Zusammenfassung
In den europäischen Krankenhäusern ist die Protein-Energie-Mangelernährung (PEM) immer noch weit verbreitet. Überdies ist nicht immer gewährleistet, dass während des Krankenhausaufenthaltes, die Voraussetzungen zur Behandlung von Patienten mit Mangelernährung gegeben sind. Dies kann zu einer Verschlechterung der Unterernährung zur Folge haben und die Risiken der Komplikationen von PEM-Patienten erhöhen sich. Das Resultat kann, durch ein erhöhtes Bewusstsein der Anwesenheit von PEM-Patienten in Krankenhäuser verbessert werden, aber auch durch entsprechende Einführung und Weiterverfolgung der Krankheit und dessen Stadium in dem sich der Patient befindet, wie auch die Durchführung von einem entsprechenden Eingreifen während des Krankenhausaufenthaltes. Neue Errungenschaften über das Wissen von Stoffwechselregulierungen und der Physiopathologie von Unterernährung ermöglichen einen maßgeschneiderten Stoffwechsel als Unterstützung für die speziellen klinischen Anforderungen. Stoffwechseltherapien mit Hormonen und Medikamente sehen auch sehr viel versprechend aus, aber es werden noch weitere Auswertungen benötigt. Ein weit umfassender Bildungsstand in klinischer Ernährung wird benötigt um das Wissen in der täglichen Anwendung weiterzugeben.
Abstract
Protein-energy malnutrition (PEM) has still a high prevalence in European Hospitals. Furthermore, during hopitalization the patient's nutrient requirements may not be met. This may further worsen malnutrition and increase the risk of PEM related complications. Outcome can be improved by an higher awareness of the presence of PEM in hospitalized patients, adequate initial and follow-up assessment of the nutritional status and the implementation of appropriate nutritional interventions during hospital stay. New achivements in the knowledge of the metabolic regulation and the physiopathology of malnutrition allow a tailored nutritional support in specific clinical conditions. Metabolic therapy with hormones and drugs seems also to be promising but it needs further evaluations. More widespread education in clinical nutrition is required to transfer knowledge to everyday clinical practice.
Schlüsselwörter
Protein-Energie-Mangelernährung - Stoffwechsel - Ernährungsberatung - Unterernährung in Krankenhäuser - Immunernährung
Key words
Protein energy malnutrition - metabolism - nutritional support - hospital malnutrition - immunonutrition
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Prof. Gianfranco Guarnieri
Istituto di Clinica Medica Generale e Terapia Medica · Ospedale di Gattinara
Strada di Fiume 447
34149 Trieste · Italy
Phone: + 39/040/910985
Fax: + 39/040/3994593
Email: guarnier@univ.trieste.it
