crrt时营养支持的特殊要求.pdf

CRRT时营养支持的特殊要求 浙江省中医院ICU 江荣林 正常机体营养需求 • 正常人体需要的营养素 碳水化合物、脂肪、蛋白质、水、电解质、微量元素和 维生素 • 机体能量储备及消耗 糖和脂肪 蛋白质不应作为能源 正常人体营养需求 营养素 需要量 比例 备注 碳水化合物 2.5-5g/kg/d 50-60% 1g=4kcal (＜7g/kg/d) 脂肪 1.0-1.5g/kg/d 40-50% 1g=9kcal (＜2g/kg/d) 蛋白质 0.8-1.0g/kg/d 热: 氮 1g 氮=6.25g蛋白质 （必要时可以2g/kg/d） =100-150:1 蛋白质含氮量16% 水 30-40ml/kg/d 电解质 K:3-5g,Na:6-12g,Ga:1000mg,Mg:350mg,P:700mg 微量元素与维 铁,锌,硒,铜, 氟,铬,锰,钼; 生素 9种水溶性维生素；4种脂溶性维生素 This diagram shows a CVVHD system with blood leaving the patient traveling through the tubing circuit to the hemodialysis filter. Maursetter L et al. Nutr Clin Pract 2011;26:382-390 This diagram shows a CVVH or CVVHF system with blood leaving the patient traveling through the tubing circuit to the hemodialysis filter. Maursetter L et al. Nutr Clin Pract 2011;26:382-390 This diagram shows a CVVHDF system with blood leaving the patient traveling through the tubing circuit to the hemodialysis filter. Maursetter L et al. Nutr Clin Pract 2011;26:382-390 Diagram of an intact hemodialysis filter and when cut open to reveal the semi-permeable membranes contained within the outside plastic housing. Maursetter L et al. Nutr Clin Pract 2011;26:382-390 Diffusion occurs within the dialysis filter when molecules move from an area of high concentration gradient to an area of low concentration across a semi-permeable membrane. Maursetter L et al. Nutr Clin Pract 2011;26:382-390 Convection occurs when fluid is forced across a semi-permeable membr