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preLekára.sk / Journals / Internal Medicine / 2019 - 3

Nutrition in the acute phase of illness

Česká verzia

Authors: František Novák
Authors place of work: IV. interní klinika 1. LF UK a VFN v Praze
Published in the journal: Vnitř Lék 2019; 65(3): 219-226
Category:

Recentní výzkum výživy v akutní fázi onemocnění ukázal důležité nové poznatky o podávání vyšších dávek proteinů a možných nežádoucích účincích u pacientů v katabolizmu. Na druhou stranu se ukazuje, že realimentační hypofosfatemie a realimentační syndrom může být významným problémem u chronicky podvyživených akutně hospitalizovaných pacientů. Navíc se zdá, že enterální výživa nemusí být výhodnější než parenterální výživa u pacientů v šokovém stavu, u kterých dokonce nelze vyloučit horší výsledky enterální přístupu.

Summary

Recent research of nutrition in the acute phase has brought up important findings regarding high protein and energy administration in critical illness with suggested adverse outcomes in catabolic patients. On the other hand, refeeding hypophosphatemia and refeeding syndrome may also be common during acute illness especially in chronically malnourished patients. Moreover, enteral nutrition is no longer superior to parenteral nutrition in recent studies as signals of harm using the enteral route in shock have been suggested. A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale has been proposed. Nutrition screening, assessment and intervention guidelines in intensive care and in chronic polymorbid internal patients has recently been published. These new findings and guidelines will probably change the practice of metabolic and nutrition therapy in acute illness and subsequent recovery.

 

Keywords:

acute illness – guidelines – inflammation – malnutrition

Zdroje

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Internal Medicine

Číslo 3
2019 Číslo 3
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