill patients with energy and nutrients required to face the demands of their illness and stress. For those unable to ingest orally, enteral feeding rather than parenteral feeding is recommended, as the former better preserves gut integrity, reduces risk of infection, and costs less. Early enteral feeding in critically ill patients is also associated with decreased disease severity, reduced complications, and shortened length of stay. Risks associated with enteral feeding include aspiration, diarrhea, vomiting, hyponatremia, and hyperglycemia. This article reviews current knowledge on enteral feeding and addresses correct feeding tube placement, proper feeding sites, assessing and managing gastric residual volume, and preventing feeding tube occultation. We also review information related to identifying and controlling risk factors for enteral feeding complications such as aspiration, diarrhea, vomiting, hyponatremia, and hyperglycemia. Nurses can use this information to provide high quality care for enteral feeding patients and develop institutional protocols, guidelines, and standards of care for such patients in intensive care units.
营养支持为重症患者提供应对疾病和应激需求所需的能量和营养。对于无法经口摄入的患者，建议采用肠内营养而非肠外营养，因为前者能更好地维持肠道完整性、降低感染风险且成本更低。重症患者早期肠内营养还与疾病严重程度降低、并发症减少及住院时间缩短相关。肠内营养相关风险包括误吸、腹泻、呕吐、低钠血症和高血糖。本文综述了关于肠内营养的现有知识，并探讨了正确的饲管放置、合适的喂养部位、评估和管理胃残余量以及预防饲管堵塞。我们还综述了与识别和控制肠内营养并发症（如误吸、腹泻、呕吐、低钠血症和高血糖）风险因素相关的信息。护士可利用这些信息为接受肠内营养的患者提供高质量护理，并制定重症监护病房此类患者的机构规程、指南和护理标准。
