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Ernährung und Dysfunktion von Leber und Magen-Darm-Trakt

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Sepsis und MODS

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Zusammenfassung

Störungen der Leber(teil)funktionen sind für Verlauf und Prognose des Patienten mit Multiorgandysfunktion von maßgeblicher Bedeutung und werden bei alleiniger Betrachtung von Serumtransaminasen und Bilirubin unterschätzt. Umgekehrt bestimmen extrahepatische Komplikationen, wie hepatorenales Syndrom und hepatische Enzephalopathie, die Prognose des akuten Leberversagens. Neben spezifischen oder kausalen Therapiemöglichkeiten stehen im Rahmen von Studien verschiedene Varianten der Albumindialyse zur Verfügung.

Dysfunktionen und Schäden des Magen-Darm-Trakts („gastrointestinal failure“, GIF; „acute gastrointestinal injury“, AGI) sind bei schwerer Sepsis, bei Schockzuständen und MODS häufig.

Die Ernährung ist mehr als ein reiner Kalorienlieferant, sondern vielmehr eine akzeptierte supportive Therapieform. Eine parenterale Ernährung stellt eine Ergänzung oder den Ersatz der enteralen Ernährung dar. Immunmodulierende Substanzen werden in der Ernährungstherapie ebenfalls seit Langem eingesetzt.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Intensivmedizin, Integriertes Forschungs- und Behandlungszentrum „Sepsis & Sepsisfolgen“, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland

    Prof. Dr. med. M. Bauer

  2. Department für Innere Medizin, Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale) der Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 6120, Halle, Deutschland

    Prof. Dr. med. K. Werdan

  3. Medizinische Klinik und Poliklinik II (Pneumologie und Internistische Intensivmedizin, Infektiologie, Gastroenterologie, Nephrologie) am Standort Gießen, Universtitätsklinikum Gießen und Marburg, Klinikstraße 33, 35392, Gießen, Deutschland

    Prof. Dr. med. K. Mayer

  4. Medizinische Klinik und Poliklinik II (Pneumologie und Internistische Intensivmedizin, Infektiologie, Gastroenterologie, Nephrologie) am Standort Gießen, Universitätsklinik Gießen und Marburg, Klinikstraße 33, 35392, Gießen, Deutschland

    Priv.-Doz. Dr. med. M. Hecker

  5. Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Prof. Dr. med. M.A. Weigand

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  1. Prof. Dr. med. M. Bauer
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  2. Prof. Dr. med. K. Werdan
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  3. Prof. Dr. med. K. Mayer
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  4. Priv.-Doz. Dr. med. M. Hecker
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  5. Prof. Dr. med. M.A. Weigand
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Correspondence to M. Bauer .

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Editors and Affiliations

  1. Department für Innere Medizin, Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle(Saale) der Martin-Luther-Universität Halle-Wittenberg, Halle(Saale), Germany

    Karl Werdan

  2. Lehrstuhl für Geriatrie, Charité-Universitätsmedizin Berlin und Evangelisches Geriatriezentrum Berlin gGmbH, Berlin, Berlin, Germany

    Ursula Müller-Werdan

  3. Hildesheim, Germany

    Hans-Peter Schuster

  4. Zentrum für Klinische Studien, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Germany

    Frank M. Brunkhorst

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Bauer, M., Werdan, K., Mayer, K., Hecker, M., Weigand, M. (2016). Ernährung und Dysfunktion von Leber und Magen-Darm-Trakt. In: Werdan, K., Müller-Werdan, U., Schuster, HP., Brunkhorst, F. (eds) Sepsis und MODS. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45148-9_12

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