ASKLEPIOS-Klinik Schwalmstadt (Njemačka)
calories, proteins, nutrition, therapy, patient, ICU
''7. Međunarodni kongres HDMSARIST-a''
Šibenik, 24.-27. travnja 2014. godine
It is increasingly recognized that the nutrition of critically ill patients is a highly
complex activity with many unanswered questions. Much research has been
performed showing that early enteral nutrition helps to avoid complications. In
addition, it has already been shown that the calorie goal as the sole diet goal rather
plays a minor role, if one pays attention to sufficient supply of proteins. The diet of
the different patient groups with their very individual physiological conditions and
their very different diseases are another difficile question in nutritional therapy. The
question about the best access path currently appears clearly to be the way of
enteral nutrition. Although there seems to be no clear advantage to the gastric
or jejunal route, the gastric tube is apparently used more often in clinical practice due
to the ease of placement. Reflux control is also currently controversially discussed.
To assess the intestinal transport capacity, control of reflux is inevitable, but the
amount of reflux that should be considered as cut-off criteria is still unclear. The field
of immunonutrition or the substitution of selenium, glutamine, and other substances
requires further research. For an successful nutrition strategy it’s important to
implement an easy to use strategy, which allows an rapid and adjusted start in
nutrition due to the patient condition.