Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2014
[The successfully treated patients - are they the satisfied ones?].
The current scientific opinion on the success of a therapy is that patients having undergone a successful therapy are satisfied. However, in reality, it is possible that patients with poor living conditions are satisfied (well-being paradox) whereas patients treated successfully are not (dissonance). The higher the psychological distress, the more rare is the assumption that successful therapy is an equivalent of satisfaction. Satisfaction depends more on fulfillment of patient expectations and involvement of the physicians.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2014
Review[Update glutamine and antioxidants in critically ill patients].
Critical illness leads to oxidative stress and can induce or exacerbate nutrient deficiencies. This predisposes patients in the intensive care unit to impaired immune function and increased risk of developing infectious complications, organ dysfunction, and therefore worsens clinical outcome. ⋯ The following article summarizes the rationale and provides an update on recent clinical studies with special focus on the use of glutamine and antioxidants in critically ill patients. It further provides recommendations for the clinical use of these substrates in this particular patient population.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2014
Review[Nutrition of intensive care patients - How to reach target parameters].
Nutrition of intensive care patients is often complex and challenging due to metabolic changes. For this reason nutritional support adapted to the metabolic state is of key importance to avoid hyper- or hypoalimentation and thus has direct impact on the prognosis. ⋯ In practice a supplementary parenteral support is often required to provide adequate calorie supply. Monitoring of residual gastric volume as a tool to regulate an effective enteral nutrition might possibly become less important due to recent study data.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2014
Review[Nutrition of the critically ill - Is less more? How much energy for the ICU patient?].
Decreased nutritional intake or preexisting malnutrition is associated with increased morbidity and mortality during hospital stay. However nutritional support in particular for the ICU patient is not trivial. ⋯ Ideally about 25 kcal/kg/d should be targeted over a few days during metabolic monitoring. Alternatively indirect calorimetry should be applied where available.