实施体外膜肺氧合的成人患者营养支持研究进展

Research progress on nutrition support for audlt patients receiving extracorporeal membrane oxygenation

体外膜肺氧合(ECMO)是一种对心肺功能衰竭患者提供持续体外呼吸与循环支持的机械循环辅助技术,以纠正患者低氧血症,改善氧代谢,维持血流动力学稳定。实施ECMO患者病情严重,此时机体常处于高分解代谢状态,合理的营养支持能改善患者的营养状况,降低并发症的发生率。探究实施ECMO患者的营养支持特点,了解营养管理的措施对促进患者机体恢复有重要的临床意义。本文主要针对成人实施ECMO患者的营养风险筛查、早期肠内营养的安全性、肠内营养对炎性因子和胃肠激素的影响、肠外营养的使用以及营养需求量等进行综述,以期为实施ECMO患者的营养支持提供一定的依据。

Extracorporeal membrane oxygenation(ECMO)is a mechanical circulatory assisted technique that provides continuous extracorporeal respiration and circulatory support for patients with cardiopulmonary failure to correct hypoxemia,improve oxygen metabolism,and maintain hemodynamic stability.These patients are seriously ill,at this time,the body is often in a state of high catabolism,Reasonable nutritional support can improve the nutritional status of patients and reduce the incidence of complications.Exploring the characteristics of nutritional support and understanding the nutritional management measures of ECMO patients for promoting the body recovery of patients is of important clinical significance.This article reviews nutrition risk screening,the safety of early enteral nutrition,the influence of enteral nutrition on inflammatory factors and gastrointestinal hormones,the use of parenteral nutrition and nutrition requirements of adult ECMO patients,so as to provide evidence for nutritional support for ECMO patients.