par Preiser, Jean-Charles 
;Fraipont, Vincent;Lheureux, Olivier
Référence Nutrition clinique et métabolisme
Publication Publié, 2019-11-01
;Fraipont, Vincent;Lheureux, Olivier Référence Nutrition clinique et métabolisme
Publication Publié, 2019-11-01
Article révisé par les pairs
| Résumé : | Following the findings of deleterious effects of excessive nutritional support during the acute phase of critical illness, the concept of “baby stomach” was introduced to characterize the restricted ability to use macro-nutrients and to inhibit the endogenous glucose production. The clinical practice guidelines evolved in parallel. “Permissive underfeeding”, e.g. caloric and nitrogen intakes lower than energy expenditure and protein losses during the acute phase are now recommended by the scientific societies. Progressive caloric intakes reaching a maximum of 70 % of energy expenditure during the first 3–7 days after injury are proposed. The underlying pathophysiological mechanisms of the deleterious effects of excessive nutritional intakes are partially elucidated and include overfeeding, the inhibition of autophagy and refeeding hypophosphatemia. The data from the available clinical studies trigger a number of basic and clinical research, whose answers are definitely needed to further improve the nutritional management of the critically ill patients. |
