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Báo cáo y học: "Too much of a good thing: the curse of overfeeding"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Too much of a good thing: the curse of overfeeding. | Available online http ccforum.eom content 11 6 176 Commentary Too much of a good thing the curse of overfeeding Richard D Griffiths Division of Metabolic Cellular Medicine School of Clinical Sciences University of Liverpool Liverpool L69 3GA UK Corresponding author Richard D Griffiths rdg@liverpool.ac.uk Published 9 November 2007 This article is online at http ccforum.com content 11 6 176 2007 BioMed Central Ltd Critical Care 2007 11 176 doi 10.1186 cc6165 See related research by Dissanaike et al. http ccforum.com content 11 5 R114 Abstract Enteral nutrition EN gives a legacy of under nutrition in intensive care patients but few appreciate that parenteral nutrition PN carries the other risk of overfeeding if used injudiciously. Overfeeding presents a significant metabolic stress but tight glycaemic control is now masking the traditional warning signs and does not on its own negate the need to give patients the right amount at the right time. Natural selection has refined our ability to handle acute infection and short-term starvation but has not prepared us for the excesses of modern life and intensive care practice. There are two key lessons from the observational study by Dissanaike and co-workers 1 who have studied parenterally fed patients in the era of tight glycaemic control. Firstly parenteral nutrition PN as practiced by intensive care doctors can result in serious overfeeding and secondly this overfeeding impacts on infectious morbidity. The title unfortunately does not address the more serious issue of overfeeding that occurs when this route of nutrition delivery is abused. Of course this perpetuates the misguided view that it is PN that is a poison 2 rather than the real issue of overfeeding. As a warning about overfeeding the authors are to be commended in exposing a rampant neglect of care that I am sure is common across all but the most ardently nutrition focussed intensive care units. It is obvious that parenteral nutrition lends itself to .