Fitzsimmons L, Hadley S A
Crit Care Nurs Q. 1995 Feb;17(4):79-90. doi: 10.1097/00002727-199502000-00013.
The nutritional management of the critically ill metabolically stressed patient has changed drastically within the last two decades. Alterations in carbohydrate, fat, and protein metabolism following severe injury affect effective substrate utilization and the provision of nutritional or metabolic support. This article describes the acute alterations in carbohydrate, fat, and protein metabolism during severe metabolic stress; reviews nutritional assessment and requirements during metabolic stress; and presents recent findings that influence nutritional support during metabolic stress. The role of gut in the provision of nutritional support and the pharmacologic properties of select enteral nutrients are reviewed.
在过去二十年中，危重症且处于代谢应激状态患者的营养管理发生了巨大变化。严重损伤后碳水化合物、脂肪和蛋白质代谢的改变会影响有效底物利用以及营养或代谢支持的提供。本文描述了严重代谢应激期间碳水化合物、脂肪和蛋白质代谢的急性改变；回顾了代谢应激期间的营养评估和需求；并介绍了影响代谢应激期间营养支持的最新研究结果。还综述了肠道在提供营养支持中的作用以及某些肠内营养物质的药理学特性。
