Flordelís Lasierra J L, Pérez-Vela J L, Montejo González J C
Servicio de Medicina Intensiva, Hospital Universitario Severo Ochoa, Leganés, Madrid, España.
Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
Med Intensiva. 2015 Jan-Feb;39(1):40-8. doi: 10.1016/j.medin.2014.04.002. Epub 2014 Jun 4.
The benefit of enteral nutrition in critically ill patients has been demonstrated by several studies, especially when it is started early, in the first 24-48h of stay in the Intensive Care Unit, and this practice is currently advised by the main clinical guidelines. The start of enteral nutrition is controversial in patients with hemodynamic failure, since it may trigger intestinal ischemia. However, there are data from experimental studies in animals, as well as from observational studies in humans that allow for hypotheses regarding its beneficial effect and safety. Interventional clinical trials are needed to confirm these findings.
多项研究已证实肠内营养对危重症患者有益,尤其是在入住重症监护病房的最初24 - 48小时内尽早开始肠内营养,目前这一做法已被主要临床指南所推荐。对于血流动力学衰竭的患者,肠内营养的启动存在争议,因为它可能引发肠道缺血。然而,动物实验研究以及人体观察性研究的数据为其有益效果和安全性提供了假设依据。需要进行干预性临床试验来证实这些发现。