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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (08) : 652 -656. doi: 10.3877/cma.j.issn.1674-0785.2020.08.014

所属专题: 文献

综述

重症新型冠状病毒肺炎的营养治疗
冀海斌1, 王蕾1, 陈强谱1,(), 王涛2   
  1. 1. 256603 山东滨州,滨州医学院附属医院临床营养科、临床营养支持中心,山东省临床营养与代谢重点实验室
    2. 256603 山东滨州,滨州医学院附属医院重症医学科
  • 收稿日期:2020-02-29 出版日期:2020-08-15
  • 通信作者: 陈强谱

Nutritional treatment of severe novel coronavirus pneumonia

Haibin Ji1, Lei Wang1, Qiangpu Chen1,(), Tao Wang2   

  1. 1. Department of Clinical Nutrition, Clinical Nutrition Support Center, Binzhou Medical University; Clinical Nutrition and Metabolism Key Laboratory of Shandong Province, Binzhou 256603, China
    2. Intensive Care Unit, Binzhou Medical University, Binzhou 256603, China
  • Received:2020-02-29 Published:2020-08-15
  • Corresponding author: Qiangpu Chen
  • About author:
    Corresponding author: Chen Qiangpu, Email:
引用本文:

冀海斌, 王蕾, 陈强谱, 王涛. 重症新型冠状病毒肺炎的营养治疗[J]. 中华临床医师杂志(电子版), 2020, 14(08): 652-656.

Haibin Ji, Lei Wang, Qiangpu Chen, Tao Wang. Nutritional treatment of severe novel coronavirus pneumonia[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(08): 652-656.

新型冠状病毒肺炎(COVID-19)是一种新型呼吸系统疾病。重症患者可累及全身多个器官,目前无特效治疗药物,以综合治疗为主。营养治疗是重症COVID-19基础治疗手段之一。本文综述和讨论了重症COVID-19的代谢特点、营养风险筛查与评估方法、各种营养素的供给、营养实施方案的选择以及肠道微生态平衡的维护等方面的问题,为临床合理的实施营养治疗提供参考。

Novel coronavirus pneumonia (COVID-19) is a newly emerging respiratory disease. Severe COVID-19 patients may have multiple organs involved. At present, there are few effective therapies for this disease, and the treatment is mainly based on comprehensive measures. Nutritional therapy is one of the basic treatments for COVID-19. This article describes the metabolic characteristics, screening and assessment methods of nutritional risks, supply of various nutrients, selection of nutritional implementation plans, and maintenance of intestinal microecological balance in patients with severe COVID-19, with an aim to provide reference for the rational implementation of nutritional therapy.

1
World Health Organization. Coronavirus disease 2019 (COVID-19) situation report [EB/OL]. (2020-04-06)

URL    
2
国家卫生健康委办公厅. 新型冠状病毒肺炎诊疗方案(试行第六版) [J/CD]. 临床指南汇编数据库, 2020, 2(1): e2.
3
中国疾病预防控制中心新型冠状病毒肺炎应急响应机制流行病学组. 新型冠状病毒肺炎流行病学特征分析 [J]. 中华流行病学杂志, 2020, 41(2): 145-151.
4
刘娇, 陈尔真, 王洪亮, 等. 重症新型冠状病毒肺炎患者营养支持治疗的专家建议 [J/OL]. 中华重症医学电子杂志, 2020, 6(00): E013-E013.
5
Faisy C, Guerot E, Diehl JL, et al. Assessment of resting energy expenditure in mechanically ventilated patients [J]. Am J Clin Nutr, 2003, 78(2): 241-249.
6
van Gassel RJJ, Baggerman MR, van de Poll MCG. Metabolic aspects of muscle wasting during critical illness [J]. Curr Opin Clin Nutr Metab Care, 2020, 23(2): 96-101.
7
田佳. 早期营养支持联合谷氨酰胺和低分子肝素对老年重症肺炎患者的疗效研究 [J]. 重庆医学, 2016, 45(19): 2648-2651.
8
Jonker R, Deutz NE, Erbland ML, et al. Alterations in whole-body arginine metabolism in chronic obstructive pulmonary disease [J]. Am J Clin Nutr, 2016, 103(6): 1458-1464.
9
Oliveira GP, de Abreu MG, Pelosi P, et al. Exogenous glutamine in respiratory diseases: myth or reality? [J]. Nutrients, 2016, 8(2): 76.
10
Alsumrain MH, Jawad SA, Imran NB, et al. Association of hypophosphatemia with failure-to-wean from mechanical ventilation [J]. Ann Clin Lab Sci, 2010, 40(2): 144-148.
11
Zhao Y, Li Z, Shi Y, et al. Effect of hypophosphatemia on the withdrawal of mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease [J]. Biomed Rep, 2016, 4(4): 413-416.
12
Koekkoek WA, van Zanten AR. Antioxidant vitamins and trace elements in critical illness [J]. Nutr Clin Pract, 2016, 31(4): 457-474.
13
中华医学会肠外肠内营养学分会. 新型冠状病毒肺炎重症患者的肠内肠外营养治疗专家建议 [J]. 中华医学杂志, 2020, 100(00): E009-E009.
14
国家卫生健康委办公厅. 新型冠状病毒肺炎重型、危重型病例诊疗方案(试行第二版)[EB/OL]. (2020-02-14)

URL    
15
陈强谱, 傅廷亮, 欧琨, 等. 人体组成的活体测量技术及评价 [J]. 生物医学工程学杂志, 2007, 24(4): 954-958.
16
杜妍妍, 魏强, 陈强谱. B型超声在测量机体瘦体组织含量中的应用 [J].中华临床营养杂志, 2016, 24(5): 316-320.
17
Nakanishi N, Oto J, Tsutsumi R, et al. Upper and lower limb muscle atrophy in critically ill patients: an observational ultrasonography study [J]. Intensive Care Med, 2018, 44(2): 263-264.
18
Misirlioglu TO, Ozyemisci Taskiran O. Reliability of sonographic muscle thickness measurements of the thenar and hypothenar muscles [J]. Muscle Nerve, 2018, 57(1): E14-E17.
19
Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit [J]. Clin Nutr, 2019, 38(1): 48-79.
20
Taylor BE, McClave SA, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN) [J]. Crit Care Med, 2016, 44(2): 390-438.
21
Tatucu-Babet OA, Ridley EJ, Tierney AC. Prevalence of underprescription or overprescription of energy needs in critically ill mechanically ventilated adults as determined by indirect calorimetry: a systematic literature review [J]. JPEN J Parenter Enteral Nutr, 2016, 40(2): 212-225.
22
Lambell KJ, Tatucu-Babet OA, Chapple LA, et al. Nutrition therapy in critical illness: a review of the literature for clinicians [J]. Crit Care, 2020, 24(1): 35.
23
Leyderman I, Yaroshetskiy A, Klek S. Protein requirements in critical illness: Do we really know why to give so much? [J]. JPEN J Parenter Enteral Nutr, 2020 Feb 11. Online ahead of print.
24
Vesterlund GK, Thomsen T, Moller MH, et al. Effects of magnesium, phosphate and zinc supplementation in ICU patients-Protocol for a systematic review [J]. Acta Anaesthesiol Scand, 2020, 64(1): 131-136.
25
Wang Y, Lin H, Lin BW, et al. Effects of different ascorbic acid doses on the mortality of critically ill patients: a meta-analysis [J]. Ann Intensive Care, 2019, 9(1): 58.
26
Thickett DR, Moromizato T, Litonjua AA, et al. Association between prehospital vitamin D status and incident acute respiratory failure in critically ill patients: a retrospective cohort study [J]. BMJ Open Respir Res, 2015, 2(1): e000074.
27
张长习, 陈强谱, 张兴元. 免疫肠内营养的临床应用及评价 [J/CD]. 中华临床医师杂志(电子版), 2011, 5(12): 3417-3420.
28
Singer P, Theilla M, Fisher H, et al. Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury [J]. Crit Care Med, 2006, 34(4): 1033-1038.
29
Naghibi T, Shafigh N, Mazloomzadeh S. Role of omega-3 fatty acids in the prevention of delirium in mechanically ventilated patients [J]. J Res Med Sci, 2020, 25: 10.
30
Dushianthan A, Cusack R, Burgess VA, et al. Immunonutrition for adults with ARDS: Results from a cochrane systematic review and meta-analysis [J]. Respir Care, 2020, 65(1): 99-110.
31
郑春辉, 周希环, 陈强谱. 肠内营养置管途径及选择 [J/CD]. 中华临床医师杂志(电子版), 2012, 6(1): 13-16.
32
Alkhawaja S, Martin C, Butler RJ, et al. Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults [J]. Cochrane Database Syst Rev, 2015(8): CD008875.
33
孙仁华, 江荣林, 黄曼, 等. 重症患者早期肠内营养临床实践专家共识 [J]. 中华危重病急救医学, 2018, 30(8): 715-721.
34
Stuever MF, Kidner RF, Chae FE, et al. Full nutrition or not? [J]. Nutr Clin Pract, 2018, 33(3): 333-338.
35
张小亚, 杨小娟, 张振祺, 等. 基于16SrDNA测序技术分析重症肺炎患者肠道菌群的变化 [J] .中华危重病急救医学, 2019, 31(12): 1479-1484.
36
Yin Y, Hountras P, Wunderink RG. The microbiome in mechanically ventilated patients [J]. Curr Opin Infect Dis, 2017, 30(2): 208-213.
37
Schorghuber M, Fruhwald S. Effects of enteral nutrition on gastrointestinal function in patients who are critically ill [J]. Lancet Gastroenterol Hepatol, 2018, 3(4): 281-287.
38
Shimizu K, Ogura H, Kabata D, et al. Association of prophylactic synbiotics with reduction in diarrhea and pneumonia in mechanically ventilated critically ill patients: a propensity score analysis [J]. J Infect Chemother, 2018, 24(10): 795-801.
39
Pirrone M, Pinciroli R, Berra L. Microbiome, biofilms, and pneumonia in the ICU [J]. Curr Opin Infect Dis, 2016, 29(2): 160-166.
40
Mahmoodpoor A, Hamishehkar H, Asghari R, et al. Effect of a probiotic preparation on ventilator-associated pneumonia in critically ill patients admitted to the intensive care unit: a prospective double-blind randomized controlled trial [J]. Nutr Clin Pract, 2019, 34(1): 156-162.
41
Davison JM, Wischmeyer PE. Probiotic and synbiotic therapy in the critically ill: State of the art [J]. Nutrition, 2019, 59: 29-36.
42
Hempel S, Newberry SJ, Maher AR, et al. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis [J]. JAMA, 2012, 307(18): 1959-1969.
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