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危重病

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危重症的肠内营养
原作者: Feras Khan,李辉翻译,肖锋校对 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2015-02-28

Title: Enteral Nutrition in Critical Care

题目:危重症的肠内营养

Author 作者: Feras Khan

翻译:李辉 校对:肖锋

 

Background

背景

• Artificial nutrition is a staple of critical care

• 人工营养是危重病的一个主题

• Patients who are unable to eat, require enteral nutrition (preferred over parental nutrition)

• 不能进食的患者需要肠内营养(优于肠外营养)

• There are some formulas that are called "immunonutrition" which try to alter the inflammatory response seen in critical illness

• 有一些被称作“免疫营养”的配方试图尝试改变危重病的炎症反应

• They may contain omega-3 fatty acids and essential amino acids such as arginine or glutamine, and anti-oxidants.

• 这些配方含有ω-3脂肪酸和必须氨基酸,比如精氨酸或谷氨酸,以及抗氧化剂。

Data

数据

1 A recent trial (MetaPlus) was designed to see if immunonutrition could decrease the development of infections in the critically ill

一个最近设计的试验(MetaPlus)观察免疫营养是否能减少危重病患者的感染发生率。

2 Compared to regular high protein formulas, there was no difference in mortality, duration of ventilation, or hospital length of stay

与常规的高蛋白配方相比,免疫营养在死亡率,通气时间和住院时间没有差异。

What to do

做什么

• Immuno-nutrition formulas cannot be routinely recommended

• 不要常规使用免疫营养配方

• Use regular high protein formulas

• 使用常规的高蛋白配方

• Start within 48 hours of identifying a need

• 应在发现需要肠内营养48小时内开始

References 参考文献:

Arthur R. H. van Zanten,, et al.

High-Protein Enteral Nutrition Enriched With Immune-Modulating Nutrients vs Standard High-Protein Enteral Nutrition and Nosocomial Infections in the ICU:A Randomized Clinical Trial[J]. JAMA. 2014;312(5):514-524. doi:10.1001/jama.2014.7698.

http://jama.jamanetwork.com/article.aspx?articleid=1892247
 

文章来源:《中华急诊医学杂志》编辑部