Veech R L
Am J Clin Nutr. 1986 Oct;44(4):519-51. doi: 10.1093/ajcn/44.4.519.
The prescribing of parenteral fluids has become so routine that most physicians have become oblivious to the toxic impact of current practices on the cellular metabolism of their patients. Few physicians recognize the iatrogenic threat of replacement of body fluids based solely on concepts of volumetric and caloric need. Understanding the metabolic and ionic organization of cells can provide the physician means to use parenteral fluids to control the inherent metabolic energy of cells. Application of new insight into physical chemistry and metabolic properties of the cell can enhance the physician's therapy of the critically ill patient.
胃肠外补液的处方已变得如此常规,以至于大多数医生都忽略了当前做法对患者细胞代谢的毒性影响。很少有医生认识到仅基于容量和热量需求概念进行体液替代所带来的医源性威胁。了解细胞的代谢和离子组成可为医生提供利用胃肠外补液来控制细胞内在代谢能量的方法。将对细胞物理化学和代谢特性的新认识应用于临床,可提高医生对重症患者的治疗水平。