Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Journal of Trauma and Emergency Surgery
Erschienen in: European Journal of Trauma and Emergency Surgery 3/2013

01.06.2013 | Review Article

Nutrition therapy for critically ill and injured patients

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Nutrition support has undergone significant advances in recent decades, revolutionizing the care of critically ill and injured patients. However, providing adequate and optimal nutrition therapy for such patients is very challenging: it requires careful attention and an understanding of the biology of the individual patient’s disease or injury process, including insight into the consequent changes in nutrients needed.

Objective

The objective of this article is to review the current principles and practices of providing nutrition therapy for critically ill and injured patients.

Methods

Review of the literature and evidence-based guidelines.

Results

The evidence demonstrates the need to understand the biology of nutrition therapy for critically ill and injured patients, tailored to their individual disease or injury, age, and comorbidities.

Conclusion

Nutrition therapy for critically ill and injured patients has become an important part of their overall care. No longer should we consider nutrition for critically ill and injured patients just as “support” but, rather, as “therapy”, because it is, indeed, a key therapeutic modality.
Literatur
1.
Martindale RG, McClave SA, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive Summary. Crit Care Med. 2009;37(5):1757–61.PubMedCrossRef
2.
Latifi R. Editorial: Nutritional support of critically ill or injured patients: do it early and do it right. Eur Surg. 2011;43(1):5–6.CrossRef
3.
Griffiths RD, Bongers T. Nutrition support for patients in the intensive care unit. Postgrad Med J. 2005;81:629–36.PubMedCrossRef
4.
Slone DS. Nutritional support of the critically ill and injured patient. Crit Care Clin. 2004;20:135–57.PubMedCrossRef
5.
Dogjani A, Zatriqi S, Uranues S, Latifi R. Biology-based nutritional support of critically ill and injured patients. Eur Surg. 2011;43(1):7–12.CrossRef
6.
7.
Ingenbleek Y, Bernstein L. The stressful condition as a nutritionally dependent adaptive dichotomy. Nutrition. 1999;15(4):305–20.PubMedCrossRef
8.
Latifi R, Caushaj PE. Nutrition support in critically ill patients: current status and practice. J Clin Ligand Assay. 1999;22:279–84.
9.
Young VR, Munro HN. N′-Methylhistidine (3-methylhistidine) and muscle protein turnover: an overview. Fed Proc. 1978;37:2291–300.PubMed
10.
Latifi R, Dudrick SJ, editors. Surgical nutrition: strategies in critically ill patients. Austin: Springer-Verlag/R.G. Landes; 1995.
11.
Souba WW, Wilmore DW. Postoperative alteration of arteriovenous exchange of amino acids across the gastrointestinal tract. Surgery. 1983;94:342–50.PubMed
12.
Kudlácková M, Andĕl M, Hájková H, et al. Acute phase proteins and prognostic inflammatory and nutritional index (PINI) in moderately burned children aged up to 3 years. Burns. 1990;16:53–6.PubMedCrossRef
13.
Boosalis MG, Ott L, Levine AS, et al. Relationship of visceral proteins to nutritional status in chronic and acute stress. Crit Care Med. 1989;17:741–7.PubMedCrossRef
14.
Church JM, Hill GL. Assessing the efficacy of intravenous nutrition in general surgical patients: dynamic nutritional assessment with plasma proteins. JPEN J Parenter Enteral Nutr. 1987;11:135–9.PubMed
15.
Isshiki H, Akira S, Sugita T, et al. Reciprocal expression of NF-IL6 and C/EBP in hepatocytes: possible involvement of NF-IL6 in acute phase protein gene expression. New Biol. 1991;3:63–70.PubMed
16.
Bankey PE, Mazuski JE, Ortiz M, et al. Hepatic acute phase protein synthesis is indirectly regulated by tumor necrosis factor. J Trauma. 1990;30:1181–7.PubMedCrossRef
17.
Fleck A, Colley CM, Myers MA. Liver export proteins and trauma. Br Med Bull. 1985;41:265–73.PubMed
18.
Ward NS, Casserly B, Ayala A. The compensatory anti-inflammatory response syndrome (CARS) in critically ill patients. Clin Chest Med. 2008;29:617–25.PubMedCrossRef
19.
Giner M, Laviano A, Meguid MM, et al. In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists. Nutrition. 1996;12:23–9.PubMedCrossRef
20.
Galanos AN, Pieper CF, Kussin PS, et al. Relationship of body mass index to subsequent mortality among seriously ill hospitalized patients. SUPPORT Investigators. The Study to Understand Prognoses and Preferences for Outcome and Risks of Treatments. Crit Care Med. 1997;25:1962–8.PubMedCrossRef
21.
McClave SA, Snider HL. Understanding the metabolic response to critical illness: factors that cause patients to deviate from the expected pattern of hypermetabolism. New Horiz. 1994;2:139–46.PubMed
22.
Windsor AC, Kanwar S, Li AG, et al. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis. Gut. 1998;42:431–5.PubMedCrossRef
23.
Kudsk KA, Croce MA, Fabian TC, et al. Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating abdominal trauma. Ann Surg. 1992;215:503–13.PubMedCrossRef
24.
Kalfarentzos F, Kehagias J, Mead N, et al. Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis: results of a randomized prospective trial. Br J Surg. 1997;84:1665–9.PubMedCrossRef
25.
Heyland DK, Schroter-Noppe D, Drover JW, et al. Nutrition support in the critical care setting: current practice in Canadian ICUs—opportunities for improvement? JPEN J Parenter Enteral Nutr. 2003;27:74–83.PubMedCrossRef
26.
Joseph B, Kulvatunyou N, Tang A, et al. Total parenteral nutrition in critically ill and injured patients. Europ Surg. 2011;43(1):19–23.CrossRef
27.
Kreymann KG, Berger MM, Deutz NE, et al. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr. 2006;25:210–23.PubMedCrossRef
28.
Payne-James JJ, de Gara CJ, Grimble GK, et al. Artificial nutrition support in hospitals in the United Kingdom—1991: second national survey. Clin Nutr. 1992;11:187–92.PubMedCrossRef
29.
Hill SA, Nielsen MS, Lennard-Jones JE. Nutritional support in intensive care units in England and Wales: a survey. Eur J Clin Nutr. 1995;49:371–8.PubMed
30.
De Jonghe B, Appere-De-Vecchi C, Fournier M, et al. A prospective survey of nutritional support practices in intensive care unit patients: what is prescribed? What is delivered? Crit Care Med. 2001;29:8–12.PubMedCrossRef
31.
Preiser JC, Berré J, Carpentier Y, et al. Management of nutrition in European intensive care units: results of a questionnaire. Working Group on Metabolism and Nutrition of the European Society of Intensive Care Medicine. Intensive Care Med. 1999;25:95–101.PubMedCrossRef
32.
Lipman TO. Grains or veins: is enteral nutrition really better than parenteral nutrition? A look at the evidence. JPEN J Parenter Enteral Nutr. 1998;22:167–82.PubMedCrossRef
33.
McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enter Nutr. 2009;33(3):277–316. http://​www.​nutritioncare.​org.PubMedCrossRef
34.
Braunschweig CL, Levy P, Sheean PM, et al. Enteral compared with parenteral nutrition: a meta-analysis. Am J Clin Nutr. 2001;74:534–42.PubMed
35.
Blackburn GL, Moldawer LL, Usui S, et al. Branched chain amino acid administration and metabolism during starvation, injury, and infection. Surgery. 1979;86:307–15.PubMed
36.
Heyland DK, Dhaliwal R, Drover JW, et al. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003;27(5):355–73.PubMedCrossRef
37.
Heyland DK, MacDonald S, Keefe L, et al. Total parenteral nutrition in the critically ill patient: a meta-analysis. JAMA. 1998;280:213–9.CrossRef
38.
Studley HO. Percentage of weight loss: a basic indicator of surgical risk in patients with chronic peptic ulcer. 1936. Nutr Hosp. 2001;16:141–3.PubMed
39.
Boullata J, Williams J, Cottrell F, et al. Accurate determination of energy needs in hospitalized patients. J Am Diet Assoc. 2007;107:393–401.PubMedCrossRef
40.
Campbell CG, Zander E, Thorland W. Predicted vs measured energy expenditure in critically ill, underweight patients. Nutr Clin Pract. 2005;20:276–80.PubMedCrossRef
41.
Ahmad A, Duerksen DR, Munroe S, et al. An evaluation of resting energy expenditure in hospitalized, severely underweight patients. Nutrition. 1999;15:384–8.PubMedCrossRef
42.
Smith LC, Mullen JL. Nutritional assessment and indications for nutritional support. Surg Clin North Am. 1991;71:449–57.PubMed
43.
Twomey P, Ziegler D, Rombeau J. Utility of skin testing in nutritional assessment: a critical review. JPEN J Parenter Enteral Nutr. 1982;6:50–8.PubMedCrossRef
44.
Gadek JE, DeMichele SJ, Karlstad MD, et al. Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. Crit Care Med. 1999;27(8):1409–20.PubMedCrossRef
45.
Davis KA, Kinn T, Esposito TJ, et al. Nutritional gain versus financial gain: the role of metabolic carts in the surgical ICU. J Trauma. 2006;61:1436–40.PubMedCrossRef
46.
Alexander E, Susla GM, Burstein AH, et al. Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. Pharmacotherapy. 2004;24:1659–67.PubMedCrossRef
47.
Faisy C, Guerot E, Diehl JL, et al. Assessment of resting energy expenditure in mechanically ventilated patients. Am J Clin Nutr. 2003;78:241–9.PubMed
48.
Cheatham ML, Safcsak K, Brzezinski SJ, et al. Nitrogen balance, protein loss, and the open abdomen. Crit Care Med. 2007;35:127–31.PubMedCrossRef
49.
Gibbs J, Cull W, Henderson W, et al. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999;134:36–42.PubMedCrossRef
50.
Kudsk KA, Minard G, Croce MA, et al. A randomized trial of isonitrogenous enteral diets after severe trauma. An immune-enhancing diet reduces septic complications. Ann Surg. 1996;224:531–43.PubMedCrossRef
51.
Bower RH, Cerra FB, Bershadsky B, et al. Early enteral administration of a formula (Impact) supplemented with arginine, nucleotides, and fish oil in intensive care unit patients: results of a multicenter, prospective, randomized, clinical trial. Crit Care Med. 1995;23:436–49.PubMedCrossRef
52.
Wischmeyer PE, Lynch J, Liedel J, et al. Glutamine administration reduces Gram-negative bacteremia in severely burned patients: a prospective, randomized, double-blind trial versus isonitrogenous control. Crit Care Med. 2001;29:2075–80.PubMedCrossRef
53.
Atkinson S, Sieffert E, Bihari D. A prospective, randomized, double-blind, controlled clinical trial of enteral immunonutrition in the critically ill. Guy’s Hospital Intensive Care Group. Crit Care Med. 1998;26:1164–72.PubMedCrossRef
54.
Houdijk AP, Rijnsburger ER, Jansen J, et al. Randomised trial of glutamine-enriched enteral nutrition on infectious morbidity in patients with multiple trauma. Lancet. 1998;352(9130):772–6.PubMedCrossRef
55.
Martindale R, Miles J. Is immunonutrition ready for prime time? Two points of view. Nutr Clin Pract. 2003;18:489–96.PubMedCrossRef
56.
Braga M, Gianotti L, Nespoli L, et al. Nutritional approach in malnourished surgical patients: a prospective randomized study. Arch Surg. 2002;137:174–80.PubMedCrossRef
57.
Seto Y, Fukuda T, Yamada K, et al. Celiac lymph nodes: distant or regional for thoracic esophageal carcinoma? Dis Esophagus. 2008;21:704–7.PubMedCrossRef
58.
Fukuda T, Seto Y, Yamada K, et al. Can immune-enhancing nutrients reduce postoperative complications in patients undergoing esophageal surgery? Dis Esophagus. 2008;21:708–11.PubMedCrossRef
59.
Souba WW, Klimberg VS, Plumley DA, et al. The role of glutamine in maintaining a healthy gut and supporting the metabolic response to injury and infection. J Surg Res. 1990;48:383–91.PubMedCrossRef
60.
Ziegler TR, Ogden LG, Singleton KD, et al. Parenteral glutamine increases serum heat shock protein 70 in critically ill patients. Intensive Care Med. 2005;31:1079–86.PubMedCrossRef
61.
Conejero R, Bonet A, Grau T, et al. Effect of a glutamine-enriched enteral diet on intestinal permeability and infectious morbidity at 28 days in critically ill patients with systemic inflammatory response syndrome: a randomized, single-blind, prospective, multicenter study. Nutrition. 2002;18:716–21.PubMedCrossRef
62.
Garrel D, Patenaude J, Nedelec B, et al. Decreased mortality and infectious morbidity in adult burn patients given enteral glutamine supplements: a prospective, controlled, randomized clinical trial. Crit Care Med. 2003;31:2444–9.PubMedCrossRef
63.
Davis SL. Plasma levels of prolactin, growth hormone and insulin in sheep following the infusion of arginine, leucine and phenylalanine. Endocrinology. 1972;91:549–55.PubMedCrossRef
64.
Saito H, Trocki O, Wang SL, et al. Metabolic and immune effects of dietary arginine supplementation after burn. Arch Surg. 1987;122:784–9.PubMedCrossRef
65.
Daly JM, Reynolds J, Thom A, et al. Immune and metabolic effects of arginine in the surgical patient. Ann Surg. 1988;208:512–23.PubMedCrossRef
66.
Kulkarni AD, Rudolph FB, van Buren CT. The role of dietary sources of nucleotides in immune function: a review. J Nutr. 1994;124(8 Suppl):1442S–6S.PubMed
67.
Beale RJ, Bryg DJ, Bihari DJ. Immunonutrition in the critically ill: a systematic review of clinical outcome. Crit Care Med. 1999;27:2799–805.PubMedCrossRef
68.
Braga M, Gianotti L, Radaelli G, et al. Perioperative immunonutrition in patients undergoing cancer surgery: results of a randomized double-blind phase 3 trial. Arch Surg. 1999;134:428–33.PubMedCrossRef
69.
Heyland DK, Dhaliwal R, Suchner U, et al. Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient. Intensive Care Med. 2005;31:327–37.PubMedCrossRef
70.
Crimi E, Liguori A, Condorelli M, et al. The beneficial effects of antioxidant supplementation in enteral feeding in critically ill patients: a prospective, randomized, double-blind, placebo-controlled trial. Anesth Analg. 2004;99:857–63.PubMedCrossRef
71.
Angstwurm MW, Engelmann L, Zimmermann T, et al. Selenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock. Crit Care Med. 2007;35:118–26.PubMedCrossRef
72.
Con J, Joseph B, Kulvatunyou N, et al. Evidence-based immune-modulating nutritional therapy in critically ill and injured patients. Eur Surg. 2011;43(1):13–8.CrossRef
73.
García-de-Lorenzo A, Ortíz-Leyba C, Planas M, et al. Parenteral administration of different amounts of branch-chain amino acids in septic patients: clinical and metabolic aspects. Crit Care Med. 1997;25:418–24.PubMedCrossRef
74.
Battistella FD, Widergren JT, Anderson JT, et al. A prospective, randomized trial of intravenous fat emulsion administration in trauma victims requiring total parenteral nutrition. J Trauma. 1997;43:52–8.PubMedCrossRef
75.
Christman JW, McCain RW. A sensible approach to the nutritional support of mechanically ventilated critically ill patients. Intensive Care Med. 1993;19:129–36.PubMedCrossRef
76.
Ziegler TR. Parenteral nutrition in the critically ill patient. N Engl J Med. 2009;361:1088–97.PubMedCrossRef
77.
EAST Practice Management Guidelines Work Group. Nutritional Support in Trauma Patients. J Trauma. 2004;57(3):660–679.
78.
Edmondson WC. Continuing education in anaesthesia. Contin Educ Anaesth Crit Care Pain. 2007;7:199–202.CrossRef
79.
Piazza-Barnett R, Matarese LE, Seidner DL, Steiger E. Techniques and monitoring of total parenteral nutrition. In: Latifi R, Dudrick SJ, editors. The biology and practice of current nutritional support. 2nd ed. Georgetown: Landes Bioscience; 2003.
Metadaten
Titel
Nutrition therapy for critically ill and injured patients
Publikationsdatum
01.06.2013
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 3/2013
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-013-0272-8

Weitere Artikel der Ausgabe 3/2013

European Journal of Trauma and Emergency Surgery 3/2013 Zur Ausgabe

Original Article

Does the ratio and thickness of prevertebral soft tissue provide benefit in blunt cervical spine injury?

Erratum

Erratum to: Gastrointestinal tract access for enteral nutrition in critically ill and trauma patients: indications, techniques, and complications

Editorial

Feed the gut, feed early and with the right stuff, but do not forget total parenteral nutrition

Original Article

Serum cleaved tau protein and traumatic mild head injury: a preliminary study in the Thai population

Review Article

Gastrointestinal tract access for enteral nutrition in critically ill and trauma patients: indications, techniques, and complications

Abstracts

32nd Meeting of the Pediatric Section of the German Society of Trauma Surgeons (DGU)

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

25.04.2024 | Hypertonie | Nachrichten

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

16.04.2024 | Spondylitis ankylosans | Nachrichten

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!
weitere anzeigen

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise