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Opublikowany online: 2024-11-19
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Nie otwieraj bram dla sepsy — znaczenie leczenia żywieniowego dla dobrostanu mikrobioty jelitowej pacjentów chorych krytycznie
DOI: 10.5603/pżk.102785
Postępy Żywienia Klinicznego 2024;19:133-138.
Streszczenie
Sepsa jest jedną z głównych przyczyn śmiertelności na świecie i stanowi poważne wyzwanie dla systemów opieki zdrowotnej. Odpowiada za około 26% zgonów na całym świecie i dotyka zarówno pacjentów ciężko chorych na oddziałach intensywnej terapii, jak i hospitalizowanych z innych powodów. Mikrobiota jelitowa, określana jako „drugi genom”, odgrywa kluczową rolę w zdrowiu człowieka, zwłaszcza w regulacji odpowiedzi immunologicznej. Choroba krytyczna, w tym sepsa, zakłóca równowagę mikrobioty jelitowej, prowadząc do dysbiozy, co z kolei wiąże się z wyższym ryzykiem infekcji i niewydolności narządów. Wczesne żywienie dojelitowe (EN) jest zalecane jako ważna interwencja wspierająca mikrobiotę jelitową u pacjentów w stanie krytycznym. Żywienie dojelitowe pomaga w utrzymaniu bariery jelitowej, redukuje translokację bakterii i zapobiega ogólnoustrojowym reakcjom zapalnym. Badania pokazują, że wczesne EN korzystnie wpływa na zdrowie jelit, podczas gdy wyłączne żywienie pozajelitowe (PN) może przyczyniać się do pogorszenia dysbiozy i w konsekwencji gorszych wyników leczenia. Włączenie wsparcia żywieniowego do terapii sepsy jest kluczowe, ponieważ wpływa nie tylko na bilans energetyczny, ale także na jakość mikrobiomu jelitowego oraz integralność bariery jelitowej, co może poprawić wyniki leczenia i przyspieszyć powrót do zdrowia.
Słowa kluczowe: choroba krytycznasepsamikrobiota jelitowaleczenie żywieniowe
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