Parenterale Ernährung in der Klinik

Zusammenfassung

Die parenterale Ernährung bedarf einer strengen Indikationsstellung und sorgfältiger Überwachung. Sie kann entweder über zentralvenöse Katheter (ZVK) erfolgen oder peripher in Kombination mit einer oralen/enteralen Nahrungsaufnahme. Bei ZVK-Verwendung sind eine streng aseptische Anlage und eine sorgfältige Versorgung der Punktionsstelle obligat. Die Abschätzung des Grundumsatzes kann meist mittels der Formel nach Harris und Benedict erfolgen, der Energiebedarf ist aber von der Art der Erkrankung und dem zeitlichen Verlauf abhängig. Nach Festlegung des Eiweiß―bedarfs wird in Abhängigkeit hiervon die notwendige Menge an Kohlehydraten und Fetten errechnet. Vitamine und Spurenelemente werden i. d. R. in Standardformulierungen appliziert. Insbesondere bei schwerer Mangelernährung ist auf die Symptomatik des Refeeding-Syndroms und die Supplementation von Thiamin zu achten.

Schlüsselwörter

Parenterale Ernährung - Zugangswege - Zusammensetzung - Komplikationen - Monitoring

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