Ernährung in der Intensivmedizin – Zielparameter der Ernährung –welche wie erreichen?

Zusammenfassung

Die Ernährung des Intensivpatienten ist aufgrund metabolischer Veränderungen oftmals komplex und herausfordernd. Eine stoffwechseladaptierte Ernährung ist somit von besonderer Bedeutung zur Vermeidung von Hyper- oder Hypoalimentation und hat direkten Einfluss auf die Prognose. Zielparameter können helfen, eine adäquate und differenzierte Ernährungsstrategie zu etablieren, wobei bezüglich der Ernährungskomponenten evidenzbasierte Daten nur für die Einstellung der Blutzuckerwerte vorliegen. Von entscheidendem prognostischen Einfluss ist ferner eine frühzeitige enterale Ernährung. Hierzu werden in der Praxis oftmals auch supplementierende parenterale Regime benötigt, um eine ausreichende Kalorienzufuhr sicherzustellen. Die Messung des gastralen Residualvolumens als Instrument zur Steuerung einer effektiven enteralen Ernährung verliert möglicherweise aufgrund neuster Studiendaten zunehmend an Bedeutung.

Abstract

Nutrition of intensive care patients is often complex and challenging due to metabolic changes. For this reason nutritional support adapted to the metabolic state is of key importance to avoid hyper- or hypoalimentation and thus has direct impact on the prognosis. Target parameters might be beneficial to establish an adequate and differentiated nutritional strategy but thus far concerning single nutritional components evidence-based data are only available for adjusting blood glucose levels. Furthermore, an early enteral nutrition is of major prognostic importance. In practice a supplementary parenteral support is often required to provide adequate calorie supply. Monitoring of residual gastric volume as a tool to regulate an effective enteral nutrition might possibly become less important due to recent study data.

Schlüsselwörter:

enterale Ernährung - Blutzucker - Mangelernährung - gastrales Residualvolumen

Keywords:

Enteral nutrition - blood glucose - malnutrition - residual gastric volume

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