Nutrition in the intensive care unit 英文参考文献.docVIP

Review R67 Nutrition in the intensive care unit Charles Weissman Nutritional support has become a routine part of the care of the critically ill patient. It is an adjunctive therapy, the main goal of which is to attenuate the development of malnutrition, yet the effectiveness of nutritional support is often thwarted by an underlying hostile metabolic milieu. This requires that these metabolic changes be taken into consideration when designing nutritional regimens for such patients. There is also a need to conduct large, multi-center studies to acquire more knowledge of the cost–benefit and cost effectiveness of nutritional support in the critically ill. Address: Department of Anesthesiology and Critical Care Medicine, Hebrew University – Hadassah, School of Medicine, Jerusalem, Israel Correspondence: Charles Weissman, MD, Department of Anesthesiology, Hadassah University Hospital, Kiryat Hadassah, POB 12000, Jerusalem, Israel 91120. Tel: 011 972 2 677 7269; fax: 011 972 2 643 4434; e-mail: Charles@hadassah. org. il Keywords: enteral nutrition, glucose, intensive care, metabolism, parenteral nutrition Received: 19 August 1999 Accepted: 27 August 1999 Published: 17 September 1999 Crit Care 1999,3:R67–R75 The original version of this paper is the electronic version which can be seen on the Internet (). The electronic version may contain additional information to that appearing in the paper version. ? Current Science Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Introduction Glucose metabolism Nutritional support has become a routine part of the care of the critically ill patient. It is an adjunctive therapy, the main goal of which is to attenuate the development of malnutrition. The effectiveness of nutritional support is often stymied by an under- lying hostile metabolic milieu. The design of a nutritional support regimen must, therefore, take into consideration this disordered metabolic situation. Pathophysiology The metabolic response to stress is c