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Nutrition clinique et métabolisme
Volume 28, n° 4
pages 294-300 (décembre 2014)
Doi : 10.1016/j.nupar.2014.10.009
Received : 10 June 2014 ;  accepted : 13 October 2014
Activité physique et nutrition en réanimation
Physical activity and nutrition in intensive care unit
 

Muriel Lemaire, Jean-Charles Preiser
 Service des soins intensifs, hôpital Erasme, université Libre de Bruxelles, 808, route de Lennik, 1070 Bruxelles, Belgique 

Auteur correspondant.
Résumé

La faiblesse musculaire acquise en réanimation représente une complication fréquente et multifactorielle décrite chez le patient agressé. L’expression clinique et les conséquences à long terme de cette entité peuvent limiter le pronostic vital et la capacité fonctionnelle. La physiopathologie en est particulièrement complexe et partiellement iatrogène, par exemple lorsqu’une sédation prolongée est appliquée. Le dépistage, la prévention et le traitement de la faiblesse musculaire de réanimation nécessitent une prise en charge multimodale associant mobilisation précoce, limitation de la durée de sédation et apports calorico-azotés optimaux, ni excessifs à la phase aiguë, ni insuffisants à la phase tardive.

The full text of this article is available in PDF format.
Abstract

Intensive care unit-acquired muscular weakness is a common and multifactorial complication of the critically ill patient. Clinical signs and long-term consequences can worsen the vital outcome and functional autonomy. The pathophysiology of this condition is complex and partially iatrogenic, when prolonged sedation is used. The screening, prevention and treatment of muscular weakness require a multimodal approach, combining early mobilization, shortening of sedation and optimal proteo-caloric intakes, avoiding overfeeding during the early phase and underfeeding during the late phase of critical illness.

The full text of this article is available in PDF format.

Mots clés : Faiblesse musculaire, Protéolyse, Sédation, Mobilisation précoce

Keywords : Muscular weakness, Protein breakdown, Sedation, Early mobilization




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