INTENSIVIST Volume 11, Issue 2 (April 2019)

How to administer the three macronutrients for critically ill patients Yoshifumi KUBOTA 1 , Masamitsu SANUI 1 1Department of Anesthesiology and Critical Care Medicine Jichi Medical University Saitama Medical Center pp.257-271
Published Date 2019/4/1
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The administration of macronutrients to critically ill patients has not been fully studied. Protein administration has been studied most. Based on the results of previous studies, the recommended amount of protein is 1.3-1.7g/kg/day. This target is preferably reached within 4 to 6 days after admission to an intensive care unit. Efficacy of larger amounts of protein is being studied in a large randomized controlled trial. As for the type of formula, an oligomeric or elemental formula with peptides or amino acids has been used to improve gastrointestinal tolerance, but the effects have not been determined.

Few studies have investigated the effects of non-glucose carbohydrates, such as xylitol, fructose, isomaltose, and dextrin, to prevent hyperglycemia and blood glucose variability. Pure soybean oil-based lipid emulsion, the only intravenous formula available in Japan, may enhance the inflammation process in critically ill patients, and therefore, administration of this emulsion within 7 days is to be avoided. It is not clear when to initiate administration of the lipid emulsion.

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11巻2号 (2019年4月)
電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル