NUTRITIONAL SUPPORT IN THE CRITICALLY ILL PATIENT

摘要: Among hospitalized patients, malnutrition has been associated with increased infectious morbidity, prolonged hospital stay, and mortality. 23,47,79,99 In critically ill may result in impaired immunological function, ventilatory drive, weakened respiratory muscles, leading to dependence morbidity 29 The metabolic response critical illness (or hypercatabolism) can lead severe wasting of the lean body mass, impairment visceral organ decrease repair immune functions. 8 Finally, beyond its digestive absorptive capacities, gastrointestinal tract is recognized for role barrier function. Several studies have documented that "bowel rest" a disruption mucosal structure augmenting inflammatory resulting greater morbidity. 13,30 Awareness these associations observations led practice providing nutritional support patients. Although many change outcomes (amino acid profile, weight gain, nitrogen balance, etc.), data are lacking demonstrate nutrition actually influences clinically important endpoints. purpose this article systematically review appraise literature examine relationship between mortality patient. Critical appraisal evidence allows us put forward clinical recommendations based on rules evidence. 80 Strong be made (i.e., Grade A recommendations) when supported by rigorous randomized trials, patient population, low chance error (level I evidence). Moderately strong (Grade B) from high risk II Weaker C) less or trials different populations focusing surrogate outcomes. no comes nonrandomized noncritically animal studies, biologic rationale. version levels grades outlined