Der Anaesthesist

, Volume 61, Issue 6, pp 553–564

Ernährung in der Intensivmedizin

CME Zertifizierte Fortbildung

Zusammenfassung

Die Ernährung von Intensivpatienten ist aufgrund der komplexen metabolischen Veränderungen eine große Herausforderung. Vor diesem Hintergrund stellt eine stoffwechseladaptierte Ernährung die einzige Möglichkeit zur Vermeidung von Hyper- oder Hypoalimentation dar und hat dadurch direkten Einfluss auf die Prognose. Neben der Analyse des Energiebedarfs ist die Wahl des Applikationswegs von entscheidender Bedeutung. Eine frühzeitige enterale Ernährung ist anzustreben. Hierbei werden in der Praxis oftmals auch supplementierende parenterale Regime benötigt, um eine ausreichende Kalorienzufuhr sicherzustellen. Die meisten heute verfügbaren Standardernährungslösungen sind in ihrer Nährstoffzusammensetzung optimiert – ein regelmäßiges metabolisches und gastrointestinales Monitoring wird trotzdem empfohlen. Bei ausgesuchten Patientengruppen kann die Verabreichung immunmodulierender Substanzen indiziert sein – von einem unkritischen Einsatz muss wegen oftmals unzureichender oder widersprüchlicher Studienlage abgeraten werden.

Schlüsselwörter

Enterale Ernährung Parenterale Ernährung Hyperalimentation, parenteral Metabolismus Nahrungsergänzung 

Nutrition in intensive care medicine

Abstract

Nutrition of intensive care patients is challenging due to complex metabolic changes. For this reason nutritional support adapted to the metabolic state is the only effective option to avoid hyperalimentation or hypoalimentation and thus has a direct influence on the prognosis. The analysis of the calorific requirement and the mode of administration are of key importance. An early enteral nutrition should be established, whereas in practice often a supplementary parenteral support is required to provide adequate calorie supply. Nowadays, most commercially available standard solutions are optimized concerning composition of nutrients; however, metabolic and gastrointestinal monitoring is recommended. In a selected group of patients the administration of immunomodulatory substances may be indicated but due to insufficient or conflicting study data an uncritical use of these supplements cannot be recommended.

Keywords

Enteral nutrition Parenteral nutrition Hyperalimentation, parenteral Metabolism Food supplementation 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Medizinische Klinik II (Pneumologie/internistische Intensivmedizin)Universitätsklinikum Gießen und Marburg, Standort GießenGießenDeutschland
  2. 2.Klinik für Anästhesiologie und operative IntensivmedizinKlinikum Neuperlach, Städtisches Klinikum MünchenMünchenDeutschland

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