重症监护中的蛋白质递送——近期试验向我们展示了什么？

Protein Delivery in Critical Care- What Have Recent Trials Shown Us?

作者信息

Paulus Michelle Carmen, van Zanten Arthur Raymond Hubert

机构信息

Department of Intensive Care Medicine & Research, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands; Division of Human Nutrition and Health, Nutritional Biology, Wageningen University & Research, HELIX (Building 124), Stippeneng 4, 6708 WE Wageningen, The Netherlands.

出版信息

Crit Care Clin. 2025 Apr;41(2):233-246. doi: 10.1016/j.ccc.2024.09.003. Epub 2024 Oct 15.

DOI:10.1016/j.ccc.2024.09.003

PMID:40021277

Abstract

Determining the optimal protein intake for intensive care unit (ICU) and post-ICU patients is a multifaceted challenge. Firstly, it is essential to avoid both underdosing (<1.0 g/kg) and overdosing (>1.6 g/kg) of actual protein intake. Secondly, the actual protein intake may deviate from the prescribed amount. Thirdly, phenotyping and endotyping are becoming increasingly crucial in tailoring protein targets. Additionally, a gradual increase in protein intake is essential during the first 4 to 5 days of ICU stay. Furthermore, no established protein targets exist for post-ICU patients, indicating the need for nutritional intervention research to identify optimal protein intake strategies.

摘要

确定重症监护病房（ICU）患者及ICU后患者的最佳蛋白质摄入量是一项多方面的挑战。首先，必须避免实际蛋白质摄入量不足（<1.0克/千克）和过量（>1.6克/千克）。其次，实际蛋白质摄入量可能与规定量存在偏差。第三，在确定蛋白质目标时，表型分析和内型分析变得越来越关键。此外，在入住ICU的前4至5天内，逐渐增加蛋白质摄入量至关重要。此外，对于ICU后患者，尚无既定的蛋白质目标，这表明需要进行营养干预研究以确定最佳蛋白质摄入策略。