College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee.
Nutrition. 2019 Jan;57:24-31. doi: 10.1016/j.nut.2018.05.008. Epub 2018 Jun 7.
Adiposity-based chronic disease, critical illness, and nutrition therapy increase the risk for overfeeding and worsened nutritional and clinical outcomes. Hypocaloric, high-protein nutrition therapy provides critically ill obese patients the opportunity to achieve net protein anabolism with a reduced risk for overfeeding-related complications. The intent of this review is to discuss the impact of obesity on clinical outcomes, describe the consequences of obesity that increase complications associated with nutrition therapy, provide the framework to develop a hypocaloric, high-protein regimen, review the scientific evidence to support this mode of therapy, and discuss its limitations. Practical suggestions for patient monitoring are also provided.
肥胖相关性慢性病、危重症和营养治疗增加了过度喂养的风险，并导致营养和临床结局恶化。低热量、高蛋白营养治疗为肥胖危重症患者提供了实现净蛋白合成的机会，同时降低了与过度喂养相关并发症的风险。本文旨在讨论肥胖对临床结局的影响，描述肥胖增加与营养治疗相关并发症的后果，提供制定低热量、高蛋白方案的框架，回顾支持这种治疗模式的科学证据，并讨论其局限性。还提供了患者监测的实用建议。
