Lipman T O
GI-Hepatology-Nutrition Section, Department of Veterans Affairs Medical Center, Washington, DC 20422, USA.
JPEN J Parenter Enteral Nutr. 1995 Mar-Apr;19(2):156-65. doi: 10.1177/0148607195019002156.
To assess the literature documenting the existence of bacterial translocation in humans, the effects of enteral nutrition on bacterial translocation in humans, and the hypothesis that enteral nutrition prevents bacterial translocation in humans.
Sources included Medline search, references from review articles, and references from animal and human studies.
The goal was to include all animal and human studies directly addressing questions of bacterial translocation and nutritional status or nutritional support.
An attempt was made to briefly summarize methodology and findings of relevent studies. No general attempt was made to assess quality of individual studies.
Bacterial translocation is a well documented phenomenon in animal models. Starvation and malnutrition of themselves do not induce bacterial translocation, but may facilitate translocation in the presence of other systemic insults. Parenteral nutrition and many forms of enteral nutrition may induce and/or facilitate bacterial translocation. Chow and certain fiber sources seem protective. Moderate direct and several lines of indirect evidence support the existence of bacterial translocation in humans. There is no direct evidence and questionable indirect evidence suggesting that enteral nutrition prevents or modifies bacterial translocation in humans.
The hypothesis relating enteral nutrition and bacterial translocation in critically ill patients remains attractive, but unproven.
评估关于人类细菌移位存在情况、肠内营养对人类细菌移位的影响以及肠内营养可预防人类细菌移位这一假说的文献。
来源包括医学文献数据库检索、综述文章参考文献以及动物和人体研究参考文献。
目标是纳入所有直接探讨细菌移位及营养状况或营养支持问题的动物和人体研究。
试图简要总结相关研究的方法和结果。未对个别研究的质量进行全面评估。
细菌移位在动物模型中是一个有充分文献记载的现象。饥饿和营养不良本身不会诱发细菌移位，但在存在其他全身性损伤时可能会促进移位。肠外营养和多种形式的肠内营养可能会诱发和/或促进细菌移位。普通食物和某些纤维来源似乎具有保护作用。适度的直接证据和多条间接证据支持人类中细菌移位的存在。没有直接证据且间接证据存疑，表明肠内营养可预防或改变人类的细菌移位。
关于重症患者肠内营养与细菌移位的假说仍然很有吸引力，但尚未得到证实。
