[Parenteral nutrition therapy. Energy and non-energy actions of carbohydrates and fats].
The object of this review is to demonstrate the non-nutritional importance of carbohydrates and fat as they represent the classic energy carriers in parenteral nutrition. Concerning the pathophysiological changes of organ metabolism and intermediary metabolism as well as the pharmacological function of this nutritive substrates it is necessary to adjust parenteral nutrition strategy to various clinical pictures. The major goals of parenteral applicated carbohydrates are to avoid hyperglycemia, to return the increased hepatic glucose production during trauma and sepsis back to normal, and to reduce protein catabolism. Realizing this goals the dosage of glucose infusion underlies close metabolic borders depending on the present disease. Because of favourable effects of hepatic glucose and protein metabolism, xylitol, a non-glucose polyol, represents an useful alternative energy source to glucose. The non-energetic nutrition therapy with fat consists of application of the essential fatty acids linoleic and alpha-linolenic acid and considers the immunmodulatory effects of various fatty acids as precursors in the eicosanoid metabolism. As demonstrated at the organ systems of liver and lung this pharmacological effects of any lipid infusion might influence specific organ functions.
Schricker
T
T
Universitätsklinik für Anästhesiologie, Klinikum der Universität Ulm.
Geisser
W
W
Georgieff
M
M
D000818:Animals; D004040:Dietary Carbohydrates / Q000494:pharmacology*; D004041:Dietary Fats / Q000494:pharmacology*; D004734:Energy Metabolism / Q000502:physiology*; D006801:Humans; D010289:Parenteral Nutrition, Total
D004040:Dietary Carbohydrates; D004041:Dietary Fats
Die parenterale Ernährungstherapie. Energetische und nicht-energetische Wirkungen von Kohlenhydraten und Fetten.