The Role of Enteral Nutrition in the Treatment of Critically Ill Patients
HAVEL E., SOBOTKA L., MAŇÁK J., CERMAN J., BLÁHA V., ZADÁK Z.
Klinika gerontologická a metabolická LF UK v Hradci Králové, přednosta prof. MUDr. Zdeněk Zadák, CSc. |
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Summary:
The positive role of enteral nutrition (EN) is widely accepted in the treatment of critically ill patients. Enteral nutrition support induces in a significant
reduction of infectious complications and reduces the overall hospital stay. EN saves gut barrier function, enhances gut blood flow and IgA secretion
on bronchial and mucosal surface in experimental animal studies. On the other hand, the application of EN may not safe for critical care patients. The
main danger of EN is development of malnutrition, regurgitation and aspiration of nutrients. The late diagnosis of gut dysfunction is characterised by
gut distension, hemodynamic instability and ventilatory alteration. We conclude that the gastric application of nutrition is more safe for critically ill
patients, because the manifestation of eventually existing gut dysfunction is earlier. The monitoring of gastric nutrition tolerance must be frequent.
The combination of EN with parenteral nutrition is useful in prevention of malnutrition. The possibility to feed critically ill patients only through the
gut is described in more than 50%.
Key words:
enteral nutrition - parenteral nutrition - intensive care - critical care
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