Quinn T, Askanazi J
College of Physicians and Surgeons, Columbia University, New York, New York.
Crit Care Clin. 1987 Jan;3(1):167-84.
The relationship between undernutrition and cardiac dysfunction in the critically ill patient is cyclical and reinforcing. Increased awareness of the high coincidence of these two problems in the ICU should improve both diagnosis and treatment. Acutely, nutritional goals often must be limited to optimizing metabolic machinery. Repletion of protein and calorie deficiencies, which requires additional fluid loads, should be approached with caution. The potential hazards associated with alimentation necessitate careful monitoring during repletion, and although restoration of an anabolic state may improve myocardial function, this is unproved. In spite of this, the advantages conferred by a generally improved nutritional state are great, particularly for patients in the perioperative period. Therefore, alimentation with the intention of restoring lean body mass seems a worthwhile goal.
危重症患者中营养不良与心脏功能障碍之间的关系是循环且相互强化的。对重症监护病房（ICU）中这两个问题高重合度的认识提高，应有助于改善诊断和治疗。在急性期，营养目标通常必须局限于优化代谢机制。补充蛋白质和热量缺乏时需谨慎，因为这需要额外的液体负荷。营养支持相关的潜在风险要求在补充过程中进行仔细监测，尽管恢复合成代谢状态可能改善心肌功能，但这尚未得到证实。尽管如此，整体营养状态改善所带来的益处是巨大的，尤其是对围手术期患者而言。因此，旨在恢复瘦体重的营养支持似乎是一个值得追求的目标。
