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Ernährungssonden bei kritisch kranken Patienten

Enteral feeding tubes for critically ill patients

  • Intensivmedizin
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Zusammenfassung

Die Verwendung von enteralen Ernährungssonden (EN) gehört mittlerweile zum Standardverfahren zur Unterstützung eines frühzeitigen enteralen Kostaufbaus in der Intensivmedizin. Auch in Bereichen mit nichtkritisch kranken Patienten, wie z. B. der (Tumor-)Chirurgie, Neurologie, Pädiatrie oder Palliativmedizin werden in gebotenen Situationen EN als temporäre oder dauerhafte Lösung verwendet. Mithilfe dieser Sonden ist eine gesicherte Gabe von Ernährung, Flüssigkeit und Medikamenten auf annähernd physiologische Weise möglich. Dieser Ernährungsweg scheint im Hinblick auf eine geringere Infektionsrate, eine verbesserte Mukosafunktion, eine gesteigerte Immunfunktion, eine mögliche kürzere Behandlungsdauer und damit verbundene niedrigere Kosten vorteilhaft zu sein. Dennoch sind sowohl die Anlage als auch die Verwendung von enteralen Sonden mit potenziellen Gefahren verbunden, die mit teilweise lebensbedrohlichen Komplikationen (Blutung, Perforation, Peritonitis etc.) einhergehen können. Der folgende Beitrag gibt einen Überblick über die verschiedenen Arten der EN und deren Einsatzgebiete sowie über Indikationen, Kontraindikationen und Vorgehen bei der Anlage von EN.

Abstract

The use of enteral feeding tubes is an important part of early enteral feeding in intensive care medicine. In other faculties with non-critically ill patients, such as (oncologic) surgery, neurology, paediatrics or even in palliative care medicine feeding tubes are used under various circumstances as a temporary or definite solution. The advantage of enteral feeding tubes is the almost physiologic administration of nutrition, liquids and medication. Enteral nutrition is thought to be associated with a reduced infection rate, increased mucosal function, improved immunologic function, reduced length of hospital stay and reduced costs. However, the insertion and use of feeding tubes is potentially dangerous and may be associated with life-threatening complications (bleeding, perforation, peritonitis, etc.). Therefore, the following article will give a summary of the different types of enteral feeding tubes and their range of application. Additionally, a critical look on indication and contraindication is given as well as how to insert an enteral feeding tube.

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  1. Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    J. Braun, T. Bein, C.H.R. Wiese, B.M. Graf &  Y.A. Zausig D.E.A.A.

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  1. J. Braun
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  2. T. Bein
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Braun, J., Bein, T., Wiese, C. et al. Ernährungssonden bei kritisch kranken Patienten. Anaesthesist 60, 352–365 (2011). https://doi.org/10.1007/s00101-010-1800-0

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