营养支持在危重病人身体和功能康复中的作用:综述

R. R. Gubajdullin, V. Kulakov, A. Yakovleva, M. Petrova, A. Shestopalov
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引用次数: 0

摘要

就长期结果而言,在危重疾病期间营养的作用一直存在争议。即使考虑到无法充分评估与营养有关的所有生物学机制,也应该认识到,现有的随机试验,即危重疾病早期阶段的营养支持,如果与其他治疗分开考虑,可能具有非常有限的长期功能价值。本文综述了最近的临床研究,并评估了关键营养对长期身体和功能恢复的影响。危重生存正日益成为人们关注的重要课题。未来关于营养支持的研究应该考虑具体的因素,这些因素可以在身体和功能恢复方面提供可测量的益处。这些因素包括制定战略以确保充分的营养干预,在生物学上有可能观察到评估结果的差异的一段时间内提供营养,以及选择适当的方法来评估在临床重要时间点记录的结果。其中一项结果是对肌肉质量和功能以及生活质量的评估。此外,选择最有可能从营养干预和从ICU转移后的营养研究中受益的患者值得特别注意。
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THE ROLE OF NUTRITIVE SUPPORT IN THE PHYSICAL AND FUNCTIONAL REHABILITATION OF CRITICAL PATIENTS: OVERVIEW
There is ongoing debate about the role of nutrition during critical illness in terms of long-term outcomes. Even taking into account the inability to adequately assess all biological mechanisms associated with nutrition, it should be recognized that the available randomized trials, nutritional support during the early phase of critical illness, when considered in isolation from other treatment, may have very limited long-term functional value. This review focuses on recent clinical studies and evaluating the impact of critical nutrition on long-term physical and functional recovery. Critical survival is becoming an increasingly important subject of attention. Future research on nutritional support should consider specific factors that can provide measurable benefits in terms of both physical and functional recovery. These factors include the development of strategies to ensure adequate nutritional interventions, the provision of nutrition for a period of time in which biologically it is possible to observe differences in the results assessed, and the selection of appropriate methods of assessing the results recorded at clinically significant time points. One of these results is an assessment of muscle mass and function, as well as quality of life. In addition, selection of patients who are most likely to benefit from nutritional interventions and nutritional research after transfer from ICU deserves special attention.
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