aDepartment of Intensive Care Medicine bDepartment of Nutrition and Dietetics, Internal Medicine, VU University Medical Center Amsterdam cDepartment of Nutrition and Dietetics, Amsterdam University of Applied Sciences dAmsterdam Public Health Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
Curr Opin Crit Care. 2017 Aug;23(4):279-283. doi: 10.1097/MCC.0000000000000425.
Protein delivery as well as exercise of critically ill in clinical practice is still a highly debated issue. Here we discuss only the most recent updates in the literature concerning protein nutrition and exercise of the critically ill.
By lack of randomized controlled trial (RCTs) in protein nutrition we discuss four post-hoc analyses of nutrition studies and one experimental study in mice. Studies mainly confirm some insights that protein and energy effects are separate and that the trajectory of the patient in the ICU might change these effects. Exercise has been studied much more extensively with RCTs in the last year, although also here the differences between patient groups and timing of intervention might play their roles. Overall the effects of protein nutrition and exercise appear to be beneficial. However, studies into the differential effects of protein nutrition and/or exercise, and optimization of their combined use, have not been performed yet and are on the research agenda.
Optimal protein nutrition, optimal exercise intervention as well as the optimal combination of nutrition, and exercise may help to improve long-term physical performance outcome in the critically ill patients.
在临床实践中，蛋白质输送以及危重症患者的运动仍然是一个备受争议的问题。在这里，我们仅讨论有关危重症患者蛋白质营养和运动的最新文献更新。
由于缺乏蛋白质营养的随机对照试验（RCT），我们讨论了四项营养研究的事后分析和一项小鼠实验研究。这些研究主要证实了一些观点，即蛋白质和能量的作用是分开的，而患者在重症监护病房（ICU）中的轨迹可能会改变这些作用。在过去的一年中，运动已经在 RCT 中得到了更广泛的研究，尽管在患者群体和干预时机方面的差异也可能起到了作用。总体而言，蛋白质营养和运动的效果似乎是有益的。然而，目前尚未进行关于蛋白质营养和/或运动的差异效应以及优化其联合使用的研究，这些研究仍在研究议程上。
最佳蛋白质营养、最佳运动干预以及营养和运动的最佳结合，可能有助于改善危重症患者的长期身体机能预后。
