文献詳細
特集 外科医が知っておくべき—《最新版》栄養療法
製剤
文献概要
【ポイント】
◆EN製剤は経口摂取と経管栄養の両者に使用できるが,それぞれの特性に合ったものを選択する必要がある.
◆中等度以上の侵襲を伴う手術の後は,比較的高蛋白のEN製剤を用い,抗酸化作用のある微量栄養素が欠乏しないように工夫する.
◆疾患別,病態別製剤を含め,多種多様のEN製剤が存在するが,各施設の必要性に応じて,また頻用する投与ルートに合わせた製剤を採用する.
◆EN製剤は経口摂取と経管栄養の両者に使用できるが,それぞれの特性に合ったものを選択する必要がある.
◆中等度以上の侵襲を伴う手術の後は,比較的高蛋白のEN製剤を用い,抗酸化作用のある微量栄養素が欠乏しないように工夫する.
◆疾患別,病態別製剤を含め,多種多様のEN製剤が存在するが,各施設の必要性に応じて,また頻用する投与ルートに合わせた製剤を採用する.
参考文献
1)ASPEN Board of Directors and the Clinical Guidelines Task Force:Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 26(1 Suppl):1SA-138SA, 2002
2)石渡一夫(編);静脈経腸栄養年鑑2020-21 製剤・食品・器具一覧.ジェフコーポレーション,2020
3)Puthucheary ZA, Rawal J, McPhail M, et al:Acute skeletal muscle wasting in critical illness.JAMA 310:1591-1600, 2013
4)Nicolo M, Heyland DK, Chittams J, et al:Clinical outcomes related to protein delivery in a critically ill population:a multicenter, multinational observation study. JPEN J parenter Enteral Nutr 40:45-51, 2016
5)Compher C,Chittams J, Sammarco T, et al:Greater protein and energy intake may be associated with improved mortality in higher risk critically ill patients:a multicenter, multinational observational study. Crit Care Med 45:156-163, 2017
6)Sevette A, Smith RC, Aslani A, et al:Does growth hormone allow more efficient nitrogen sparing in postop-erative patients requiring parenteral nutrition?:a double-blind, placebo-controlled trial. Clin Nutr 24:943-955, 2005
7)McClave SA, Taylor BE, Martindale RG, et al:Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient:Society of Critical Care Medicine(SCCM)and American Society for Parenteral and Enteral Nutrition(A. S. P. E. N.). JPEN J parenter Enteral Nutr 40:159-211, 2016 http://www.criticalcarenutrition.corn/cpgs
8)日本集中治療医学会 重症患者の栄養管理ガイドライン作成委員会:日本版重症患者の栄養療法ガイドライン.日集中医誌23:185-281,2016
9)日本静脈経腸栄養学会(編);静脈経腸栄養ガイドライン 第3版.照林社,2013
10)厚生労働省:日本人の食事摂取基準(2020年版).https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/kenkou/eiyou/syokuji_kijyun.html
11)Okubo T, Ishihara N, Takahashi H, et al:Effects of partially hydrolyzed guar gum incake on human intestinal microflora and its metabolism. Biosci Biotechnol Biochem 58:1364-1369, 1994
12)Parisi GC, Zilli M, Miani MP, et al:High-fiber diet supplemen-tation in patients with irritable bowel syndrome(!BS):a multicenter, randomized, open trial comparison between wheat bran diet and partially hydrolyzed guar gum(PHGG). Dig Dis Sci 47:1697-1704, 2002
13)Yamada K, Tokunaga Y, Ikeda A, et al:Dietary effect of guargum and its partially hydrolyzed product on the lipid metab-olism and immune function of Sprague-Dawley rats. Biosci Biotcchnol Biochem 63:2163-2167, l999
14)Beale llJ, Bryg DJ, Bihari DJ:lmmunonutrilion in the criti cally ill:a systematic review of clinical outcome. Crit Care Med 27:2799-2805, 1999
15)Hcyland DK. Novak F, Drover JW, et al:Should immunonutrition become routine in the critically ill patients?:a sys-tcmatic review of the evidence. JAMA 286:944-953, 2001
16)Goodyear-Bruch C. Pierce JD:Oxidative stress in critic ill patients. J Clin Care 11:543-551, 2002
17)Bukan MH. Bukan N, Kaymakcioglu N. et al:Effects of open vs. laparoscopic cholecystectomy on oxidative stress. Tohoku J Exp Med 202:51-56, 2004
18)Jones NE. Heyland DK:Pharmaconutrition:a new emerging paradigm. Curr Opin Gastroenterol 24:215-222, 2008
19)Suchner U, Heyland DK, Peter K:Immune-modulatory actions of arginine in the critically ill. Br J Nut 87:S121-132, 2002
20)Stechmiller JK, Childress B, Porter T:Arginine immunonu-trition in critically ill patients:a clinical dilemma. Am J Crit Care 13:17-23, 2004
21)Taniguchi N, Kaneto H, Asahi M. et al:Involvement of glycation and oxidative stress in diabetic macroangiopathy. Diabetes 45(Suppl 3):S81-83, 1996
22)Faure P:Protective effects of antioxidant micronutrients(vitamin E, zinc and selenium)in type 2 diabetes mellitus. Clin Chem Lab Med 41:995-998, 2003
23)Anderson RA, Roussel AM, Zouari N, et al:Potential anti-oxidant effects of zinc and chromium supplementation in people with type 2 diabetes mellitus. J Am Coll Nutr 20:212-218, 2001
24)Anderson RA:Chromium in the prevention and control of diabetes. Diabetes Metab 26:22-27, 2000
25)日本臨床栄養代謝学会(編);日本臨床栄養代謝学会JSPENテキストブック.南江堂,2021,pp 235-239
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