2022年医学专题—欧洲ESPEN关于危重症患者的肠内营养指南(1).pptVIP免费

ESPENGuidelinesonEnteralNutrition:Intensivecare程俊峰程俊峰普外科普外科第一页，共二十一页。GeriatricsLiverdiseaseSurgeryincludingorgantransplantationWastinginHIVandotherchronicinfectiousdiseasesAdultrenalfailureGastroenterologyPancreasCardiologyandpulmonologyNon-surgicaloncologyIntensivecareGuidelinesonEGuidelinesonPN:N:GeriatricssurgerysurgeryardiologyandpneumologyAdultrenalfailureAdultrenalfailureGastroenterologyGastroenterologyPancreasPancreashomeparenteralnutrition(HPN)inadultpatients第二页，共二十一页。SummaryEnteralnutrition(EN)的定义及目的：1、ENisthepreferredwayoffeedingthecriticallyillpatientandcounteractingforthecatabolicstateinducedbyseverediseases.2、Intendedtogiveevidence-basedrecommendationsfortheICUpatient,focusingparticularlyonthosewhodevelopasevereinflammatoryresponse,i.e.patientswhohavefailureofatleastoneorganduringtheirICUstay.EN的时机(shíjī)及要求：1、ENshouldbegiventoallICUpatientswhoarenotexpectedtobetakingafulloraldietwithinthreedays.2、thefirst24husingastandardhigh-proteinformula.theacuteandinitialphases≤20–25kcal/kg/d（exogenousenergy）.Recovery,25–30kcal/kg/d.3、Glutamineshouldbesupplementedinpatientssufferingfromburnsortrauma.第三页，共二十一页。SubjectSubjectRecommendationsGradeGradeindicationindicationAllpatientswhoarenotexpectedtobeonafulloraldietwithin3daysCCApplicationTherearenodatasupportusingearlyENcanimprovetheirPrognosis，butthecommitteestillrecommendtheearly（<24h）appropriateamountoffeeding,oncethepatienthaveahaemo-dynamicallystableandafunctioninggastrointestinaltract.CCExogenousenergysupply:theacuteandinitialphase:≥25kcal/kg/dlessfavourableRecovery：≥25kcal/kg/dCCsevereunder-nutrition：theENenergysupplyshouldupto25kcal/kg/d，ifnotreached，pleaseaddPNCCIfthepatientintolerance(suchashighgastricresiduals)toEN,metoclopramide（胃复安）orErythromycin（红霉素）shouldbeconsidered.CCRouteRouteUseENinpatientswhocanbefedviatheenteralroute.CCViajejunalversusgastricfeeding,thereisnosignificantdifference.CCIfthepatientstolerate...