RESUMO
Critically ill patients are often unable to eat by themselves over a long period of time, sometimes for weeks. In the acute phase, serious protein-energy malnutrition may develop with progressive muscle weakness, which may result in assisted respiration of longer duration as well as longer stay in intensive care unit and hospital. In view of the metabolic processes, energy and protein intake targets should be defined and the performance of metabolism should be monitored. Enteral nutrition is primarily recommended. However, parenteral supplementation is often necessary because of the disrupted tolerance levels of the gastrointestinal system. Apparently, an early parenteral supplementation started within a week would be of no benefit. Some experts believe that muscle loss can be reduced by increased target levels of protein. Further studies are needed on the effect of immune system feeding, fatty acids and micronutrients.
Assuntos
Cuidados Críticos/métodos , Estado Terminal , Ingestão de Energia , Nutrição Enteral , Debilidade Muscular/complicações , Nutrição Parenteral , Desnutrição Proteico-Calórica/etiologia , Aminoácidos/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Metabolismo Energético , Humanos , Debilidade Muscular/etiologia , Debilidade Muscular/prevenção & controle , Necessidades Nutricionais , Estado Nutricional , Insuficiência Respiratória/etiologia , Oligoelementos/administração & dosagem , Vitaminas/administração & dosagemRESUMO
Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient's condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy.