ISSN:0884-5336    

DOI:10.1177/011542659200700397

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/011542659200700399

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Host defenses within the gastrointestinal tract exclude bacteria and other intraluminal substances, which if released into the systemic circulation, would be toxic to the body. This is accomplished via complex interactions between these external pathogens and local immune responses and nonimmunologic processes. In addition to the mechanical and chemical barriers of the nonimmunologic defense system within the gastrointestinal tract, there is an effective immunologic barrier composed of aggregated and nonaggregated lymphoid cells. Gut‐associated lymphoid tissue protects the intestinal mucosa from invading pathogens by intricate pathways of antigen processing. Gut‐associated lymphoid tissue also transfers protection to other secretory sites within the body through the common mucosal immune system. The integrity of both the immunologic and nonimmunologic barriers may be affected by any number of pathologic insults as well as by nutritional influences. This article reviews the structural and functional characteristics of this complex and critically important host defense system. Specific nutrient requirements of the immunologic processes are discussed.

ISSN:0884-5336    

DOI:10.1177/0115426592007003100

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Early enteral feeding is increasingly advocated for the nutrition support of severely stressed patients. The successful use of this modality in critical illness is often limited by the patient's condition, the availability of access for feeding, and the patient's tolerance of the enteral formula. Factors such as abdominal injury or constraints on fluid volume also complicate nutrition support in this setting. Attention to a secure and well‐maintained small bowel access tube and appropriate formula selection allow safe tube feeding in these patients. This case report describes the clinical course of a patient with severe chest and abdominal trauma who received enteral nutrition despite a large, open abdominal wound.

ISSN:0884-5336    

DOI:10.1177/0115426592007003113

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Metabolic support is an integral component in the care of the critically injured patient. When hypermetabolism occurs, there are increases in energy demands along with changes in substrate utilization. This article reviews the prospective randomized clinical trials that were undertaken at Denver General Hospital over the past decade that address both the timing of nutritional support and the route of administration in this critically injured population. Also discussed is a review of a meta‐analysis that attests to the feasibility of early postoperative enteral feeding with the possibility of decreased septic morbidity in high‐risk surgical patients. With the clinical knowledge gained from these trials, an algorithm for nutritional intervention was developed that represents our current standard of practice.

ISSN:0884-5336    

DOI:10.1177/0115426592007003117

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700308

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700310

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700312

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700313

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

The nutritional needs of the child with bronchopulmonary dysplasia (BPD) vary significantly from those of a healthy child. To address the many special aspects of the nutritional care of the child with BPD, a nutrition management protocol was established at the University of Iowa Hospitals and Clinics. This protocol discusses caloric requirements; selection of enteral feedings; electrolyte, vitamin, and mineral supplements; growth, oral feeding advancement, and monitoring of nutritional status. Although many of the guidelines are supported by research, some are based on clinical practice. Many questions remain to be answered about the optimal nutrition therapy for these infants. One goal of this protocol is to stimulate discussion and research that will lead to a better understanding of the nutritional requirements of the BPD population.

ISSN:0884-5336    

DOI:10.1177/0115426592007003127

出版商:Sage Publications    

年代:1992

数据来源: WILEY