Cox Jill, Rasmussen Louisa
Jill Cox is an assistant professor of nursing at Rutgers University, Newark, New Jersey. She maintains a clinical practice as an advanced practice and certified wound, ostomy, and continence nurse at Englewood Hospital and Medical Center, Englewood, New Jersey.Louisa Rasmussen is the registered dietician for the critical care service at Englewood Hospital and Medical Center.
Crit Care Nurse. 2014 Dec;34(6):15-27; quiz 28. doi: 10.4037/ccn2014950.
Prevention and healing of pressure ulcers in critically ill patients can be especially challenging because of the patients' burden of illness and degree of physiological compromise. Providing adequate nutrition may help halt the development or worsening of pressure ulcers. Optimization of nutrition can be considered an essential ingredient in prevention and healing of pressure ulcers. Understanding malnutrition in critical care patients, the effect of nutrition on wound healing, and the application of evidence-based nutritional guidelines are important aspects for patients at high risk for pressure ulcers. Appropriate screenings for nutritional status and risk for pressure ulcers, early collaboration with a registered dietician, and administration of appropriate feeding formulations and micronutrient and macronutrient supplementation to promote wound healing are practical solutions to improve the nutritional status of critical care patients. Use of nutritional management and enteral feeding protocols may provide vital elements to augment nutrition and ultimately result in improved clinical outcomes.
由于重症患者的疾病负担和生理功能受损程度,预防和治疗其压疮可能极具挑战性。提供充足的营养有助于阻止压疮的发展或恶化。优化营养可被视为预防和治疗压疮的重要因素。了解重症监护患者的营养不良情况、营养对伤口愈合的影响以及循证营养指南的应用,是压疮高危患者的重要方面。对营养状况和压疮风险进行适当筛查、尽早与注册营养师合作,以及给予适当的喂养配方和微量营养素及宏量营养素补充剂以促进伤口愈合,是改善重症监护患者营养状况的切实可行的解决方案。使用营养管理和肠内喂养方案可能会提供重要元素以增强营养,最终改善临床结局。