Abstract:
Circadian rhythms in humans are biological rhythms that regulate various physiological processes within a 24-hour time frame. Critical illness can disrupt the circadian rhythm, as can environmental and clinical factors, including altered light exposure, organ replacement therapies, disrupted sleep-wake cycles, noise, continuous enteral feeding, immobility, and therapeutic interventions. Nonpharmacological interventions, controlling the ICU environment, and pharmacological treatments are among the treatment strategies for circadian disruption. Nutrition establishes biological rhythms in metabolically active peripheral tissues and organs through appropriate synchronization with endocrine signals. Therefore, adhering to a feeding schedule based on the biological clock, a concept known as \"chrononutrition,\" appears to be vitally important for regulating peripheral clocks. Chrononutritional approaches, such as intermittent enteral feeding that includes overnight fasting and consideration of macronutrient composition in enteral solutions, could potentially restore circadian health by resetting peripheral clocks. However, due to the lack of evidence, further studies on the effect of chrononutrition on clinical outcomes in critical illness are needed. The purpose of this review was to discuss the role of chrononutrition in regulating biological rhythms in critical illness, and its impact on clinical outcomes.
摘要:
人类的昼夜节律是在24小时时间范围内调节各种生理过程的生物节律。重病会扰乱昼夜节律,环境和临床因素也是如此,包括改变曝光,器官替代疗法,睡眠-觉醒周期中断,噪音,连续肠内喂养,不动,和治疗干预措施。非药物干预措施,控制ICU环境,和药物治疗是昼夜节律中断的治疗策略之一。营养通过与内分泌信号的适当同步,在代谢活跃的外周组织和器官中建立生物节律。因此,坚持基于生物钟的喂养时间表,一个被称为“慢性营养”的概念,“似乎对于调节外围时钟至关重要。时间营养方法,例如间歇性肠内喂养,包括过夜禁食和考虑肠内溶液中的大量营养素组成,可以通过重置外围时钟来恢复昼夜节律健康。然而,由于缺乏证据,我们需要进一步研究慢性营养对危重病患者临床结局的影响.这篇综述的目的是讨论慢性营养在调节危重病生物节律中的作用。及其对临床结果的影响。