دانلود رایگان مقاله انگلیسی تغذیه و مراقبت های پس از عمل بعد از حاملگی - الزویر 2018

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عنوان فارسی

تغذیه و مراقبت های پس از عمل بعد از حاملگی

عنوان انگلیسی

Intensive Care Nutrition and Postintensive Care Recovery

صفحات مقاله فارسی

0

صفحات مقاله انگلیسی

11

سال انتشار

2018

نشریه

الزویر - Elsevier

فرمت مقاله انگلیسی

PDF

نوع مقاله

ISI

نوع نگارش

مقالات مروری

رفرنس

دارد

پایگاه

اسکوپوس

کد محصول

E9598

رشته های مرتبط با این مقاله

پزشکی

گرایش های مرتبط با این مقاله

علوم تغذیه

مجله

کلینیک های مراقبت های بحرانی - Critical Care Clinics

دانشگاه

Clinical Division and Laboratory of Intensive Care Medicine - Department of Cellular and Molecular Medicine - Belgium

کلمات کلیدی

بیماری بحرانی، تغذیه، تغذیه تزریقی، تغذیه روده ئی، ضعف ناشی از ICU، کاتابولیسم، بازیابی، خودخواری

doi یا شناسه دیجیتال

https://doi.org/10.1016/j.ccc.2018.06.004

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معرفی

INTRODUCTION

Intensive care unit (ICU)-acquired weakness is a devastating complication of critical illness. With time in ICU, the incidence increases and its presence is associated with increased short-term and long-term mortality.1,2 In ICU survivors, ICU-acquired weakness often does not recover completely, even years after ICU admission.3 Persistent ICU-acquired weakness is considered to be part of the postintensive care syndrome, which encompasses a spectrum of persistent physical, mental, and cognitive impairment seen in survivors of critical illness, especially after prolonged and/or severe critical illnesses.4 The mechanisms underlying ICU-acquired weakness are complex and involve structural and functional alterations in both muscles and nerves.5 Attained myofibers show signs of atrophy, which may be triggered by inflammation, immobilization, endocrine and metabolic alterations, impaired microcirculation, denervation, and certain drugs.5 Apart from that, relative starvation may also play a role. Indeed, a considerable number of patients have a nutritional deficit on ICU admission and/or cannot receive normal feeding. In healthy volunteers, prolonged underfeeding mimics the severe muscle atrophy as typically observed in prolonged critically ill patients. In these otherwise healthy people, this condition obviously can be reversed by giving nutrition.

خلاصه

SUMMARY

Despite the association of a nutritional deficit with poor outcome, recent large RCTs have not shown benefit of early full nutritional support. Two large studies showed harm by early supplementation of insufficient EN with PN with more infections, more ICU-acquired weakness, and a prolongation of organ failure, hereby prolonging ICU dependency. Likewise, early full EN delivered to patients with severe shock and glutamine administration to patients with multiple organ failure was found to be harmful. The harmful effect of early full nutritional support may at least partially be explained by feeding-induced suppression of autophagy. The ideal timing, dose, and composition of artificial nutrition remain unclear.

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