脓毒症的营养治疗。
Nutrition Therapy in Sepsis.
机构信息
Department of Anesthesiology, Duke University School of Medicine, 2400 Pratt Street, Office: NP 7060, Durham, NC 27705, USA.
出版信息
Crit Care Clin. 2018 Jan;34(1):107-125. doi: 10.1016/j.ccc.2017.08.008. Epub 2017 Oct 13.
Abstract
Sepsis is characterized by early massive catabolism, lean body mass (LBM) loss, and escalating hypermetabolism persisting for months to years. Early enteral nutrition should attempt to correct micronutrient/vitamin deficiencies, deliver adequate protein and moderated nonprotein calories, as well-nourished patients can generate reasonable endogenous energy. After resuscitation, increasing protein/calories are needed to attenuate LBM loss and promote recovery. Malnutrition screening is essential, and parenteral nutrition can be safely added when enteral nutrition is failing based on preillness malnutrition. Following discharge from intensive care unit, significantly increased protein/calorie delivery is required for months to years to facilitate functional and LBM recovery.
摘要
脓毒症的特征是早期大量的分解代谢、瘦体重（LBM）丢失和持续数月至数年的代谢亢进。早期的肠内营养应试图纠正微量营养素/维生素缺乏，提供足够的蛋白质和适量的非蛋白热量，营养良好的患者可以产生合理的内源性能量。复苏后，需要增加蛋白质/热量来减少 LBM 丢失并促进恢复。营养不良筛查至关重要，根据患病前的营养不良情况，当肠内营养失败时，可以安全地添加肠外营养。从重症监护病房出院后，需要数月至数年的时间来增加蛋白质/热量的摄入，以促进功能和 LBM 的恢复。
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