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158 SOPORTE NUTRICIONAL EN CONDICIONES ESPECIALES PACIENTE CRÍTICO Resumen de requerimientos nutricionales en la nutrición enteral en nuestro paciente: • 3.300 kcal • Proteínas: 150 g/día • Hidratos de carbono: 400 g/día; mantener glucemia < 150 mg/dl • Grasas: 90 g/día • Incremento de las dosis diarias recomendadas de vitaminas (A y C) y oligoelementos (cobre, selenio y cinc) • Glutamina: 0,3 g/kg/día BIBLIOGRAFÍA • Berger MM, Spertini F, Shenkin A, Wardle C, Wiesner L, Schindler C, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a doubleblind, placebo-controlled trial. Am J Clin Nutr. 1998;68:365-71. • Bertolini G, Iapichino G, Radrizzani D, Facchini R, Simini B, Bruzzone P, et al. Early enteral immunonutrition in patients with severe sepsis: results of an interim analysis of a randomized multicentre clinical trial. Intensive Care Med. 2003;29:834-40. • Boivin MA, Levy H. Gastric feeding with erythromycin is equivalent to transpyloric feeding in the critically ill. Crit Care Med. 2001;29:1916-9. • Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving Sepsis Campaign Management Guidelines Committee: surviving sepsis campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32:858-73. • Dhaliwal R, Jurewitsch B, Arrieta D, Harrietha D, Heyland DK. Combination enteral and parenteral nutrition in critically ill patients: harmful o beneficial? A systematic review of the evidence. Intensive Care Med. 2004;30:1666-71. • Doig GS, Simpson F; the Australian and New Zealand Intensive Care Society Clinical Trials Group. Evidence-based guidelines for nutritional support of the critically ill: results of a bi-national guideline development conference. Carlton: Australian and New Zealand Intensive Care Society; 2005. • Garrel D, Patenaude J, Nedelec B, Samson L, Dorais J, Champoux J, et al. Decreased mortality and infectious morbidity in adult burn patients given enteral glutamine supplements: a prospective, controlled, randomized clinical trial. Crit Care Med. 2003;31:2444- 9.
SOPORTE NUTRICIONAL EN CONDICIONES ESPECIALES PACIENTE CRÍTICO • Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P. Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003;27:355-73. • Heyland DK, Dhaliwal R, Suchner U, Berger MM. Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient. Intensive Care Medicine. 2005;31:327- 37. • Jacobs DG, Jacobs DO, Kudsk KA, Moore FA, Oswanski MF, Poole GV, et al. The EAST Practice Management Guidelines Workgroup. Practice managenent guidelines for nutritional support of the trauma patient. 2003. J Trauma. 2004;57(3):660-78. • Kreymann KG, Berger MM, Deutz NEP, Hiesmayr M, Jolliet P, Kazandjiev G, et al. ESPEN Guidelines on enteral nutrition: intensive care. Clin Nutr. 2006;25:<strong>21</strong>0-23. • Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review. Crit Care Med. 2001;29:2264-70. • Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ; for The Southwestern Ontario Critical Care Research Network. Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT). CMAJ. 2004;170:197-204. • Meier R, Ockenga J, Pertkiewicz M, Pap A, Milinic L, Macfie J, et al. ESPEN Guidelines on Enteral Nutrition: Pancreas. Clinical Nutrition. 2006;25:275-84. • Novak F, Heyland DK, Avenell A, Drover JW, Su X. Glutamine supplementation in serious illnes: a systematic rewiew of evidences. Crit Care Med. 2002;30:2022-9. • Singer P, Theilla M, Fisher H, Gibstein L, Grozovski E, Cohen J. Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury. Crit Care Med. 2006;34:1033-8. • Van den Berghe G, Wilmer A, Hermans G, Meerssman W, Wouters PJ, Milants I, et al. Intensive insulin therapy in the medical ICU. New Engl J Med. 2006;354:449-61. • Watkinson PJ, Barber VS, Dark P, Young JD. The use of pre- pro- and synbiotics in adult intensive care unit patients: systematic review. Clinical Nutrition. 2007;26:182-92. 159
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Dr. Aomar Abdel-lah Mohamed Dra. Ju
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