Skip to main content
SpringerLink
Log in

Enterale Ernährung des Intensivpatienten

  • Chapter
Ernährung des Intensivpatienten

  • 3898 Accesses

Zusammenfassung

Der Einfluss des Ernährungsstatus auf die Inzidenz von Komplikationen beim Intensivpatienten, insbesondere die Infektionsrate, kardiopulmonale Probleme und die Wundheilung, ist unzweifelhaft. Dies zeigen auch aktuelle Literaturübersichten (Pichard et al. 2009; Felbinger et al. 2010). Die Leitlinien der Europäischen Gesellschaft für Klinische Ernährung und Stoffwechsel für die enterale Ernährung des Intensivpatienten besagen: »Eine nicht ausreichende Nahrungszufuhr für mehr als 14 Tage ist mit einer erhöhten Letalität assoziiert. Die Indikation zur künstlichen Ernährung besteht daher auch bei Patienten ohne Zeichen der Mangelernährung, die voraussichtlich mehr als 7 Tage keine orale Nahrungszufuhr oder mehr als 14 Tage oral eine nicht bedarfsdeckende Kost erhalten« (Kreymann et al. 2006).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Akinnusi ME, Pineda LA, EL Solh AA (2008) Effect of obesity on intensive care morbidity and mortality: A meta-analysis. Crit Care Med 36: 151–158

    Article  PubMed  Google Scholar 

  • Al Saady NM, Blackmore CM, Bennett ED (1989) High fat, low carbohydrate, enteral feeding lowers PaCO2 and reduces the period of ventilation in artificially ventilated patients. Intensive Care Med 15: 290–295

    Article  PubMed  CAS  Google Scholar 

  • Alberda C, Gramlich L, Jones N, Jeejeebhoy K, Day AG, Dhaliwal R, Heyland DK (2009) The relationship between nutritional intake and clinical outcomes in critically ill patients: results of an international multicenter observational study. Intensive Care Med 35: 1728–1737

    Article  PubMed  Google Scholar 

  • Barr, J, Hecht M, Flavin KE, Khorana A, Gould MK (2004) Outcomes in critically ill patients before and after the implementation of an evidence-based nutritional management protocol. Chest 2:1446–1457

    Article  Google Scholar 

  • Berger MM (2011) Enteral nutrition in hemodynamic instability, Intensivmed 48: 117–118

    Article  Google Scholar 

  • BesselinkMG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM, Nieuwenhuijs VB, Bollen TL, van Ramshorst B, Witterman BJ, Rosman C, Ploeg RJ, Brink MA, Schaapherder AF, Dejong CH, Wahab PJ, van Larhoven CJ, van der Harst E, van Wijck CH, Cuesta MA, Akkermans LM, Gooszen HG (2008) Dutch Acute Pancreatitis Study Group. Pro-biotic prophylaxis in predicted severe acute pancreatitis: a randomised, double- blind, placebo-controlled trial. Lancet 371: 651–659

    Article  PubMed  Google Scholar 

  • Burlew CC, Moore EE, Cushieri J, Jurkovich GJ, Codner P, Nirula R, Millar D, Cohgen MJ, Kutcher ME, Haan J, Macnew HG, Ochsner MG, Rowell SE, Truitt MS, Moore FO; Pieracci FM, Kaups KL, the WTA Study Group (2012) Who should we feed? A Western Trauma association multi- institutional study of enteral nutrition in the open abdomen after injury. J Trauma Acute Care Surg Jul 24 (Epub ahead of print)

    Google Scholar 

  • Casaer MP, Mesotten D, Hermans G, Wouters PJ, Schetz M, Meyfroidt G, Van Cromphout S, Ingels C, Meersseman P, Muller J, Vlasselaers D, Debaveye Y, Desmet L, Dubois J, Van Assche A, Vanderheyden S, Wilmer A, Van den Berghe G (2011) Early versus late parenteral nutrition in critically ill adults. N Engl J Med 365: 506–517

    Article  PubMed  CAS  Google Scholar 

  • Doig GS, Heighes PT, Simpson F, Sweetman EA (2010) Early enteral nutrition reduces mortality in trauma patients requiring intensive care: A meta-analysis of randomised controlled trials. Injury 42: 50–56

    Article  Google Scholar 

  • Dunham CM, Frankenfield D, Belzberg H, Wiles C, Cushing B, Grant Z (1994) Gut failure – predictor of or contributor to mortality in mechanically ventilated blunt trauma patients? J Trauma 37:30–34

    Article  PubMed  CAS  Google Scholar 

  • Falcao de Arruda IS, de Aguilar-Nascimento JE (2004) Benefits of early enteral nutrition with glutamine and probiotics in brain injury patients. Clin Sci (Lond) 106: 287–292

    Article  CAS  Google Scholar 

  • Felbinger TW, Sachs M (2010) Prognostische Bedeutung der Mangelernährung in der Intensivmedizin. In: Weimann A, Schütz T, Lochs H (Hrsg) Krankheitsbedingte Mangelernährung – eine Herausforderung für unser Gesundheitswesen. Pabst, Lengerich, S. 60–65

    Google Scholar 

  • Fisher CA, Merrel PK (2006) Feeding tube perils and how to get it done safely. JPEN J Parent Enteral Nutr 30; S41–42

    Google Scholar 

  • Herve P, Simonneau G, Girard P, Carrina J, Matthieu M, Duroux P (1985) Hypercapnic acidosis induced by nutrition in mechanically ventilated patients: glucose versus fat. Crit Care Med 13:537–540

    Article  PubMed  CAS  Google Scholar 

  • Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P (2003) Canadian Critical Care Clinical Practice Guidelines Committee. Canadian Clinical Practice Guidelines for nutrition support in mechanically ventilated critically ill adult patients. JPEN J Parenter Enteral Nutr 27: 355–373

    Article  PubMed  Google Scholar 

  • Holzinger U, Brunner R, Miehsler W, Herkner H, Kitzberger R, Fuhrmann V, Metnitz PG, Kamolz LP, Madl C (2011) Jejunal tube placement in critically ill patients: A prospective randomized trial comparing the endoscopic technique with the electromagnetically visualized method. Crit Care Med 39: 73–77

    Article  PubMed  Google Scholar 

  • Johnson CD, Kudsk KA, Fukatsu K, Renegar KB, Zarzaur BL (2003) Route of nutrition influences generation of antibody-forming cells and initial defense to an active viral infection in the upper respiratory tract. Ann Surg 237: 565–573

    PubMed  Google Scholar 

  • Kanwar S, Windsor AC, Welsh F, Barclay GR, Guillou PJ, Reynolds JV (2000) Lack of correlation between failure of gut barrier function and septic complications aftre major upper gastro- intestinal surgery. An Surg; 231; 88–95

    Article  CAS  Google Scholar 

  • Khalid I, Doshi P, DiGiovine B (2010) Early enteral nutrition and outcomes of critically ill patients treated with vasopressors and mechanical ventilatio . Am J Crit Care 19: 261–268

    Article  PubMed  Google Scholar 

  • Kompan L, Kremzar B, Gadzijev E, Prosek M (1999) effects of early enteral nutrition on intestinal permeability and the development of multiple organ failure after multiple injury. Intensive Care Med 25: 157–161

    Article  PubMed  CAS  Google Scholar 

  • Kompan L, Vidmar G, Spindler-Vesel A, Pecar J (2004) Is early enteral nutrition a risk factor for gastric intolerance and pneumonia. Clin Nutr 23: 527–532

    Article  PubMed  Google Scholar 

  • Koretz RL, Avenell A, Lipman TO, Braunschweig CL, Milne AG (2007) Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials. Am J Gastroenterol 102: 412–429

    Article  PubMed  Google Scholar 

  • Krejci V, Hildtbrandt L, Büchi C, Ali SZ, Contaldo C, Takala J, Sigurdsson GH, Jacob SM (2006) Decreasing gut wall glucose as an early marker of impaired intestinal perfusion. Crut Care Med 34: 2406–2414

    Article  CAS  Google Scholar 

  • Kreymann G, Adolph M, Mueller MJ (2009) Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine. Energy intake and energy expenditure. Guidelines on parenteral nutrition. Chapter 3 Ger Med Sci.;7:Doc25.

    Google Scholar 

  • Kreymann KG, Berger MM, Deutz NEP, Hiesmayr M, Jolliet P, Kazandjiev G, Nitenberg G, van den Berghe G, Wernerman J (2006) ESPEN Guidelines Enteral Nutrition: Intensive Care. Clin Nutr 25: 210–223

    Article  PubMed  CAS  Google Scholar 

  • Kudsk KA (2003) Effect of route and type of nutrition on intestine-derived inflammatory responses. Am J Surg 185: 16–21

    Article  PubMed  Google Scholar 

  • MacLeod JB, Lefton J, Houghton D, Roland C, Doherty J, Cohn SM, Barquist ES (2007) Prospective randomized control trial of intermittent versus continuous gastric feeds for critically ill trauma patients. J Trauma 63: 57–61

    Article  PubMed  Google Scholar 

  • Mc Clave SA, Lukan JK, Stefater JA, Lown CC, Looney SW, Matheson PJ, Gleeson K, Spain DA (2005) Poor validity of residual volumes as a marker of risk for aspiration in critically ill patients. Crit Care Med 33: 324–330

    Article  Google Scholar 

  • McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci (2009) A.S.P.E.N. Board of Directors and the American College of Critical Care Medicine Guidelines for the provision and assessment of nutrition support therapy in the adult critically patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) JPEN J Parenter Enteral Nutr 33: 277–316

    Article  PubMed  Google Scholar 

  • Menne R, Adolph M, Brock E, Schneider H, Senkal M (2008) Cost analysis of parenteral nutrition regimens in the intensive care unit: three-compartment bag system vs multibottle system. JPEN J Parenter Enteral Nutr 32: 606–612

    Article  PubMed  Google Scholar 

  • Montejo JC, Minambres E, Bordeje L, Mesejo A, Heras A, Ferre M, Fernadez-Ortega F, Vaquerizo Cl, Manazanedo R (2010) Gastric residual volume during enteral nutrition in ICU patients: the REGANE study. Intensive Care Med 36: 1386–1393

    Article  PubMed  CAS  Google Scholar 

  • Moore EE, Moore FA, Franciose RJ, Kim FJ, Biffl WL, Banerjee A (1994) The postischemic gut serves as a priming bed for circulating neutrophils that provoce multiple organ failure. J trauma 37: 881–887

    Article  PubMed  CAS  Google Scholar 

  • Moss G (2009) The etiology and prevention of feeding intolerance paralytic ileus – revisiting an old concept. Ann Surg Innov Res 3: 3

    Article  PubMed  Google Scholar 

  • Nolopp M, Weimann A (2011) Enterale Ernährung bei hämodynamischer Instabilität. In: Eckart J, Forst H, Briegel P (Hrsg) Intensivmedizin – Kompendium und Repetitorium zur interdisziplinären Weiter- und Fortbildung, ecomed, Landsberg, XI-7.1, S. 1–11

    Google Scholar 

  • Osland E, Yunus RM, Khan S, Memon MA (2011) Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. JPEN J Parent Enteral Nutr 35: 473–487

    Article  Google Scholar 

  • Peter JV, Moran JL, Philipps-Hughes JA (2005) metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients. Crit Care Med 33: 213–220

    Article  PubMed  Google Scholar 

  • Peterson SJ, Tsai AA, Scala CM, Sowa DC, Sheehan PM, Braunschweig CL (2010) Adequacy of oral intake in critically ill patients 1 week after extubation. J Am Diet Assoc 110: 427–433

    Article  PubMed  Google Scholar 

  • Petros S, Engelmann L (2006) Enteral nutrition delivery and energy expenditure in medical intensive care patients. Clin Nutr 25: 51–59

    Article  PubMed  Google Scholar 

  • Pichard C, Thibault R, Heidegger CP, Genton L (2009) Enteral and parenteral nutrition for critically ill patients: A logical combination to optimize nutritional support. Clin Nutr 4 (Suppl 1): 3–7

    CAS  Google Scholar 

  • Poulard F, Dimet J, Martin-Lefevre L, Bontemps F, Fiancette M, Clementi E, Lebert C, Renard B, Reignier J (2010) Impact if not measuring residual gastrioc volume in mechanically ventilated patients receiving early enteral feeding: a prospective before-after study. JPEN J Parenter Enteral Nutr; 34: 125–130

    Article  PubMed  Google Scholar 

  • Powell NJ, Collier B (2012) Nutrition and the open abdomen. Nutr Clin Pract 27: 499–506

    Article  PubMed  Google Scholar 

  • Rayes N, Hansen S, Seehofer D, Müller A R, Serke S, Bengmark S, Neuhaus P (2002) Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition 18: 609–615

    Article  PubMed  Google Scholar 

  • Rayes N, Pilarski T, Stockmann M, Bengmark S, Neuhaus P, Seehofer D (2012) Effect of pre- and probiotics on liver regeneration after resection: a randomised, double-blind pilot study. Benef Microbes 3: 237–244

    Article  PubMed  CAS  Google Scholar 

  • Rayes N, Seehofer D, Theruvath T, Schiller R A, Langrehr J M, Jonas S, Bengmark S, Neuhaus P (2005) Supply of pre- and probiotics reduces bacterial infection eates after liver transplantation- a randomized double-blind trial. Am J Transplantat 5: 125–130

    Article  Google Scholar 

  • Reinhart K, Brunkhorst FM, Bone HG, Berdutzky J, Dempfle CE, Forst H, Gastmeier P; Gerlach H, Gründling M, John S, Kern W, Kreymann G, Krüger W, Kujath P, Marggraf G, Martin J, Mayer K, Meier-Hellmann A, Oppert M, Putensen C, Quintel M, Ragaller M, Rossaint R, Seifert H, Spies C, Stüber F, Weiler N, Weimann A, Werdan K, Welte T (2010) Prävention, Diagnose, Therapie und Nachsorge der Sepsis – erste Revision der S"k-Leitlinien der Deutschen Sepsis-Gesellschaft e.V. (DSG) und der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI), Intensivmed 47: 185–207

    Article  Google Scholar 

  • Reintam A, Parm P, Kitus R, Starkopf J, Kern H (2008) Gastrointestinal failure score in critically ill patients: a prospective observational study. Crit Care, 12(4): p. R90

    Article  Google Scholar 

  • Simpson F, Doig GS (2005) Parenteral vs enteral nutrition in the critically ill patient: a meta-analysis of trials using the intention to treat principle. Intensive Care Med 31: 12–23

    Article  PubMed  Google Scholar 

  • Singer P, Berger MM, Van den Berghe G, Biolo G, Calder P, Forbes A. Griffiths R, Kreymann G, Leverve X, Pichard C (2009) ESPEN Guidelines on Parenteral Nutrition: Intensive Care, Clin Nutr 28: 387–400

    Article  PubMed  Google Scholar 

  • The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network.(2012) Initial trophic vs. full enteral feeding in patients with acute lung injury: The EDEN randomized trial. JAMA 307: 785–803

    Article  Google Scholar 

  • Thibault R, Pichard C, Wernerman J, Bendjelid K (2011) Cardiogenic shock and nutrition: safe? Intensive Care Med 37: 35–45

    Article  PubMed  CAS  Google Scholar 

  • Ukleja, A (2010) Altered GI motility in critically Ill patients: current understanding of pathophysiology, clinical impact, and diagnostic approach. Nutr Clin Pract, 25:16–25

    Article  PubMed  Google Scholar 

  • Van den Berg B, Bongaard JM, Hop WC (1994) High fat. Low carbohydrate, enteral feeding in patients weaning from the ventilator. Intensive Care Med 20: 470–475

    Article  PubMed  Google Scholar 

  • Villet S, Chiolero RL, Bollmann MD, Reveilly JP, Cayeux RNMC, Delarue J, Berger MM (2005) Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr 24: 502–509

    Article  PubMed  Google Scholar 

  • Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P (2006) ESPEN Guidelines on Enteral Nutrition: Surgery including Organ Transplantation. Clin Nutr 25: 224–244

    Article  PubMed  CAS  Google Scholar 

  • Weimann A, Ebener C, Hausser L, Holland-Cunz S, Jauch KW, Kemen M, Krähenbühl L, Kuse ER, Längle F (2007) Leitlinie Parenterale Ernährung: Chirurgie und Transplantation, Aktuel Ernaehr Med 32: S114-S123

    Article  Google Scholar 

  • Weimann A, Ebener CH, Holland-Cunz S, Jauch KW, Hausser L, Kemen M, Kraehenbuehl L, Kuse ER, Längle F (2009) Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine Surgery and transplantation – Guidelines on parenteral nutrition, Chapter 18, GMS German Medical Science – an Interdisciplinary Journal, ISSN 1612–3174

    Google Scholar 

  • Woodcock NP, Zeigler D, Palmer MD, Buckley P, Mitchell CJ, MacFie J (2001) Enteral versus parenteral nutrition: a pragmatic study. Nutrition 17:1–12

    Article  PubMed  CAS  Google Scholar 

  • Zaloga GP, Roberts PR, Marik P (2003) Feeding the hemodynamically unstable patient: a critical evaluation of the evidence. Nutr Clin Pract 18: 285–293

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Allgemein- und Visceralchirurgie, Klinikum St. Georg Leipzig, Delitzscher Straße 141, 04129, Leipzig

    Prof. Dr. med. Arved Weimann & Professor Dr. med. Matthias Nolopp

Authors
  1. Prof. Dr. med. Arved Weimann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Professor Dr. med. Matthias Nolopp
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie, Kliniken Wesermünde, Langener Straße 66, 27607, Langen

    Andreas Rümelin

  2. Zentrum für Innere Medizin, Medizinische Klinik II, Universtitätsklinikum Gießen u. Marburg, Klinikstraße 36, 35392, Gießen

    Konstantin Mayer

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Weimann, A., Nolopp, M. (2013). Enterale Ernährung des Intensivpatienten. In: Rümelin, A., Mayer, K. (eds) Ernährung des Intensivpatienten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-29773-1_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-29773-1_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-29772-4

  • Online ISBN: 978-3-642-29773-1

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation