Allaparthi Saisnigdha, Bode Amanda, Bury Christan, Vest Amanda R
Tufts University School of Medicine, Boston, MA, USA.
Cleveland Clinic, Cleveland, OH, USA.
Curr Cardiol Rep. 2025 Apr 4;27(1):79. doi: 10.1007/s11886-025-02208-9.
Many critical care clinicians are unfamiliar with management principals or recent studies that guide nutritional optimization of patients in the cardiac intensive care unit (CICU). The goal of this review is to describe the prevalence of malnutrition in the CICU, the frameworks for malnutrition diagnosis and assessment of skeletal muscle wasting, and the potential clinical consequences of improper feeding practices.
Malnutrition is common and has been linked to poor outcomes across various CICU patient populations. Several nutritional randomized controlled trials have refined best practices around the timing of enteral nutrition and the selection of protein intake targets in the intensive care setting. A hypocaloric, rather than normocaloric, feeding regimen usually preferred during the early phase of critical illness, and it is important to await adequate gut perfusion before uptitrating enteral feeds. There is an evolving evidence base that defines current practice in CICU nutritional management, albeit with multiple knowledge gaps warranting further study.
许多重症监护临床医生不熟悉指导心脏重症监护病房（CICU）患者营养优化的管理原则或近期研究。本综述的目的是描述CICU中营养不良的患病率、营养不良诊断和骨骼肌消耗评估的框架，以及不当喂养方式的潜在临床后果。
营养不良很常见，并且与各种CICU患者群体的不良预后相关。多项营养随机对照试验完善了重症监护环境下肠内营养时机和蛋白质摄入目标选择的最佳实践。在危重症早期通常更倾向于采用低热量而非正常热量的喂养方案，并且在增加肠内喂养量之前等待足够的肠道灌注很重要。虽然存在多个需要进一步研究的知识空白，但目前已有不断发展的证据基础来界定CICU营养管理的现行做法。
