Nutrition therapy in non-intubated patients with acute respiratory failure: a narrative review.

Pierre Singer
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Abstract

Objectives: Non-invasive ventilation use is increasing in patients from acute respiratory failure. However, nutritional assessment and medical nutritional therapy are often missed and patients may be frequently underfed. This review evaluates the tools for nutritional screening and assessment, assesses the use of medical nutritional therapy in various techniques of non invasive ventilation and suggested tools to improve this therapy.

Methods, results: A review of the literature was performed to evaluate the tools available to define malnutrition and determine the energy needs of patients requiring non invasive ventilation. Energy and protein intake was assessed in 16 recent papers. High Flow Nasal Cannula Oxygen therapy and non invasive ventilation using mask were described and nutritional therapy determined in each condition.

The Global Leadership International Malnutrition Assessment seems to be the best assessment to be recommended. Energy expenditure is optimally obtained by indirect calorimetry. Patients with Non invasive ventilation are even more underfed than patients receiving High Flow Nasal Cannula Oxygen therapy.

Conclusions: A better determination of malnutrition, a more adequate energy requirement and an improved energy and protein administration are required in patients with acute respiratory failure treated with non invasive ventilation.

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非插管急性呼吸衰竭患者的营养治疗:综述。
目的:急性呼吸衰竭患者越来越多地使用无创通气。然而,营养评估和医学营养治疗经常被忽略,患者可能经常进食不足。本综述评估了营养筛查和评估的工具,评估了医学营养疗法在各种无创通气技术中的应用,并提出了改善这种疗法的建议:我们对文献进行了回顾,以评估用于定义营养不良和确定需要无创通气患者能量需求的工具。最近的 16 篇论文对能量和蛋白质摄入量进行了评估。对高流量鼻导管供氧疗法和使用面罩的无创通气疗法进行了描述,并确定了每种情况下的营养疗法。能量消耗最好通过间接热量测定法获得。与接受高流量鼻导管供氧治疗的患者相比,接受无创通气治疗的患者营养不良程度更高:结论:对于接受无创通气治疗的急性呼吸衰竭患者,需要更好地确定营养不良情况、更充足的能量需求以及更好的能量和蛋白质管理。
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