An Xiang, Liu Yun, Zhu Lizhen
Department of Medicine, Zhongshan People's Hospital, Zhongshan City, Guangdong Province, People's Republic of China.
Int J Gen Med. 2025 Aug 12;18:4437-4444. doi: 10.2147/IJGM.S535478. eCollection 2025.
Enteral nutrition remains the standard approach for nutritional support in critically ill patients, with established benefits for immune function and recovery. Intermittent fasting, a dietary strategy characterized by extended fasting intervals, has emerged as a potential adjunctive therapy. IF may induce beneficial metabolic responses such as autophagy activation and ketogenesis, contributing to improved glucose regulation, reduced intestinal permeability, modulation of gut microbiota, enhanced insulin sensitivity, and preservation of muscle mass. Unlike prolonged fasting, IF elicits these effects without causing sustained caloric deprivation. This review summarizes the current evidence regarding the physiological mechanisms, implementation strategies, clinical outcomes, and safety considerations of IF in the intensive care setting to provide a theoretical basis for further validation of the safety efficacy of the intermittent fasting paradigm for use in the ICU.
肠内营养仍然是重症患者营养支持的标准方法，对免疫功能和康复具有既定的益处。间歇性禁食是一种以延长禁食间隔为特征的饮食策略，已成为一种潜在的辅助治疗方法。间歇性禁食可能会诱导有益的代谢反应，如自噬激活和生酮作用，有助于改善血糖调节、降低肠道通透性、调节肠道微生物群、增强胰岛素敏感性以及维持肌肉质量。与长期禁食不同，间歇性禁食在不导致持续热量剥夺的情况下引发这些效应。本综述总结了关于间歇性禁食在重症监护环境中的生理机制、实施策略、临床结果和安全考虑因素的现有证据，为进一步验证间歇性禁食模式在重症监护病房使用的安全性和有效性提供理论依据。
