Onichimowski Dariusz, Goraj Radosław, Jalali Rakesh, Grabala Jolanta, Mayzner-Zawadzka Ewa, Czuczwar Mirosław
Chair of Anaesthesiology and Intensive Care, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland.
Anaesthesiol Intensive Ther. 2017;49(4):309-316. doi: 10.5603/AIT.a2017.0052. Epub 2017 Oct 13.
Continuous renal replacement therapy (CRRT) in critically ill patients has significant impact on one's ability to provide efficient nutritional therapy. CRRT may help in the prevention of intestinal oedema and the maintenance of the proper function of the gastrointestinal tract by enabling strict control of the fluid balance. It facilitates early introduction of nutrition via the enteral route, as well as allowing for the composition of high-volume feeding mixtures. It is necessary to take into consideration that during CRRT, together with blood purification of toxic substances, nutritive elements are also eliminated to some extent (micro- and macronutrients). In this article, the authors discuss the impact of CRRT on nutritive elements loss, energetic balance and present the principles of adjusting feeding prescriptions to changes implied by CRRT.
连续性肾脏替代治疗（CRRT）对危重症患者有效进行营养治疗的能力有重大影响。CRRT通过严格控制液体平衡，有助于预防肠道水肿并维持胃肠道的正常功能。它有利于通过肠内途径早期引入营养，也允许配制高容量喂养混合物。必须考虑到，在CRRT期间，在血液净化有毒物质的同时，营养成分（微量和常量营养素）也会在一定程度上被清除。在本文中，作者讨论了CRRT对营养成分损失、能量平衡的影响，并提出了根据CRRT所带来的变化调整喂养处方的原则。
