赵 琴 1 许美霞 2
1.湖北医药学院研究生院;2.武汉市第四医院重症医学科
摘要(Abstract):
重症医学是现代医学的一个关键领域。在重症状态下,患者的营养需求显著增加,因此合理的营养支持对于促进康复和改善预后具有重要的作用。近年来,随着对重症患者生理状态的深入探讨,营养支持的有效性和安全性逐渐成为临床研究和实践的关注重点。然而,目前在营养支持的实施过程中依然面临许多挑战,包括个体化营养方案的制定、营养评估方法的标准化以及不同重症病人群体的适应性等问题。本文旨在回顾当前重症医学领域中营养支持的研究成果,分析临床实践中的主要障碍,并展望未来可 能出现的技术与方法上的创新,为进一步优化重症患者的营养管理提供参考。
关键词(KeyWords):
重症医学;营养支持;临床实践;未来趋势;研究成果
参考文献(References):
[1]Raina R,Sethi S K,Soundararajan A ,et al.A survey on nutritional management of critically ill children on continuous renal replacement therapy[J].Nutrition, 2023, 111(000):4.
[2]Ardie S W ,Nugroho R B ,Dirpan A ,et al.Foxtail millet research in supporting climate change resilience efforts: Bibliometric analysis and focused literature review[J].Heliyon, 2025, 11(3).
[3]Wall R J .Nutritional Support in the ICU[J].Critical Care Alert, 2013.
[4] Glenys J ,Elaine M ,D D M , et al.Putting nutrition education on the table: development of a curriculum to meet future doctors' needs.[J].The British journal of nutrition,2022,129 (6):1-9.
[5] Dumitriu M A , Cobilinschi C , Dumitriu B , et al.Advancing Nutritional Care Through Bioelectrical Impedance Analysis in Critical Patients[J].Nutrients,2025,17(3):380-380.
[6] M. H A , M. Y A .Nutrition support for critically ill patients[J].Journal of Parenteral and Enteral Nutrition,2021,45 (S2):47-59.
[7]Zhang H ,Zhao L ,Jia B .Research progress on nutritional support in the neonatal and pediatric populations receiving extracorporeal membrane oxygenation[J].Frontiers in Nutrition, 2024,111370286-1370286.
[8] Carlos J D L ,Lluís G S ,Teodoro C G , et al.Factors associated with the need of parenteral nutrition in critically ill patients after the initiation of enteral nutrition therapy[J]. Frontiers in Nutrition,2023,101250305-1250305.
[9] Stoppe C ,Hill A ,Christopher B K , et al.Toward Precision in Nutrition Therapy.[J].Critical care medicine,2024.
[10] Chen W ,Song J ,Gong S .Advances in nutritional metabolic therapy to impede the progression of critical illness [J].Frontiers in Nutrition,2024,111416910-1416910. [11] Kittrell D H ,Shaikh A ,Adintori A P , et al.Role of artificial intelligence in critical care nutrition support and research. [J].Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition,2024,39 (5):1069-1080.
[12] Christian S , Robert G V , Joop J , et al.First international meeting of early career investigators: Current opportunities , challenges and horizon in critical care nutrition research [ J ] .Clinical Nutrition ESPEN , 2020 , 40 (prepublish):92-100. [13]Fatemeh R ,Effat S ,Sadat S A ,et al.Clinical nutrition approach in medical management of COVID-19 hospitalized patients: A narrative review.[J]. Nutrition and health, 2022, 28 (3):2601060221101696-2601060221101696.
[14]Braga J S D ,Mello G T ,Viviane M B ,et al.Impact of Nutrition on the Prevention and Treatment of Pressure Injuries in Critically Ill Patients: An Integrative Review[J].Advances in Skin & Wound Care,2022,35(10):566-572.
[15]Fidelis U ,A O O ,Opeyemi T ,et al.Enteral Nutrition Versus Parenteral Nutrition on Outcomes in Acute Pancreatitis: Insights From the Nationwide Inpatient Sample.[J].Cureus,2023, 15(9):e44957-e44957.
[16] Martin H ,Petter G ,Marius L Y , et al.Nutritional support for critically ill patients in the intensive care unit. [J].Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke,2020,140(2).
[17]R R L ,W C .[The nutritional management in the early rehabilitation for critically ill patients][. J].Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases,2022,45(9):845-848.
[18] McCully K , Extance A .Malnutrition incidence in individuals with body-mass index >25 kg/m2 on admission to intensive care[J].Journal of the Intensive Care Society,2024,25 (1):107-108.
[19]Lyons G , Summers M , Marshall A ,et al.Systematic review of clinicians' knowledge , attitudes , and beliefs about nutrition in intensive care.[J].Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2021
[20]Youquan W ,Yanhua L ,Yuting L ,et al.Enteral feeding strategies in patients with acute gastrointestinal injury: From limited to progressive to open feeding[. J].Nutrition(Burbank,Los Angeles County, Calif.),2023,117112255-112255.
[21] L C M ,C N ,M S , et al.Refeeding Syndrome in the Critically Ill: a Literature Review and Clinician's Guide.[J].Current gastroenterology reports,2019,21(11):58. [22] Im M K ,Kim Y E .Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective , Single-Labeled , Randomized Controlled Trial[J].Nutrients,2023,15(21):4684-.
[23] Marshall P A ,Ridley J E ,Chapple S A L .Engaging family members in nutrition care during recovery from critical illness.[J].Current opinion in clinical nutrition and metabolic care, 2024.
[24] Stefan B ,Johannes K ,Ørnstrup M K .Reproductive health of the sow during puerperium[. J]. Molecular reproduction and development, 2022, 90(7):561-579.
[25]Nina K ,Montserrat F ,Fiona K ,et al.Nutritional trials using high protein strategies and long duration of support show strongest clinical effects on mortality.: Results of an updated systematic review and meta-analysis[J].Clinical Nutrition ESPEN, 2021,4545-54.
[26] Cardiac Critical Care Medicine Of China Internationgnal Exchange And Promotion For Medical And Healthcare,Nutrition Support Expert Committee Of Chinese Cardiac Critical Care Medicine.Chinese consensus guideline for nutrition support therapy in the perioperative period of adult cardiac surgery in 2019 [J].Zhonghua wei zhong bing ji jiu yi xue,2019,31(7):801-810.
[27]H. D H ,Berger M M .Reprint of: Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States [J].Journal of the Academy of Nutrition and Dietetics,2022,122 (10S):S55-S66.
[28] Anwer M ,Wei Q M .Harnessing the power of probiotic strains in functional foods: nutritive , therapeutic , and next-generation challenges[J].Food Science and Biotechnology, 2024,33(9):2081-2095.
[29] Berber V , Marion G , Emilia V , et al.The immune-supportive diet in allergy management. A narrative review and proposal.[J].Allergy,2023,78(6).
[30]Aguilera M J .Food matrices as delivery units of nutrients in processed foods[. J].Journal of food science,2025,90(2):e70049.
[31]Choukri M ,Laamrani A ,Chehbouni A .Use of Optical and Radar Imagery for Crop Type Classification in Africa: A Review [J].Sensors,2024,24(11):3618-.