M. Popescu *
* Dr. Marian Popescu – medic specialist ATI – Spitalul Elias – București
Abstract
Nutrition is an essential component in the management of the critically The main nutritional goals in intensive care are to match – caloric utilization and to minimize negative nitrogen (N) balance. here is a corelation between cumulative negative caloric balance and mortality rate in critically ill patients. The gut should be used whenever possible; ever if total support is not attainable by enteral route, partial feedings may help maintain gut mucosal lntegrity. Injury and sepsis increase energy expenditure and tissue catabolism in proportion to their severity. The effects of the wound or sepsis are mediated by the afferent nervous system and by cytokines. Increased substrate cycling (turnover) of proteins, fats and carbohydrates is characteristics of metabolic response to injury. Trauma and sepsis alter the response to nutritional support; positive nitrogen balance is difficult or impossible to achieve without enormous caloric loading. Catabolism after trauma or during sepsis can still be reduced to an acceptable level by a rational nutritional support. Postoperative complications can be reduced by appropriate nutritional support.