medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-35-56-72medalphabet-4135Research ArticleСтатьиПрограммы нутритивного обеспечения у пациентов в отделениях реанимацииNutritional support programs in intensive care units patientshttps://orcid.org/0000-0003-2843-8672СластниковЕ. Д.SlastnikovE. D.

Сластников Евгений Дмитриевич

Москва

Slastnikov Evgeny D.

Moscow

Slast08@yandex.ruhttps://orcid.org/0000-0003-4535-2563ВласенкоА. В.VlasenkoA. V.

Власенко Алексей Викторович

Москва

Vlasenko Alexey V.

Moscow

dr.vlasenko67@mail.ruЕвдокимовЕ. А.EvdokimovE. A.

Евдокимов Евгений Александрович

Москва

Evdokimov Evgeny A.

Moscow

ea_evdokimov@mail.ruhttps://orcid.org/0000-0002-5278-7058ШестопаловА. Е.ShestopalovA. E.

Шестопалов Александр Ефимович

Москва

Shestopalov Alexander E.

Moscow

ashest@yandex.ruhttps://orcid.org/0000-0002-3852-8877РодионовЕ. П.RodionovE. P.

Родионов Евгений Петрович

Москва

Rodionov Evgeny P.

Moscow

dr.rodionov@gmail.comhttps://orcid.org/0000-0002-5477-4242КорякинА. Г.KoryakinA. G.

Корякин Альберт Геннадьевич

Москва

Koryakin Albert G.

Moscow

koriakinalbert@gmail.comhttps://orcid.org/0000-0003-1050-0415КлюевИ. С.KlyuevI. S.

Клюев Иван Сергеевич

Москва

Klyuev Ivan S.

Moscow

ivan.kluev11@gmail.comhttps://orcid.org/0000-0002-7263-0058МаковейВ. И.MakoveyV. I.

Маковей Виктория Ивановна

Москва

Makovey Victoria I.

Moscow

nica-m-med@yandex.ruhttps://orcid.org/0000-0002-7320-3322ЕрофеевВ. В.ErofeevV. V.

Ерофеев Владимир Владимирович

Москва

Erofeev Vladimir V.

Moscow

ErofeevVV@rmapo.ruГБУЗ г. Москвы «Городская клиническая больница имени С. П. Боткина Департамента здравоохранения Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияBotkin City Hospital; Anesthesiology and Emergency Medicine Department of the Russian Medical Academy Continuing Professional EducationRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияAnesthesiology and Emergency Medicine Department of the Russian Medical Academy Continuing Professional EducationRussian Federation202423012025035Кардиология. Неотложная медицина (4)5672Copyright © Сластников Е.Д., Власенко А.В., Евдокимов Е.А., Шестопалов А.Е., Родионов Е.П., Корякин А.Г., Клюев И.С., Маковей В.И., Ерофеев В.В., 20252025Сластников Е.Д., Власенко А.В., Евдокимов Е.А., Шестопалов А.Е., Родионов Е.П., Корякин А.Г., Клюев И.С., Маковей В.И., Ерофеев В.В.Slastnikov E.D., Vlasenko A.V., Evdokimov E.A., Shestopalov A.E., Rodionov E.P., Koryakin A.G., Klyuev I.S., Makovey V.I., Erofeev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4135

Своевременная и адекватная нутритивная поддержка стоит в одном ряду по эффективности с этиотропной и патогенетической терапией, особенно у пациентов реанимационного профиля. Критическое состояние и системное воспаление любой этиологии ведут не только к первичному и вторичному повреждению органов и тканей, развитию полиорганной недостаточности (ПОН), но и запускают каскад реакций направленных на мобилизацию энергетических субстратов для поддержания гомеостаза и обеспечения регенерации. Это ведет к быстрому истощению эндогенных запасов макро- и микроэлементов и без должного восполнения развивается синдром метаболической дисфункции, который, в свою очередь, способствует прогрессированию ПОН, развитию гнойно-септических и метаболических осложнений, что увеличивает сроки госпитализации и фармакоэкономические затраты, ухудшает результаты лечения. В повседневной клинической практике при диагностике нутритивной недостаточности или риске ее развития, клиницист должен определить не только программу питания, но и формат ее реализации. В данной работе представлен критический анализ наиболее распространенных способов обеспечения питания и алгоритмы персонифицированного выбора нутритивной терапии у пациентов в отделениях реанимации.

Timely and adequate nutritional support is on a par with etiotropic and pathogenetic therapy in terms of effectiveness, especially in intensive care patients. Critical condition and systemic inflammation of any etiology lead not only to primary and secondary damage to organs and tissues, the development of multiple organ failure, but also trigger a cascade of reactions aimed at mobilizing energy substrates to maintain homeostasis and ensure regeneration. This leads to a rapid depletion of endogenous reserves of macro- and microelements and, without proper replenishment, a syndrome of metabolic dysfunction develops, which, in turn, contributes to the progression of multiple organ failure, the development of purulentseptic and metabolic complications, which increases the time of hospitalization and pharmacoeconomical costs, worsens the results of treatment. In everyday clinical practice, when diagnosing nutritional deficiency or the risk of its development, the clinician must determine not only the nutrition program, but also the format of its implementation. This paper presents a critical analysis of the most common ways of providing nutrition and algorithms for personalized choice of nutritional therapy in patients in intensive care units.

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The authors declare that there are no conflicts of interest present.