关键词: 重症医学, 肠内营养, 急性胃肠道损伤, 胃肠超声, 喂养不耐受, 营养评估

Abstract: Difficulties and countermeasures in the implementation of enteral nutrition in Surgical critically ill patients                    MA Xiao-chun, DU Yu-rong, ZHU Ran. Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
Corresponding author: ZHU Ran,E-mai:18040097997@163.com
Abstract    Almost all surgeons recognize early enteral nutrition benefits surgical critically ill patients but it is still a huge challenge to provide a fulfilled early enteral nutrition to surgical critically ill patients. First, early risk prediction may help to reduce surgical injury to the gastrointestinal tract in surgical critically ill patients. Second, optimization of enteral nutrition with other critical care management may reduce iatrogenic injury, such as feeding-associated intestinal ischemia or perforation. Third, assessment of nutritional status, nutritional risks, and nutritional requirements should be appropriately applied before enteral nutrition. Assessment of gastrointestinal tract structure, perfusion, function, feeding intolerance, and nutritional effectiveness should be appropriately applied after enteral nutrition. Surgical critically ill patients are frequently complicated with acute gastrointestinal injury and feeding intolerance. Gastrointestinal ultrasound combined with other clinical parameters could help with a better assessment in critical care management and also in providing enteral nutrition, further improving clinical enteral nutrition effectiveness. Enteral nutrition is part of critical care management in surgical critically ill patients. A correct and renewed peri-intensive care management concept will make nutrition therapy improve the prognosis of surgical critically ill patients.

Key words: critical care medicine, enteral nutrition, acute gastrointestinal injury, gastrointestinal ultrasound, feeding intolerance, nutrition assessment