Special commentary : a call for intensive metabolic support.

Détails

ID Serval
serval:BIB_FB3C13011168
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Special commentary : a call for intensive metabolic support.
Périodique
Current Opinion in Clinical Nutrition and Metabolic Care
Auteur⸱e⸱s
Mechanick J.I., Chiolero R.
ISSN
1363-1950
Statut éditorial
Publié
Date de publication
2008
Volume
11
Numéro
5
Pages
666-670
Langue
anglais
Résumé
PURPOSE OF REVIEW: This special commentary addresses recent clinical reviews regarding appropriate nutrition and metabolic support in the critical care setting. RECENT FINDINGS: There are divergent approaches between North America and Europe for the use of early nutrition support and combined enteral nutrition and parenteral nutrition support possibly due to the commercial availability of specific parenteral nutrients. The advent of intensive insulin therapy has changed the landscape of metabolic support in the intensive care unit, and previous notions about infective risk of parenteral nutrition will need to be re-addressed. Patients with brain failure may benefit from an intensive insulin therapy with a blood glucose target that is higher than that used in patients without brain failure. Patients with heart failure may benefit from the addition of nutritional pharmacology that targets proximate oxidative pathophysiological pathways. Intradialytic parenteral nutrition may be viewed as another form of supplemental parenteral nutrition when enteral nutrition is insufficient in patients on hemodialysis in the intensive care unit. SUMMARY: It is proposed that intensive metabolic support be routinely implemented in the intensive care unit based on the following steps: intensive insulin therapy with an appropriate blood glucose target, nutrition risk assessment, early and if needed combined enteral nutrition and parenteral nutrition to target 20-25 kcal/kg/day and 1.2-1.5 g protein/kg/day, and nutritional and metabolic monitoring.
Mots-clé
Blood Glucose, Critical Care, Dialysis, Glucose Metabolism Disorders/therapy, Humans, Insulin/adverse effects, Insulin/therapeutic use, Intensive Care Units, Nutritional Support/methods, Sepsis/therapy
Pubmed
Web of science
Création de la notice
15/10/2009 7:37
Dernière modification de la notice
20/08/2019 16:26
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