ABSTRACT
El enfermo neurocrítico precisa un soporte nutricional especializado debido a su intenso catabolismo y a un prolongado período de ayuno. La vía de administración nutricional preferente es la gastrointestinal, particularmente la vía gástrica, siendo alternativas la vía transpilórica o la nutrición mixta enteral-parenteral en caso de no obtener un volumen nutricional eficaz superior al 60%. El aporte calórico total oscila entre 20-30 kcal/kg/día, según el período de evolución clínica en que se encuentre, con un aporte proteico superior al 20% de las calorías totales (hiperproteico). El inicio del aporte nutricional debe ser precoz. La incidencia de complicaciones gastrointestinales es superior al enfermo crítico en general, siendo el aumento del residuo gástrico el más frecuente. Debe establecerse un estrecho control de la glucemia, manteniéndose por debajo de 150 mg/ dl como en el resto de los enfermos críticos (AU)
Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/ dL (AU)
Subject(s)
Humans , Brain Injuries, Traumatic/therapy , Brain Neoplasms/therapy , Enteral Nutrition/standards , Parenteral Nutrition/standards , Societies, Medical/standards , Societies, Scientific/standards , Critical Care/methods , Shock/therapy , Critical Illness , Dietary Proteins/administration & dosage , Energy Intake , Metabolism , Blood Glucose/analysis , Brain Injuries, Traumatic/complications , Brain Injuries, Traumatic/metabolism , Brain Neoplasms/complications , Brain Neoplasms/metabolism , Enteral Nutrition , Enteral Nutrition/methods , Parenteral Nutrition/methods , Consciousness Disorders/etiology , Consciousness Disorders/therapy , Glutamine/administration & dosage , Hyperglycemia/prevention & control , Hypnotics and Sedatives/adverse effects , Nutritional Requirements , Stroke/complications , Stroke/metabolism , SpainABSTRACT
Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is gene -rally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL (AU)
El enfermo neurocrítico precisa un soporte nutricional especializado debido a su intenso catabolismo y a un prolongado período de ayuno. La vía de administración nutricional preferente es la gastrointestinal, particularmente la vía gástrica, siendo alternativas la vía transpilórica o la nutrición mixta enteral parenteral en caso de no obtener un volumen nutricional eficaz superior al 60%.El aporte calórico total oscila entre 20-30 kcal/kg/día, según el período de evolución clínica en que se encuentre, con un aporte proteico superior al 20% de las calorías totales (hiperproteico). El inicio del aporte nutricional debe ser precoz. La incidencia de complicaciones gastrointestinales es superior al enfermo crítico en general, siendo el aumento del residuo gástrico el más frecuente. Debe establecerse un estrecho control de la glucemia, manteniéndose por debajo de 150 mg/dl como en el resto de los enfermos críticos (AU)
Subject(s)
Humans , Craniocerebral Trauma/complications , Brain Injury, Chronic/diet therapy , Hyperglycemia/diet therapy , Critical Illness/therapy , Nutritional Support/methods , Evidence-Based Practice/methods , Practice Patterns, Physicians' , Nutritional RequirementsABSTRACT
Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.
Subject(s)
Brain Injuries/therapy , Brain Neoplasms/therapy , Critical Care , Enteral Nutrition/standards , Parenteral Nutrition/standards , Societies, Medical/standards , Societies, Scientific/standards , Stroke/therapy , Blood Glucose/analysis , Brain Injuries/complications , Brain Injuries/metabolism , Brain Neoplasms/complications , Brain Neoplasms/metabolism , Consciousness Disorders/etiology , Consciousness Disorders/therapy , Contraindications , Critical Care/methods , Critical Illness/therapy , Dietary Proteins/administration & dosage , Energy Intake , Enteral Nutrition/methods , Glutamine/administration & dosage , Humans , Hyperglycemia/prevention & control , Hypnotics and Sedatives/adverse effects , Metabolism , Nutritional Requirements , Parenteral Nutrition/methods , Spain , Stroke/complications , Stroke/metabolismABSTRACT
Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calorie intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.
