危重症病人血流动力学不稳定时的早期肠内营养支持

Early enteral nutrition support in hemodynamically unstable patients of critical illness

早期肠内营养(EEN)支持给危重症病人带来诸多确切益处的同时也带来相关并发症的风险,对血流动力学不稳定,需血管活性药物提供支持的危重症病人给予EEN支持一直颇具争议。以下将围绕危重症病人的EEN支持、血管活性药物对病人胃肠道血流及灌注变化的影响,并介绍有关血管活性药物对EEN所致的风险,以及影响危重症病人血流动力学不稳定时EEN支持安全性的可能因素。

Early enteral nutrition support brings critical ill patients definite benefits as well as elevated risks of related complications.There is always a wide debate about early enteral nutrition support in hemodynamically unstable patients who need vasoactive agents.This review will summary the influence of early enteral nutrition support and vasoactive agents on gastrointestinal blood flow and perfusion of critical ill patients,introduce some reports of complications about the patients that receive enteral nutrition support and vasoactive agents at the same time and analysis some factors which may determine the safety of early enteral nutrition support in hemodynamically unstable patients.