[Nutritional concepts for patients under intensive care].
The clinical outcome of critical ill patients can be improved by standardised nutrition. However, trials meeting the standard of evidence-based medicine are rare. For this reason, standards still have to be based on pathophysiological considerations. We describe a concept of combined nutrition for critically ill patients which avoids hyperalimentation and considers also immunological aspects. An equivalent composition of enteral and parenteral nutrition allows a transition between both forms without problems. The nutritional goal is defined by multiplication of the base rate, i. e., body weight in kg as delivery rate in mL/h, - corresponding to 24 kcal/kg BW/24 h - with a target factor which varies between 0.2 and 1.8. Both forms of nutrition are complemented by immune-modulating substrates as glutamine and antioxidants.
Klinik für Intensivmedizin, Universitätskrankenhaus Hamburg-Eppendorf. kreymann@uke.uni-hamburg.de
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KG
Kreymann
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G
de Heer
T
T
Felbinger
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S
Kluge
A
A
Nierhaus
U
U
Suchner
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RF
Meier
D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D005858:Germany; D006801:Humans; D044623:Nutrition Therapy / Q000379:methods*; D009752:Nutritional Status; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'