ISSN:0884-5336    

DOI:10.1177/0115426594009004125

出版商:Sage Publications    

年代:1994

数据来源: WILEY

摘要:

Sepsis, shock, multiple trauma, and burns are often associated with altered metabolism characterized by severe catabolism, wasting of the lean body mass, immune dysfunction, and compromised wound healing. Nutrition support is one of the mainstays in the management of these critically ill patients and is aimed at minimizing these complications. The purpose of this article is to compare stress hypermetabolism and starvation metabolism, to review current recommendations for the provision of energy and substrate to the critically ill patient, and to review pertinent literature regarding enteral vs parenteral nutrition. Finally, this article will provide a brief overview of new and future therapies with emphasis on specific substrates and growth factors and the potential for their use in the critically ill patient.

ISSN:0884-5336    

DOI:10.1177/0115426594009004127

出版商:Sage Publications    

年代:1994

数据来源: WILEY

摘要:

Oxidative stress plays an important contributory role in a number of diseases. In critically ill patients, oxidative stress is a major problem that results from a number of compounding factors such as supportive oxygen therapy, pulmonary inflammation, and the nutritional inadequacies of these patients. It has been known for some time that the circulating concentration of vitamin E, the primary lipid‐soluble antioxidant, is low in critically ill patients. However, supplementation with vitamin E by oral loading has not been successful in improving clinical status. A better understanding of the bioavailability of vitamin E in these patients and of the synergistic action of other antioxidant nutrients such as vitamin C and glutathione with vitamin E has provided new opportunities to reexamine the use of antioxidant supplementation for the critically ill.

ISSN:0884-5336    

DOI:10.1177/0115426594009004141

出版商:Sage Publications    

年代:1994

数据来源: WILEY

摘要:

Neurosurgical patients in pentobarbital coma are a complex nutrition support population. Physiologic changes associated with the primary injury to the brain, combined with the pharmacodynamic influences of barbiturate therapy, contribute to the difficulties of initiating aggressive nutrition support. Early nutritional repletion is important to the overall outcome of traumatically injured patients. Consequently, factors that influence nutrition support decisions must be understood to assure appropriate intervention. The metabolic changes associated with traumatic head injury, pentobarbital therapy, and nutrition support strategies are reviewed.

ISSN:0884-5336    

DOI:10.1177/0115426594009004146

出版商:Sage Publications    

年代:1994

数据来源: WILEY

摘要:

Obstruction resulting from superior mesenteric artery syndrome is not often considered a possible cause for gastrostomy‐tube complications in tube‐fed patients. This case report details our experience with a patient who had had a feeding gastrostomy tube in place for 2 years. She then developed continuous leakage around the area of the gastrostomy insertion site associated with pain and inability to tolerate feedings. Her gastrointestinal series revealed compression of the third portion of the duodenum with delayed emptying of the stomach and dilatation of the proximal duodenum. After resection of the necrotic gastrostomy site, takedown of the ligament of Treitz to free the fourth portion of the duodenum, and insertion of a feeding jejunostomy, the patient was again able to gain weight and tolerate her tube feedings. We present this as an unusual complication occurring in a tube‐fed patient.

ISSN:0884-5336    

DOI:10.1177/0115426594009004151

出版商:Sage Publications    

年代:1994

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369400900406

出版商:Sage Publications    

年代:1994

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369400900408

出版商:Sage Publications    

年代:1994

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369400900409

出版商:Sage Publications    

年代:1994

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369400900410

出版商:Sage Publications    

年代:1994

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369400900413

出版商:Sage Publications    

年代:1994

数据来源: WILEY