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Ernährung kritisch Kranker auf der Intensivstation

Nutrition of critically ill patients in intensive care

  • Schwerpunkt: Ernährungsmedizin
  • Published:
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Zusammenfassung

Es wird ein Konzept zur einheitlichen enteralen und parenteralen Ernährung schwer kranker Patienten auf der Intensivstation vorgestellt. Das Konzept berücksichtigt die endogene Substratproduktion in der akuten Phase der Erkrankung und vermeidet eine Hyperalimentation. Das Ernährungsziel ergibt sich aus der Multiplikation der Grundrate, d. h. dem Körpergewicht in kg als Laufrate in ml/h (≙ 24 kcal/kg KG/24 h), mit dem Zielfaktor, der zwischen 0,2 und 1,8 liegt. Eine äquivalente Zusammensetzung von enteraler und parenteraler Ernährung ermöglicht den problemlosen Übergang zwischen beiden Ernährungsformen. Gleichzeitig werden immunologische Gesichtspunkte bei der Substratauswahl berücksichtigt und beide Ernährungsformen von einer Zufuhr immunmodulierender Substanzen wie Glutamin und Antioxidantien begleitet.

Abstract

A concept for combined enteral and parenteral nutrition for critically ill patients is described in which endogenous substrate production during the acute phase of illness is taken into consideration and hyperalimentation is avoided. The nutritional goal is defined by multiplication of the base rate, i.e. body weight (BW) in kg as delivery rate in ml/h (≙ 24 kcal/kg BW/24 h), with a target factor, which varies between 0.2 and 1.8. An equivalent composition of enteral and parenteral nutrition allows a transition between both forms without problems. Simultaneously, immunologic aspects of nutrition are considered as well and both forms of nutrition are complemented by immune-modulating substrates such as glutamine and antioxidants.

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Notes

  1. Das hier beschriebene Konzept wurde in Zusammenarbeit mit der Firma Fresenius Kabi Deutschland GmbH entwickelt.

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Interessenskonflikt

K.G.K. hat ein Honorar für die Entwicklung des Konzeptes von Fresenius Kabi Deutschland GmbH enthalten, außerdem Vortragshonorare von Baxter Deutschland GmbH, B. Braun Melsungen AG und Fresenius Kabi Deutschland GmbH. R.M. hat Vortragshonorare von Baxter Deutschland GmbH, B. Braun Melsungen AG und Fresenius Kabi Deutschland GmbH erhalten. T.F. u. R.F.M. haben Vortragshonorare von Fresenius Kabi Deutschland GmbH erhalten.

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Authors and Affiliations

  1. Klinik für Intensivmedizin, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    K.G. Kreymann, G. de Heer, T. Felbinger, S. Kluge & A. Nierhaus

  2. Fresenius Kabi Deutschland GmbH, Bad Homburg v.d.H., Deutschland

    U. Suchner

  3. Kantonsspital Liestal, Liestal, Schweiz

    R.F. Meier

Authors
  1. K.G. Kreymann
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  2. G. de Heer
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  3. T. Felbinger
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  4. S. Kluge
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  5. A. Nierhaus
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  6. U. Suchner
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  7. R.F. Meier
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Corresponding author

Correspondence to K.G. Kreymann.

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Dieser Artikel erschien in veränderter Form auch in Pneumologie 2007, 61 (im Druck)

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Kreymann, K., de Heer, G., Felbinger, T. et al. Ernährung kritisch Kranker auf der Intensivstation. Internist 48, 1084–1092 (2007). https://doi.org/10.1007/s00108-007-1926-6

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  • DOI: https://doi.org/10.1007/s00108-007-1926-6

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