Metabolic Support of the Critically Ill Patient PDF
Preview Metabolic Support of the Critically Ill Patient
17 Update in Intensive Care and Emergency Medicine Edited by J.-L.Vincent D. W. Wilmore Y. A. Carpentier (Eds.) Metabolic Support of the Critically III Patient With 89 Figures and 68 Tables Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Barcelona Budapest Series Editor Prof. Dr. Jean-Louis Vincent Clinical Director, Department of Intensive Care, Erasme Hospital Free University of Brussels, Route de Lennik 808 1070 Brussels, Belgium Volume Editors Prof. Dr. Douglas W. Wilmore Laboratory for Surgical Metabolism, Brigham and Women's Hospital 75 Francis Street, Boston Massachussetts 02115, USA Prof. Dr. Yvon A. Carpentier L. Deloyers Laboratory for Experimental Surgery, Free University of Brussels, Avenue J. Wybran 40, 1070 Brussels, Belgium ISBN-13:978-3-642-85013-4 e-ISBN-13:978-3-642-85011-0 DOl: 10.1007/978-3-642-85011-0 This work is subject to copyright. All rigths are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illus trations, recitation, broadcasting, reproduction on microfilms or in other ways, and sto rage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1993 Softcover reprint of the hardcover 1st edition 1993 The use of registered names, trademarks, etc. in the publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant pro tective laws and regulations and therefore free for general use ..' Product Liability: The publisher can give no guarantee for information about drug dos age and application thereof contained in this book. In every individual case the respec tive user must check its accuracy by consulting other pharmaceutical literature. 19/3130-54321 0 - Printed on acid-free paper Contents Monitoring Compositional Changes and Biochemical Functions Measuring Body Composition in Intensive Care Patients (G.L.Hill, D.Monk, and L.D.Plank) ............ 3 Applications of Magnetic Resonance Spectroscopy to Nutrition and Metabolism (D. O. Jacobs and M. K. Robinson) .............. 19 Muscle Function and Energetics (K. N. Jeejeebhoy) ........ . . ....... 46 Muscle Intracellular Ions during Malnutrition and Refeeding (c. Pichard, D. Slosman, and A. G. Dulloo) . . . . . . .. 63 Estimation of Peroxidative Damage (H. Esterbauer) . . . . . . . . . . . . . . . . . . . . . . . . .. 80 What Type of Metabolic Support? Does Indirect Calorimetry Reflect Energy Expenditure in the Critical III Patient? (R. Chiolero, D. Bracco, and J. P. Revelly) . . . . . . . .. 95 Are We Giving Unbalanced Amino Acid Solutions? (P. Furst and P. Stehle) ..................... 119 Anabolic Drive in Critically III Patients: Pros and Cons a Prevailing Glucose System (G. Iapichino and D. Radrizzani) ..... . ........ 137 Are Present Fat Emulsions Appropriate? (Y. A. Carpentier) ........................ 157 VI Contents Organ Specific Nutrients and Associated Therapy Effects of Enteral Nutrients on the Critically III Gut (J. L Lew and J. L. Rombeau) . . . . . . . . . . . . . . . 175 Nutrition of some Cells of the Immune System and its Importan~e in the Response to Trauma (E.A Newsholme) . . . . . . . . . . . . . .. . ...... 198 The Impact of Nutrition on Muscle Tissue in Critical Illness (J. Wemerman, P. Garlick, and E. Vinnars) . .215 Enhancing Wound Healing in Severely Burned Patients (D. A Gilpin, M.l. Muller, and D. N. Hemdon) . . 236 Organ Specific Nutrients and Associated Therapy: Growth Factors - Growth Hormone (L.S. Young, T.AByme, and D. W. Wilmore) ........ 252 Preventing Complications Parenteral versus Enteral Nutrition (G. P. Zaloga) ........... . . ...... 267 The Importance of the Gut as a Central Organ in the Pathogenesis of MOF (M. P. Fink) . . . . . . . . . . . . . . . . . . . . . . . . 294 Altering Bowel Contents with Lactulose and other Substances prevents Endotoxemia (P.AM. van Leeuwen, M.A:Boermeester, and A P.J.Houdijk) ............. . . .. 306 Metabolic Support: Modulation of Purine Metabolism (J.M.Boeynaems) ................... . .. 320 Metabolic Responses to Anti-Cytokine Thera'pies (S. F. Lowry) .................. . . . . . 333 The Maintenance of Antioxidant Defenses during Inflammation (R. F. Grimble) .......................... 347 Contents VII DiseaselNutrients Interactions Acute Renal Failure in the ICU: Approaches to Nutritional Support (D. Bihari, 1. Mitchell, and R. Chang) ............. 367 Nutritional Support in Liver Disease (E. Lerebours) ............ . .. 377 Nutrition and Metabolism in Acute Respiratory Failure (J. Takala) .......................... . 390 Nutritional Complications associated with Chemotherapy and Irradiation in Cancer Treatment (T. R. Ziegler) . . . . . . . . . . . . . . . . . . . . . . . 407 Nutrition in Sepsis (F. B. Cerra) ....................... 427 Subject Index ......................... 439 List of Contributors Bihari D. Chiolero R. Department of Intensive Care, Intensive Care Unit, CHU Vaudois, Guy's Hospital, St Thomas Street, 1011 Lausanne, Switzerland London SEI 9RT, United Kingdom Dulloo A.G. Boermeester M.A. Institute of Physiology, University Department of Surgery, Free Hospital, Geneva, Switzerland University Hospital, De Boelelaan 1117,1081 HV Amsterdam, Esterbauer H. The Netherlands Institute of Biochemistry, University of Graz, Schubertstrasse 1, Boeynaems J. M. 8010 Graz, Austria Institute of Interdisciplinary Research, School of Medicine, Free University of Brussels, 808 Route Fink M.P. de Lennik, 1070 Brussels, Belgium Division of Trauma and Surgical Critical Care, Beth Israel Hospital, Bracco D. 330 Brookline Avenue, Boston Institute of Physiology, University MA 02215, USA of Lausanne, Lausanne, Switzerland Furst P. Byrne T.A. Institute for Biological Chemistry Laboratories of Nutrition and and Nutrition, University of Metabolism, Brigham and Women's Hohenheim, Garbenstrasse 30, Hospital, 75 Francis Street, Boston 70599 Stuttgart, Germany MA 02115, USA Garlick P. Carpentier Y. A. Rowett Research Institute, L. Deloyers Laboratory for Aberdeen, Scotland, Experimental Surgery and Clinical United Kingdom Nutrition Unit, Free University of Brussels, 40 Avenue J. Wybran, 1070 Brussels, Belgium Gilpin D.A. Shriners Burns Institute, 815 Cerra F.B. Market Street, Galveston Department of Critical Care and TX 77550-2725, USA Clinical Nutrition, University of Minnesota, Minneapolis MN 55455, Grimble R. F. USA Department of Human Nutrition, University of Southampton, Chang R. Biomedical Sciences Building, Department of Intensive Care, Bassett Crescent East, Guy's Hospital, St. Thomas Street, Southampton S09 3TU, London SEl 9RT, United Kingdom United Kingdom X List of Contributors Herndon D. N. Muller M.I. Shriners Burns Institute, Shriners Burns Institute, 815 Market Street, Galveston 815 Market Street, Galveston TX 77550-2725, USA TX 77550-2725, USA Hill G. L. Newsholme E. A. Department of Surgery, Auckland Department of Biochemistry, Hospital, Auckland 3, New Zealand University of Oxford, South Park Road, Oxford OX1 3QU, Houdijk A. P. I. United Kingdom Department of Surgery, Free University Hospital, De Boelelaan Pichard C. 1117,1081 HV Amsterdam, Clinical Nutrition Dietetics, The Netherlands Division of Gastroenterology, University Hospital, Geneva, Iapichino G. Switzerland Intensive Care Unit, Ospedale Maggiore, Via F. Sforza 33, Plank L.D. 20122 Milano, Italy Department of Surgery, Auckland Hospital, Auckland 3, New Zealand Iacobs D. O. Radrizzani D. Division of General and Intensive Care Unit, Ospedale Gastrointestinal Surgery, Brigham Maggiore, Via F. Sforza 33, and Women's Hospital, 75 Francis 20122 Milano, Italy Street, Boston MA 02115, USA Revelly I. P. Ieejeebhoy K. N. Intensive Care Unit, Department Department of Medicine, St of Anesthesiology, University Michaels Hospital, 30 Bond Street, Hospital, Lausanne, Switzerland Toronto Ontario, Canada Robinson M. K. Lerebours E. Division of General and Service des Maladies de I' Appareil Gastrointestinal Surgery, Brigham Digestif et de la Nutrition, Hopital and Women's Hospital, 75 Francis Charles Nicolle, 1 rue de Germont, Street, Boston MA 02115, USA 76031 Rouen, France Rombeau I. L. Lew I.!. Department of Surgery, University Department of Surgery, University Hospital, 4 Silverstein Pavilion, Hospital, 4 Silverstein Pavilion, Philadelphia P A 19104, USA Philadelphia PA 19104, USA Slosman D. Lowry, S.F. Department of Nuclear Medicine, Department of Surgery, New York University Hospital, Geneva, Hospital-Cornell Medical Center, Switzerland 525 E. 68th Street, New York NY 10021, USA Stehle P. Institute for Biological Chemistry Mitchell I. and Nutrition,; University of Department of Intensive Care, Hohenheim, Garbenstrasse 30, Guy's Hospital, St Thomas Street, 70599 Stuttgart, Germany London SE1 9RT, United Kingdom Takala I. MonkD. Department of Intensive Care, Department of Surgery, Auckland Kuopio University Hospital, Hospital, Auckland 3, New Zealand 70210 Kuopio, Finland List of Contributors XI Van Leeuwen P. A. M. Young L.S. Department of Surgery, Free Laboratories of Nutrition and University Hospital, De Boelelaan Metabolism, Brigham and Women's 1117,1081 HV Amsterdam, Hospital, 75 Francis Street, Boston The Netherlands MA 02115, USA Vinnars E. Zaloga G.P. Kabi Pharmacia Infusion, Section of Critical Care, 112 87 Stockholm, Sweden Department of Anesthesiology, Bowman Gray School of Medicine, Wernerman 1. Medical Center Boulevard, Winston Department of Anesthesiology, Salem NC 27157-1009, USA Metabolic Research Laboratory, Karolinska Institute, St Goran's Ziegler T. R. Hospital, 112 81 Stockholm, Sweden Department of Medicine, Brigham and Women's Hospital, Joslin Wilmore D. W. Diabetes Center, 1 Joslin Place, Laboratories of Nutrition and Boston MA 02215, USA Metabolism, Brigham and Women's Hospital, 75 Francis Street, Boston MA 02115, USA Abbreviations AIDS Acquired immuno-deficiency syndrome ARDS Adult respiratory distress syndrome ATP Adenosine triphosphate BCCA Branched-chain amino acids BCM Body cell mass BPI Bactericidal/permeability increasing protein BW Body weight CNS Central nervous system COPD Chronic obstructive pulmonary disease DNA Deoxyribonucleic acid ECW Extracellular water EE Energy expenditure EN Enteral nutrition FA Fatty acids GALT Gut associated lymphoid tissue GH Growth hormone GI Gastro-intestinal GSH Gluthatione HDL High density lipoprotein HPLC Human plasma lipid chromatography ICU Intensive care unit ICW Intracellular water IFN Interferon- IGF Insulin-like growth factor IL Interleukin IV Intravenous LBP Lipopolysaccharide binding protein LDH Lactate dehydrogenase LDL Low density lipoproteins LPS Lipopolysaccharide
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