Heyland Daren K, Wischmeyer Paul E
Crit Care. 2013 Aug 27;17(4):324. doi: 10.1186/cc12701.
Recent studies challenge the beneficial role of artificial nutrition provided to critically ill patients and point out the limitations of existing studies in this area. We take a differing view of the existing data and refute many of the arguments put forward by previous authors. We review the mechanistic, observational, and experimental data supporting a role for early enteral nutrition in the critically ill patient. We conclude without question that more, high-quality research is needed to better define the role of artificial nutrition in the critical care setting, but until then early and adequate delivery of enteral nutrition is a legitimate, evidence-based treatment recommendation and we see no evidence-based role for restricting enteral nutrition in critically ill patients. The role of early supplemental parenteral nutrition continues to be defined as new data emerge.
近期研究对给予重症患者人工营养的益处提出了质疑,并指出了该领域现有研究的局限性。我们对现有数据持有不同观点,并反驳了先前作者提出的许多论点。我们回顾了支持早期肠内营养在重症患者中作用的机制、观察性和实验性数据。我们毫无疑问地得出结论,需要更多高质量的研究来更好地界定人工营养在重症监护环境中的作用,但在此之前,早期充分给予肠内营养是一项合理的、基于证据的治疗建议,而且我们没有看到有基于证据的理由限制重症患者的肠内营养。随着新数据的出现,早期补充肠外营养的作用仍在不断明确。