Division of General Internal and Emergency Medicine, Medical University Department, Cantonal Hospital Aarau, Aarau.
University of Basel, Basel, Switzerland.
Curr Opin Clin Nutr Metab Care. 2023 Mar 1;26(2):138-145. doi: 10.1097/MCO.0000000000000894. Epub 2022 Nov 25.
ICU survivors often spend long periods of time in general wards following transfer from ICU in which they are still nutritionally compromised. This brief review will focus on the feeding of patients recovering from critical illness, as no formal recommendations or guidelines on nutrition management are available for this specific situation.
While feeding should start in the ICU, it is important to continue and adapt nutritional plans on the ward to support individuals recovering from critical illness. This process is highly complex - suboptimal feeding may contribute significantly to higher morbidity and mortality, and seriously hinder recovery from illness. Recently, consensus diagnostic criteria for malnutrition have been defined and large-scale trials have advanced our understanding of the pathophysiological pathways underlying malnutrition. They have also helped further develop treatment algorithms. However, we must continue to identify specific clinical parameters and blood biomarkers to further personalize therapy for malnourished patients. Better understanding of such factors may help us adapt nutritional plans more efficiently.
Adequate nutrition is a vigorous component of treatment in the post-ICU period and can enhance recovery and improve clinical outcome. To better personalize nutritional treatment because not every patient benefits from support in the same manner, it is important to further investigate biomarkers with a possible prognostic value.
重症监护病房(ICU)幸存者在转入普通病房后往往需要长时间康复,在此期间他们仍存在营养不足的问题。本综述将重点关注重症康复患者的喂养问题,因为目前尚无针对这种特殊情况的营养管理正式建议或指南。
尽管应在 ICU 开始喂养,但在病房中继续并调整营养计划以支持重症康复患者非常重要。这一过程非常复杂——喂养不足可能会显著增加发病率和死亡率,并严重阻碍疾病康复。最近,营养不良的共识诊断标准已经确定,大规模试验也加深了我们对营养不良相关病理生理途径的理解。它们还帮助进一步制定了治疗算法。然而,我们必须继续确定特定的临床参数和血液生物标志物,以进一步针对营养不良患者进行个体化治疗。更好地了解这些因素可能有助于我们更有效地调整营养计划。
在 ICU 后阶段,充足的营养是治疗的重要组成部分,可以促进康复并改善临床结局。为了更好地进行个体化营养治疗,因为并非每个患者都以相同的方式受益于支持,因此,进一步研究具有潜在预后价值的生物标志物非常重要。