Can parenteral nutrition keep the last position of life?

1.What is parenteral nutrition?

     Parenteral nutrition is to provide nutrition from the intravenous as nutritional support before and after surgery and in critically ill patients. The parenteral nutrition pathway includes peripheral vein nutrition and central vein nutrition. Parenteral nutrition is a nutritional element that is supplied to patients via the intravenous route, including calories (carbohydrates, fat emulsions), essential and non-essential amino acids, vitamins, electrolytes and trace elements.

2.Classification of parenteral nutrition

Parenteral nutrition is divided into complete parenteral nutrition and partial supplemental parenteral nutrition. Total nutrition from the parenteral supply is called complete parenteral nutrition. Supplemental parenteral nutrition.

3.Purpose of parenteral nutrition

    The purpose of parenteral nutrition is to enable patients to maintain nutritional status, weight gain and wound healing even when they cannot eat normally, and young children can continue to grow and develop.

4.Ideal is full, the reality is very skinny

In a multicenter randomized controlled study, 2920 patients in intensive care units requiring mechanical ventilation were divided into the simple parenteral nutrition group, early supplemental parenteral nutrition group, and late supplementary parenteral nutrition group (entered intensive care unit). 48 hours later) The results show that although supplemental parenteral nutrition can increase patients 'caloric and protein intake, at the same time, supplemental parenteral nutrition, whether administered early or late, can increase patients' 60-day mortality. Therefore, it is believed that although supplementary parenteral nutrition can improve the nutritional status of patients to a certain extent, it cannot improve clinical outcomes.

In addition, some scholars believe that early supplementary parenteral nutrition for patients with lower nutritional risk cannot improve patient outcomes and even worsen outcomes. At the same time, there are still many studies suggesting that the early application of supplementary parenteral nutrition has not improved the outcome better than the late application of supplementary parenteral nutrition, and may even worsen the clinical outcome.

Studies have shown that early supplemental parenteral nutrition can increase the rate of nosocomial infections and prolong the length of hospital stay in the intensive care unit. The meta-analysis of several randomized controlled studies in recent years also shows that although early application of supplementary parenteral nutrition can bring certain benefits in terms of mechanical ventilation time, etc., in general, early application of supplementary parenteral nutrition can not The use of supplemental parenteral nutrition leads to better clinical outcomes, so early application of supplemental parenteral nutrition is not recommended.

5.When to consider parenteral nutrition

If the intestine still has function, you should choose special medical food as enteral nutrition as early as possible. Only when the intestinal function has almost no function and is forced to die, helplessness, then consider parenteral nutrition.

             肠内肠外营养特点对比

6. Importance of enteral nutrition

The intestine is the body's largest immune organ, the body's largest detoxification organ, the body's largest endocrine organ, and the body's largest gas station. In traditional Chinese medicine, the gastrointestinal unit belongs to the Yangming Jing, while the large intestine and small intestine belong to the stomach. The Yellow Emperor's Internal Scriptures states that a person who has a stomach qi will live, and a person without a stomach qi will die. Therefore, if the function of the intestine is extremely weak and it is almost impossible to digest and absorb, the human body's stomach gas will soon be cut off. Instead of trying to supplement nutrition through parenteral means at this time, it is better to prevent it when you are not sick. When the intestine is still functioning, use special medical foods as early as possible for enteral nutrition. Letting the body recover in time is a more sensible choice.

There are still a large number of hospitalized patients, and the reality of malnutrition is widespread. In the case of intestinal function, there is no good supplementation for enteral nutrition. On the contrary, many patients use parenteral nutrition with higher price and higher risk. Because in the past, the special medical food industry has not yet legislated, and the development of the special medical industry lags behind many developed countries. Therefore, before the legislation of the special medical food industry, many scholars also called for both the country, doctors and patients to pay more attention to enteral nutrition in order to control medical expenses and medical reform. It is believed that in the near future, with the improvement of legislation and the vigorous promotion of the country, special medical foods and enteral nutrition will shine brightly.

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