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中华重症医学电子杂志 ›› 2022, Vol. 08 ›› Issue (04) : 321 -325. doi: 10.3877/cma.j.issn.2096-1537.2022.04.008

专题笔谈

危重症患者营养风险筛查:因病制宜,因人而异
杨晓1, 胡波1,()   
  1. 1. 430071 武汉,武汉大学中南医院重症医学科
  • 收稿日期:2022-11-08 出版日期:2022-11-28
  • 通信作者: 胡波

Nutritional risk screening among critically ill: tailored to "diseases" or "patients"

Xiao Yang1, Bo Hu1,()   

  1. 1. Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, China
  • Received:2022-11-08 Published:2022-11-28
  • Corresponding author: Bo Hu
引用本文:

杨晓, 胡波. 危重症患者营养风险筛查:因病制宜,因人而异[J]. 中华重症医学电子杂志, 2022, 08(04): 321-325.

Xiao Yang, Bo Hu. Nutritional risk screening among critically ill: tailored to "diseases" or "patients"[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(04): 321-325.

危重患者存在营养高风险,入住ICU后需要尽早进行营养风险筛查,以及时推进营养治疗并改善预后。但当前危重患者营养风险筛查存在评分系统众多,易与营养评定混淆等问题。基于此,本文旨在厘清危重患者营养风险筛查的内涵,并尝试根据不同危重患者特点,推荐合适的营养风险筛查工具:针对所有危重患者,推荐营养风险筛查量表2002(NRS 2002)和危重病营养风险评分(NUTRIC)/改良NUTRIC(mNUTRIC)作为首选营养风险筛查评分;对于老年危重患者,微型营养评定简表(MNA-SF)和老年营养风险指数(GNRI)可作为有效补充;而对于非老年高危围术期患者,可考虑将营养不良通用筛查工具(MUST)评分作为有效补充。因此,对于危重患者的营养风险筛查,应做到因病制宜,因人而异。

The critically ill are considered to be of high nutritional risk, and nutritional risk screening is recommended to be performed once the patients are admitted to the ICUs. This is to help advancing the nutritional treatment and to expect better prognosis. Currently, multiple nutritional risk screening or scoring systems are available, and are easy to be confused with nutritional assessment systems. Therefore, we aim to clarify the connotation of nutritional risk screening in critically ill and recommend appropriate nutritional risk screening tools according individually. Nutritional Risk Screening 2002 (NRS 2002) and NUTRIC/mNUTRIC score are recommended be used as the initial screening system for all the critically ill patients; for geriatric ICU patients, MNA-SF and GNRI could be supplemental to NRS 2002; for non-geriatric perioperative patients, MUST could be considered. As a conclusion, nutritional risk screening among critically ill should be tailored to "diseases" or "patients".

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