Hecker M, Felbinger T W, Mayer K
Medizinische Klinik II (Pneumologie/internistische Intensivmedizin), Universitätsklinikum Gießen und Marburg, Standort Gießen, Klinikstr. 33, 35392, Gießen, Deutschland.
Med Klin Intensivmed Notfmed. 2013 Jun;108(5):379-83. doi: 10.1007/s00063-012-0199-6. Epub 2013 Jun 7.
Acute respiratory distress syndrome (ARDS) is characterized by the formation of a protein-rich alveolar edema caused by increased permeability of the alveolocapillary membrane. The key clinical feature is refractory arterial hypoxemia, which in severe cases necessitates the application of extracorporeal membrane oxygenation. Besides lung-protective ventilation as a confirmed therapeutic option, supportive therapy is an integral part of ARDS management. In this context, modern and individualized nutritional regimens are of special importance; however, their prognostic impact, especially of immunonutrition, for ARDS patients is controversial. In this review, basic features of nutrition in intensive care medicine and ARDS-specific aspects (e.g., immunonutrition) are presented and discussed.
急性呼吸窘迫综合征(ARDS)的特征是肺泡毛细血管膜通透性增加导致富含蛋白质的肺泡水肿形成。关键临床特征是难治性动脉低氧血症,在严重病例中需要应用体外膜肺氧合。除了肺保护性通气作为已证实的治疗选择外,支持治疗是ARDS管理的一个组成部分。在这种情况下,现代个体化营养方案尤为重要;然而,它们对ARDS患者的预后影响,尤其是免疫营养的影响,存在争议。在本综述中,将介绍并讨论重症医学中营养的基本特征以及ARDS的特定方面(如免疫营养)。