Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
JPEN J Parenter Enteral Nutr. 2023 Sep;47(7):859-865. doi: 10.1002/jpen.2539. Epub 2023 Jul 15.
The landmark NUTRIREA-2 and NUTRIREA-3 trials compared the route and dose of nutrition, respectively, in critically ill patients with circulatory shock. The results of both trials support a "less-is-more" paradigm shift in the early acute phase of critical illness. In this review, the authors outline and appraise the results of the NUTRIREA-2 and NUTRIREA-3 trials, introduce the concept of identifying the "sweet spot" for nutrition dose based on severity of illness/nutrition risk and nutrition dose, and identify the unintended consequences of delivering full-dose nutrition in sicker critically ill patients during the early acute phase of critical illness.
里程碑式的 NUTRIREA-2 和 NUTRIREA-3 试验分别比较了循环性休克重症患者的营养途径和剂量。这两项试验的结果均支持在重症疾病的早期急性阶段实现“少即是多”的范式转变。在这篇综述中，作者概述并评估了 NUTRIREA-2 和 NUTRIREA-3 试验的结果，介绍了根据疾病严重程度/营养风险和营养剂量确定营养剂量“最佳点”的概念，并确定了在重症疾病的早期急性阶段给病情较重的重症患者提供全剂量营养的意外后果。
