ESPEN guidelines on enteral nutrition: Intensive care
ESPEN guidelines on enteral nutrition: Intensive care
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DOI：
10.1016/j.clnu.2006.01.021
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发表时间：
2006-04-01
影响因子：
6.3
通讯作者：
Spies, C.
中科院分区：
文献类型：
--
作者：
Kreymann, K. G.;Berger, M. M.;Spies, C.
通过管饲的肠内营养（EN）是目前喂养危重M患者的首选方式，也是对抗严重疾病引起的分解代谢状态的重要手段。这些指南旨在为ICU住院期间病程复杂的患者使用EN提供循证建议，特别关注那些发生严重炎症反应的患者，即在ICU住院期间至少有一个器官衰竭的患者。这些指南是由一个跨学科专家小组根据官方认可的标准制定的，并基于所有相关的自1985年以来出版。他们在一次共识会议上讨论并接受了这些建议。EN应该给予所有预计三天内不能完全口服饮食的ICU患者。它应该在第一个24小时内开始使用标准的高蛋白配方。在危重病的急性和初始阶段，应避免超过20-25 kcal/kg BW/天的外源性能量供应，而在恢复期间，目标应是提供25-30 kcal/ kg BW/天的总能量值。补充性肠外营养仍然是一种后备措施，只应给予那些EN不能达到目标营养摄入量的患者。对于严重疾病或脓毒症且APACHE II评分>15的患者，没有免疫调节配方的一般适应症。谷氨酰胺应补充患者遭受烧伤或创伤。这篇文章的完整版本可在www.espen.org。（C）2006年欧洲临床营养和代谢学会。All rights reserved.
Enteral nutrition (EN) via tube feeding is, today, the preferred way of feeding the critically M patient and an important means of counteracting for the catabolic state induced by severe diseases. These guidelines are intended to give evidence-based recommendations for the use of EN in patients who have a complicated course during their ICU stay, focusing particularly on those who develop a severe inflammatory response, i.e. patients who have failure of at least one organ during their ICU stay.These guidelines were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publications since 1985. They were discussed and accepted in a consensus conference.EN should be given to all ICU patients who are not expected to be taking a full oral diet within three days. It should have begun during the first 24h using a standard high-protein formula. During the acute and initial phases of critical illness an exogenous energy supply in excess of 20-25 kcal/kg BW/day should be avoided, whereas, during recovery, the aim should be to provide values of 25-30 total kcal/ kg BW/day. Supplementary parenteral nutrition remains a reserve toot and should be given only to those patients who do not reach their target nutrient intake on EN atone.There is no general indication for immune-modulating formulae in patients with severe illness or sepsis and an APACHE II Score >15. Glutamine should be supplemented in patients suffering from burns or trauma.The full version of this article is available at www.espen.org. (C) 2006 European Society for Clinical Nutrition and Metabolism. All rights reserved.