The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review
- 作者: Bear D.1,2, Wandrag L.1, Merriweather J.3,4, Connolly B.1,2,5, Hart N.2,1, Grocott M.6,7,8
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隶属关系:
- Guy’s and St Thomas’ NHS Foundation Trust
- King’s College London
- University of Edinburgh
- Royal Infirmary of Edinburgh
- The University of Melbourne
- University of Southampton
- Southampton NIHR Biomedical Research Centre
- University Hospital Southampton NHS Foundation Trust
- 期: 卷 2, 编号 3 (2021)
- 页面: 157-172
- 栏目: Reviews
- URL: https://journals.rcsi.science/2658-4433/article/view/96169
- DOI: https://doi.org/10.17816/clinutr96169
- ID: 96169
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详细
Randomized controlled trials addressing the role of nutrition during long-term recovery from critical illness, including other outcomes, have not shown clear benefits, leading to significant controversy on the topic. Although methodological caveats with failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.
This narrative review focuses on recent clinical trials, evaluating the impact of nutrition on long-term physical and functional recovery from critical illness, with specific emphasis on the details of trial design and methodological limitations. Such limitations include delivery of caloric and protein targets, patient heterogeneity, short duration of intervention, inappropriate clinical outcomes, and disregard for baseline nutritional status and intake in the post-ICU period. With survival at the forefront of critical care research, it is imperative that nutrition studies carefully consider biological mechanisms and trial design, which strongly influence long-term physical and functional outcomes among others. Failure to do so may lead to inconclusive clinical trials and consequent rejection of the potential benefits of nutrition interventions during critical illness.
This article is the legal Russian-language translation from the original publication of Bear D.E. et al. “The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review” in Critical Care [2017;21(1):226. doi: 10.1186/s13054-017-1810-2] with the permission of the copyright holders.
作者简介
Danielle Bear
Guy’s and St Thomas’ NHS Foundation Trust; King’s College London
Email: cnm@eco-vector.com
Department of Nutrition and Dietetics, Department of Critical Care, Division of Asthma, Allergy, and Lung Biology, National Institute for Health Research (NIHR), Biomedical Research Centre, Lane Fox Clinical Respiratory Physiology Research Centre
英国, London; LondonLiesl Wandrag
Guy’s and St Thomas’ NHS Foundation Trust
Email: cnm@eco-vector.com
Department of Nutrition and Dietetics, Department of Critical Care
英国, LondonJudith Merriweather
University of Edinburgh; Royal Infirmary of Edinburgh
Email: cnm@eco-vector.com
Anaesthesia, Critical Care and Pain Medicine
英国, Edinburgh; EdinburghBronwen Connolly
Guy’s and St Thomas’ NHS Foundation Trust; King’s College London; The University of Melbourne
编辑信件的主要联系方式.
Email: cnm@eco-vector.com
National Institute for Health Research (NIHR), Biomedical Research Centre, Lane Fox Clinical Respiratory Physiology Research Centre, Centre for Human and Aerospace Physiological Sciences, Department of Physiotherapy
英国, London; London; Melbourne, VIC, AustraliaNicholas Hart
King’s College London; Guy’s and St Thomas’ NHS Foundation Trust
Email: cnm@eco-vector.com
Division of Asthma, Allergy, and Lung Biology, National Institute for Health Research (NIHR), Biomedical Research Centre, Lane Fox Clinical Respiratory Physiology Research Centre
英国, London; LondonMichael Grocott
University of Southampton; Southampton NIHR Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust
Email: cnm@eco-vector.com
Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Respiratory and Critical Care Research Theme, Anaesthesia and Critical Care Research Unit
英国, Southampton; Southampton; Southampton参考
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