Intravenous Lipids in Adult Intensive Care Unit Patients
Intravenous Lipids in Adult Intensive Care Unit Patients
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DOI：
10.1159/000365667
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发表时间：
2015-01-01
期刊：
影响因子：
--
通讯作者：
Mayer, Konstantin
中科院分区：
文献类型：
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作者：
Hecker, Matthias;Mayer, Konstantin
重症监护病房（ICU）中重症患者营养不良是一种普遍现象。脂质乳剂 (LE) 能够提供足够的热量支持和必需脂肪酸，以纠正能量不足并改善结果。此外，LE 的成分可能会影响 ICU 环境中的细胞和器官功能。目前所有可供肠外使用的 LE 都能有效提供能量并具有良好的安全性。然而，以大豆油为基础的 LE 与不良后果风险升高有关，这可能是由于其 omega-6 脂肪酸含量较高。更多新开发的乳剂用中链甘油三酯、鱼油或橄榄油以各种组合部分替代大豆油，以减少其对免疫功能和炎症的负面影响。大多数实验研究和小型临床试验为这些现代 LE 对危重患者的有益影响提供了初步证据。然而，需要大型、精心设计的临床试验来评估哪种 LE 在临床结果方面具有最大优势。脂质乳剂 (LE) 是一种强大的能量来源，可以帮助调整重症监护病房 (ICU) 患者的热量不足。 LEs具有多种生物活性，但其对危重患者的后续影响有待进一步研究。 (C) 2015 S. Karger AG，巴塞尔
Malnutrition of critically ill patients is a widespread phenomenon in intensive care units (ICUs) worldwide. Lipid emulsions (LEs) are able to provide sufficient caloric support and essential fatty acids to correct the energy deficit and improve outcome. Furthermore, components of LEs might impact cell and organ function in an ICU setting. All currently available LEs for parenteral use are effective in providing energy and possess a good safety profile. Nevertheless, soybean oil-based LEs have been associated with an elevated risk of adverse outcomes, possibly due to their high content of omega-6 fatty acids. More newly developed emulsions partially replace soybean oil with medium-chain triglycerides, fish oil or olive oil in various combinations to reduce its negative effects on immune function and inflammation. The majority of experimental studies and smaller clinical trials provide initial evidence for a beneficial impact of these modern LEs on critically ill patients. However, large, well-designed clinical trials are needed to evaluate which LE offers the greatest advantages concerning clinical outcome. Lipid emulsions (LEs) are a powerful source of energy that can help to adjust the caloric deficit of intensive care unit (ICU) patients. LEs possess various biological activities, but their subsequent impact on critically ill patients awaits further investigations. (C) 2015 S. Karger AG, Basel