Parenteral Nutrition In Critically ill Patient
| Main Author: | Utariani, Arie |
|---|---|
| Format: | Article PeerReviewed Book |
| Bahasa: | eng |
| Terbitan: |
Pusat Pengembangan Paliatif & Bebas Nyeri RSU Dr. Soetomo
, 2012
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| Subjects: | |
| Online Access: |
http://repository.unair.ac.id/62580/2/Peerreview9.parenteral%20nutrition.pdf http://repository.unair.ac.id/62580/13/karil9.ParenteralAnastesi.pdf http://repository.unair.ac.id/62580/ |
Daftar Isi:
- MALNUTRITION among hospitalized patients has been associated with increased morbidity, prolonged hospital stay, and increased costs to the health care system.l-2 Several studies have documented that "bowel rest" is associated with a disruption of the mucosal barrier structure and function augmenting the inflammatory response to illness and resulting in greater infectious morbidity. As a consequence, nutritional support has become a standard of care for hospitalized patients. Critically ill patients often have a history of decreased spontaneous food intake before ICU admission, because of anorexia, gastrointestinal symptoms, depression, anxiety, and other medical and surgical factors. In addition, their food intake may have been restricted for diagnostic or therapeutic procedures.Such patients commonly have episodes of abnormal nutrient loss from diarrhea, vomiting, polyuria, wounds, drainage tubes, renal-replacement therapy, and other causes.2 Bed rest, decreased physical activity, and neuromuscular blockade during mechanical ventilation cause skeleral-muscle wasting and inhibit protein anabolic responses.Drugs that are frequently administered to patients in the ICU may themselves increase skeletal-muscle breakdown (corticosteroids), decrease splanchnic blood flow (pressor agents), or increase urinary loss of electrolytes, minerals, and water-soluble vitamins (diuretics). Infection, operative trauma, and other stresses may increase energy expenditure and protein and micronutrient needs. Nutritional support has become a standard of care for hospitalized patients, but whether parenteral nutrition(PN) affects morbidity and mortality is unclear.