New Aspects in Enteral Nutrition in Critical Patients at the Surgical Intensive Care Unit


Authors: J. Šiller;  M. Šácha;  T. Daněk;  K. Havlíček;  Z. Grofová
Authors‘ workplace: Chirurgická klinika KN Pardubice, přednosta: doc. MUDr. K. Havlíček, CSc. ;  Fakulta zdravotnických studií, Univerzita Pardubice, prof. MUDr. A. Pellant, DrSc.
Published in: Rozhl. Chir., 2007, roč. 86, č. 3, s. 139-141.
Category: Monothematic special - Original

Overview

Introduction:
Nutritional support in critically ill patients has an impact on both prevention and treatment. Development of complications and organ failure can be prevented, good status of gut mucosa kept and positive nitrogen balance induced. Inflammatory response can be modulated.

Nutritional screening:
Patients undergoing major surgery should be actively screened for the nutritional risk level according to described parameters since it is considered to be very important for the postoperative period.

Enteral nutrition (EN) versus parenteral nutrition (PN):
Current study findings do not show any difference in mortality of critically ill patients with regard to the administration route. Inflammatory complications rate is significantly lower in EN patients.

ESPEN Guidelines on Enteral Nutrition:
The most recent recommendations for surgery patients are based on the evidence.

Conclusion:
There is a need for an active nutritional screening to find patients in the risk. Other important points are the following: a progressive approach to early enteral nutrition combined with PN, multiprofessional cooperation and protocol implementation.


Sources

1. Lochs, H., Allison, S. P., Meier, R., Pirlich, M., Kondrup, J., Schneider, S., van den Berghe, G., Pichard, C. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, Definitions and General Topics, Clinical Nutrition (2006) 25, 180–186.

2. Kreymann, K. G., Berger, M. M., Deutz, N. E. P., Hiesmayr, M., Jolliet, P., Kazandjiev, G., Nitenberg, G., van den Berghe, G., Wernerman, J. DGEM: C. Ebner, W. Hartl, C. Heymann, C. Spies: ESPEN Guidelines on Enteral Nutrition: Intesive care. Clinical Nutrition (2006) 25, 210–223.

3. Weimann, A., Braga, M., Harsanyi, L., Laviano, A., Ljungqvist, O., Soeters P. DGEM: K. W. Jauch, M. Kemen, J. M. Hiesmayr, T. Horbach, E. R. Kuse, K. H. Vestweber: ESPEN Guidelines on Enteral Nutrition: Surgery including Organ Transplantation. Clinical Nutrition (2006) 25, 224–244.

Labels
Surgery Orthopaedics Trauma surgery
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