Nutritional support in patients with burns
| العنوان: | Nutritional support in patients with burns |
|---|---|
| المؤلفون: | Benjak, Paula |
| المساهمون: | Pirjavec Mahić, Aleksandra, Grbas, Harry, Grebić, Damir, Medved, Igor |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | parenteralna prehrana, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Kirurgija, nutritional support, nutritivna potpora, parenteral nutrition, bjelančevine, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Surgery, hipermetabolizam, proteins, burns, hypermetabolism, enteral nutrition, opekline, enteralna prehrana |
| الوصف: | Opekline prekidaju kontinuitet, integritet i zaštitnu funkciju kože. Opekline uvode u stanje hipermetabolizma i katabolizma zbog lučenja hormona poput kortizola, adrenalina i glukagona. Potrošnja energije povećava se i do 100% u odnosu na potrošnju prije ozljede. Katekolamini djeluju katabolički na skeletne mišiće i smanjuju mišićnu masu. Dostupno je nekoliko načina računanja energetskih potreba kod pacijenata s opeklinama. Jedna od metoda je indirektna kalorimetrija, a mogu se koristiti Currerijeva i Harris-Benedictova jednadžba. Procjena kalorijskog unosa iznosi oko 20-30 kcal/kg dnevno. Glavni izvor energije su ugljikohidrati koji čuvaju bjelančevine. Ako pacijenti ne mogu torerirati veću količinu ugljikohidrata, dodaje se inzulin. Preporuka unosa proteina, kod pacijenata s opeklinama, je 2g/kg dnevno. Dodatno se unosi aminokiselina glutamin zbog poboljšanja ishoda liječenja. Mikronutrijenti, koji se moraju nadoknađivati, su vitamini A, C, E i K, te minerali željezo, bakar i cink. Dva su načina prehrane, parenteralna i enteralna. Parenteralna se koristi kada enteralna nije moguća ili u samom početku liječenja. Brojne su komplikacije vezane uz centralni venski kateter koji služi za dopremu parenteralne prehrane. Također, veća je mogućnost infekcija vezanih uz centralni venski kateter, te se češće javlja hiperglikemija. Enteralna prehrana započinje 24-48 sati od nastanka ozljede, putem nazogastrične sonde. Enteralna prehrana ima manju mogućnost infekcija, te čuva integritet i funkciju crijeva. Često se upotrebljavaju visokoproteinski enteralni pripravci koji osiguravaju dovoljno proteina za cijeljenje rane i očuvanje mišićne mase. Burns interrupt integrity, continuity and protective function of the skin. Burns lead to state of hypermetabolism and catabolism, because of hormon secretion such as cortisol, adrenaline and glucagon. Energy consumption increases up to 100% comparing to state prior to injury. Catecholamines have a catabolic effect on skeletal muscles and decrease lean muscle mass. Several ways of calculating energy needs are available for burned patients. One of the methods is indirect calorimetry, but Curreri or Harris-Benedict formula could also be used. Estimated caloric intake is around 20-30 kcal/kg daily. Main source of energy are carbohydrates, which help maintain proteins. If patient cannot tolerate increased carbohydrate quantity, insulin can be added. Recommendation for protein intake, in burned patients, is 2 g/kg daily. Amino acid glutamine is added additionally to improve outcome. Micronutrients, which must be compensated, are vitamin A, C, E and K and minerals iron, copper and zinc. There are two different ways of feeding, parenteral and enteral. Parenteral nutrition is used when enteral is not possible or at the beginning of the treatment. There are numerous complications related to central venous catheter, which is used for application of parenteral nutrition. Also, there is higher chance of getting infection related to central venous catheter and hyperglycemia. Enteral nutrition begins 24-48 hours after the injury, through nasogastric tube. Enteral nutrition has lower chance of getting infections and it preserves the integrity and function of the gastrointestinal system. High-protein solutions, which provide enough protein to heal wounds and preserve muscles mass, are often used. |
| وصف الملف: | application/pdf |
| اللغة: | Croatian |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::3277109030609f16a6dccfe87e735d33 https://urn.nsk.hr/urn:nbn:hr:184:198575 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.dedup.wf.001..3277109030609f16a6dccfe87e735d33 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |