Lord L M, Sax H C
AACN Clin Issues Crit Care Nurs. 1994 Nov;5(4):450-8. doi: 10.1097/00044067-199405040-00005.
The gastrointestinal tract is a major immunologic organ that must be maximally supported during critical illness. Gastrointestinal tissues require direct contact with nutrients to support their own rapid cellular turnover rate and carry out the multitude of metabolic and immunologic functions needed for successful adaptation to stress. Disruption in the ecologic equilibrium of the gastrointestinal tract often occurs during critical illness and the therapies provided. Problems encountered include stress ulcers, intestinal ischemia, bacterial overgrowth, aspiration pneumonia, bacterial translocation, sepsis, and the systemic inflammatory response syndrome. Early enteral nutrition has been shown to be a viable, economic, and physiologically beneficial way to support the gastrointestinal tract during critical illness. The fortification of enteral formulas with glutamine, arginine, or fiber is being studied to determine each one's unique role in the gut and immunologic changes that occur with severe stress.
胃肠道是一个主要的免疫器官，在危重病期间必须得到最大程度的支持。胃肠道组织需要与营养物质直接接触，以维持自身快速的细胞更新率，并执行成功适应应激所需的众多代谢和免疫功能。在危重病期间以及所提供的治疗过程中，胃肠道的生态平衡常常会被打破。出现的问题包括应激性溃疡、肠道缺血、细菌过度生长、吸入性肺炎、细菌移位、败血症以及全身炎症反应综合征。早期肠内营养已被证明是在危重病期间支持胃肠道的一种可行、经济且生理上有益的方法。目前正在研究用谷氨酰胺、精氨酸或纤维强化肠内配方食品，以确定它们各自在肠道以及严重应激时发生的免疫变化中的独特作用。
