Metabolism and Artificial Nutrition in the Critically III

by Guarnieri, G.; Iscra, F.

• ISBN13: 9788847000421
• ISBN10: 8847000424
• eBook ISBN(s): 9788847029019
• Format: Paperback
• Copyright: 1999-02-01
• Publisher: Springer Verlag

Summary

The critically ill patient in intensive care often has to face significant metabolic alterations caused directly by the illness or secondary by complications (i.e. infections, organ failure or sepsis). Situations of rapidly evolving altered metabolism are maintained by or can trigger complex hormonal reactions which in turn promote further metabolic derangements. Surgery or trauma patients and those afflicted by septic complications can present significant nitrogen loss with consequent altered protein, carbohydrate or lipid metabolism. Further knowledge regarding the pathophysiology of metabolism and how abnormal stimulation of pyhsiological mechanisms can alter the consumption of principal energy substrates is necessary for optimal care of patients with altered metabolic functions.

Table of Contents

Basics and methods
Substrate Metabolism in Critical Illness	p. 3
Measurement of the body composition	p. 11
Energy and ATP: costs and benefits	p. 29
Indirect calorimetry in the critically ill: theoretical aspects and practical problems	p. 47
Local and Systemic Effects on Metabolism
Hormonal response of the hypothalamo-pituitary-adrenal axis in injury	p. 61
Sympathetic nervous system and metabolism	p. 71
Regional and systemic metabolic effects after surgical injury	p. 85
What about metabolism and the glutathione system?	p. 93
Carbohydrate and insulin activity in critically ill patients	p. 101
Muscle catabolism, amino acid flux and protein turnover in injury	p. 105
TPN vs ENT Nutrition - Cost and Benefits
Total parenteral nutrition vs. total enteral nutrition in critically ill patients: costs and benefits	p. 115
New Strategies on Metabolism and Nutrition
Hormone and growth factors in intensive care patients: anabolic strategy or utopia?	p. 125
Which metabolic strategies in the early phase of injury?	p. 133
Effects of artificial nutrition on the immune system cells	p. 147
Selective antioxidants and early artificial nutrition as prevention of multiple organ failure	p. 161
Pharmacological nutrition in ICU patients	p. 169
Nutrition - Steps for the Future
Metabolism and nutrition in the critically ill: steps for the future	p. 177
Gut and Nutrition
The gut in healthy conditions	p. 187
The gut in local and systemic disease	p. 193
Bacterial translocation	p. 203
Gut and nutrients	p. 211
Old Dilemma or New Strategies
Parenteral vs. enteral nutrition	p. 225
Main symbols	p. 233
Subject index	p. 235
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