Hsu Chih-Chieh, Sun Ci-Yuan, Tsai Chun-Yi, Chen Ming-Yang, Wang Shang-Yu, Hsu Jun-Te, Yeh Chun-Nan, Yeh Ta-Sen
Division of General Surgery, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.
Division of Colon & Rectal Surgery, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.
J Multidiscip Healthc. 2021 May 14;14:1107-1117. doi: 10.2147/JMDH.S306350. eCollection 2021.
The clinical impact of nutrition therapy in critically ill patients has been known for years, and relevant guidelines regarding nutrition therapy have emphasized the importance of proteins. During critical illness, such as sepsis or the state following major surgery, major trauma, or major burn injury, patients suffer from a high degree of stress/inflammation, and during this time, metabolism deviates from homeostasis. The increased degradation of endogenous proteins in response to stress hormones is among the most important events in the acute phase of critical illness. Currently published evidence suggests that adequate protein supplementation might improve the clinical outcomes of critically ill patients. The role of sufficient protein supplementation may even surpass that of caloric supplementation. In this review, we focus on relevant physiological alterations in critical illness, the effects of critical illness on protein metabolism, nutrition therapy in clinical practice, and the function of specific amino acids.
营养治疗对重症患者的临床影响已为人所知多年，有关营养治疗的相关指南强调了蛋白质的重要性。在危重病期间，如脓毒症或大手术后、重大创伤或严重烧伤后的状态，患者会遭受高度应激/炎症，在此期间，新陈代谢偏离内稳态。对应激激素反应导致的内源性蛋白质降解增加是危重病急性期最重要的事件之一。目前发表的证据表明，充足的蛋白质补充可能改善重症患者的临床结局。充足蛋白质补充的作用甚至可能超过热量补充。在本综述中，我们重点关注危重病中的相关生理改变、危重病对蛋白质代谢的影响、临床实践中的营养治疗以及特定氨基酸的作用。
