Notwendigkeit und Möglichkeit der parenteralen Ernährung bei chirurgischen Patienten

Schultis, K; Kori-Lindner, C.; Beisbarth, H.; Brand, O.

doi:10.1007/978-3-642-95269-2_1

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…Eine massive zerebrale Schädigung, beispielsweise bei einem schweren Schädel-Hirn-Trauma, erfordert wegen der anHinglichen Magen-Darm-Atonie initial immer eine rein parenterale Ernährung (3,4,5,9,32,35,43,51,59,62,63).…”

Section: Parenterale Ernährungunclassified

Die künstliche Ernährung in der Nervenheilkunde - Indikationsstellungen und Problematiken*

Fuchs¹,

Brandl²,

Arnold³

et al. 1983

Fortschr Neurol Psychiatr

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36 patients with severe neurological diseases (craniocerebral trauma, cerebrovascular insufficiency, meningo-encephalitis, polyneuropathy, paraplegia, intoxication etc.) received for more than 3 months monosaccharides and polyols (Triofusin E 1000) and a 10-%-concentration of crystalline amino acids (Aminofusin L10% kohlenhydratfrei) via the parenteral route in combination with / or exclusively a nutrient-defined diet (Biosorb). Exclusive enteral nutrition was given preference if possible. Numerous laboratory parameters, as for example blood counts, "hepatic enzymes", electrolytes, trace elements, plasma proteins, lipids, urea and creatinine were determined once a week. Substitutions and secondary complications were registered in addition. Iron and plasma proteins had to be substituted most frequently. It could be proved that hypoferremia was caused by insufficient iron supply in case of exclusive/prevailing parenteral nutrition, incorrect application of the iron preparations, inflammatory complications with iron moving into the R.E.S., as well as malabsorption syndromes probably induced by bacteria. Inflammatory complications were also the major cause of protein deficiency syndromes (hypoalbuminemia). In case of relatibely often occurring diarrhea, however, it could clearly be proved that it was not induced by nutrition but was produced by a broad-spectrum antibiosis. Chronically persistent diarrhea with colitis-like colonic changes required enteral feeding with an oligopeptide diet (z.B. Peptisorb) via jejunal feeding tube. Nitrogen balances which were determined after more than 3 months of artificial nutrition formed the basis of a nutritional plan differentiated according to diagnostic groups and stages of disease.

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Section: Parenterale Ernährungunclassified

Die künstliche Ernährung in der Nervenheilkunde - Indikationsstellungen und Problematiken*

Fuchs¹,

Brandl²,

Arnold³

et al. 1983

Fortschr Neurol Psychiatr

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Niederkalorische postoperative Ernährung

Löhlein¹

1986

ZAK Zürich

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Principles and indications of hypocaloric parenteral nutrition

Löhlein

1986

World j. surg.

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Postoperative metabolism is characterized by increased energy demand and nitrogen loss. Whereas autoregulatory mechanisms are able to meet the energy needs by enhanced lipolysis without endogenous problems, nitrogen loss mainly affects functionally and metabolically important proteins. In order to prevent these protein losses during the acute postoperative period, hypocaloric parenteral nutrition is suggested. The concept of hypocaloric nutrition consists of adequate amino acid substitution of 1.2-1.5 g/kg body weight per day and a low-dosed carbohydrate supply not to exceed 150-200 g per day. According to our own experience, this carbohydrate supply is best done with glucose substitutes like polyoles, since these substrates do no greater damage to the endogenous autoregulatory mechanism and give additional support to hepatic gluconeogenesis so that amino acids can be spared. Analyzing a 6-year period of using both hypocaloric and caloric-adequate postoperative parenteral nutrition we believe that hypocaloric nutrition is as beneficial as higher caloric parenteral nutrition, which in its application and monitoring is more expensive and time-consuming.

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Notwendigkeit und Möglichkeit der parenteralen Ernährung bei chirurgischen Patienten

Cited by 3 publications

References 9 publications

Die künstliche Ernährung in der Nervenheilkunde - Indikationsstellungen und Problematiken*

Die künstliche Ernährung in der Nervenheilkunde - Indikationsstellungen und Problematiken*

Niederkalorische postoperative Ernährung

Principles and indications of hypocaloric parenteral nutrition

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