Ernährung & Medizin 2010; 25(2): 63-70
DOI: 10.1055/s-0030-1248864
Wissen
© Hippokrates Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Parenterale Ernährung in der Klinik

Indikationen, Zugangswege, Zusammensetzung und TherapiekontrollenAlexander Koch1* , Edouard Sanson1* , Edmund Purucker2 , Christian Trautwein1
  • 1Medizinische Klinik III, Universitätsklinikum Aachen
  • 2Medizinische Klinik V, Evangelisches Krankenhaus Dinslaken
    * beide Autoren haben zu gleichen Teilen zum Manuskript beigetragen
Further Information

Publication History

Publication Date:
15 June 2010 (online)

Zusammenfassung

Die parenterale Ernährung bedarf einer strengen Indikationsstellung und sorgfältiger Überwachung. Sie kann entweder über zentralvenöse Katheter (ZVK) erfolgen oder peripher in Kombination mit einer oralen/enteralen Nahrungsaufnahme. Bei ZVK-Verwendung sind eine streng aseptische Anlage und eine sorgfältige Versorgung der Punktionsstelle obligat. Die Abschätzung des Grundumsatzes kann meist mittels der Formel nach Harris und Benedict erfolgen, der Energiebedarf ist aber von der Art der Erkrankung und dem zeitlichen Verlauf abhängig. Nach Festlegung des Eiweiß―bedarfs wird in Abhängigkeit hiervon die notwendige Menge an Kohlehydraten und Fetten errechnet. Vitamine und Spurenelemente werden i. d. R. in Standardformulierungen appliziert. Insbesondere bei schwerer Mangelernährung ist auf die Symptomatik des Refeeding-Syndroms und die Supplementation von Thiamin zu achten.

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Dr. med. Alexander Koch

Medizinische Klinik III

Universitätsklinikum Aachen

Pauwelsstr. 30

52072 Aachen

Email: akoch@ukaachen.de

Dr. med. Edouard Sanson

Medizinische Klinik III

Universitätsklinikum Aachen

Pauwelsstr. 30

52072 Aachen

Email: esanson@ukaachen.de