Publication:
Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus SEMICYUC-SENPE: Critically-ill burnt patient

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Date
2011-11
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Aula Médica Ediciones
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Abstract
La respuesta que se objetiva tras una agresión térmica grave se caracteriza por hipermetabolismo (es el modelo de agresión más hipermetabólica que existe) e hipercatabolismo, con una elevada destrucción de la musculatura esquelética. Los trastornos metabólicos son más evidentes en las 2 primeras semanas tras la quemadura, aunque pueden prolongarse en relación directa con las complicaciones aparecidas. El soporte nutrometabólico forma parte indiscutible del tratamiento de estos pacientes y debe ser precoz, utilizando preferentemente la vía enteral y la nutrición parenteral complementaria. Es dificultoso el cálculo exacto de los requerimientos caloricoproteicos, aun empleando calorimetría indirecta, debido a las elevadas pérdidas cutáneas de proteínas y Co2. Cabe destacar la indicación de farmaconutrientes específicos, de dosis elevadas de micronutrientes y, en algunas situaciones, del empleo de medicaciones o fármacos con efectos anabólicos.
The response to severe burns is characterized by hypermetabolism (the most hypermetabolic existing model of aggression) and hypercatabolism, with a high degree of destruction of the skeletal musculature. Metabolic disorders are most evident in the first two weeks after the burn, although they can be prolonged in direct relation to the complications that these patients develop. Nutritional-metabolic support is an essential part of the treatment of these patients and should be started early, preferentially through the enteral route, with parenteral nutrition as complementary support. Exact calculation of calorie-protein requirements in these patients is difficult, even when indirect calorimetry is used, due to the high loss of proteins and CO2 through the skin. Specific pharmaconutrients are indicated, with a high dose of micronutrients. The use of drugs or medications with anabolic effects is also sometimes indicated.
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Guideline; Journal Article; Review;
MeSH Terms
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus
Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness
Medical Subject Headings::Technology, Industry, Agriculture::Food and Beverages::Food::Dietary Carbohydrates
Medical Subject Headings::Technology, Industry, Agriculture::Food and Beverages::Food::Dietary Fats
Medical Subject Headings::Technology, Industry, Agriculture::Food and Beverages::Food::Dietary Fiber
Medical Subject Headings::Technology, Industry, Agriculture::Food and Beverages::Food::Dietary Proteins
Medical Subject Headings::Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet::Energy Intake
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Feeding Methods::Enteral Nutrition
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases
Medical Subject Headings::Technology, Industry, Agriculture::Food and Beverages::Food::Micronutrients
Medical Subject Headings::Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Nutritional Requirements
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Nutritional Support
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Feeding Methods::Parenteral Nutrition
Medical Subject Headings::Diseases::Wounds and Injuries::Burns
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Keywords
Critically-ill burnt patient, Hypovolemic shock, Complementary parenteral nutrition, Hyperproteic nutrition., Quemado crítico, Shock hipovolémico, Nutrición parenteral complementaria, Nutrición hiperproteica
Citation
García de Lorenzo y Mateos A, Ortiz Leyba C, Sánchez SM. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: critically-ill burnt patient. Nutr Hosp. 2011 ; 26 Suppl 2:59-62