Metabolismo y nutrición del paciente en estado crítico
El modo de soporte nutricional en el paciente en estado crítico es motivo de controversia y abundan las opiniones al respecto. Algunos consideran las demandas calóricas como el objetivo principal de la nutrición en el estado crítico con base en un supuesto alto grado de hipermetabolismo, pero hemos demostrado que tan elevado hipermetabolismo realmente no existe y que, primordialmente, se deben atender las necesidades proteicas en esta condición que es altamente catabólica. El clima hormonal y humoral del estado crítico lleva a que buena parte de las necesidades calóricas sean atendidas por degradación de la proteína corporal. En el estado crítico existe una especie de dependencia de la proteína. El estado clínico del paciente en estrés agudo hace difícil adelantar investigaciones prospectivas y de asignación aleatoria. Una característica del estado crítico es la variabilidad y labilidad de las condiciones fisiopatológicas. En el Servicio de Soporte Metabólico y Nutricional del Hospital Universitario Fundación Santa Fe de Bogotá, desde hace muchos años, se reconoce la particular importancia del aporte proteico y se reduce el aporte calórico en forma de carbohidratos a no más de 600 kcal en 24 horas (150-200 g/24 horas), como fundamento para elegir el soporte nutricional, sea parenteral, entérico o mixto. En este artículo se revisan los fundamentos que llevan a considerar la proteína como el nutriente fundamental para el paciente en estado crítico
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| Journal Title: | Revista Colombiana de Cirugía |
|---|---|
| First author: | Patricia Savino |
| Other Authors: | José Félix Patiño |
| Traslated Keywords: | |
| Language: | Undetermined |
| Get full text: | https://www.revistacirugia.org/index.php/cirugia/article/view/257 |
| Resource type: | Journal Article |
| Source: | Revista Colombiana de Cirugía; Vol 31, (Year 2016). |
| Publisher: | Asociación Colombiana de Cirugía |
| Usage rights: | Reconocimiento - NoComercial - SinObraDerivada (by-nc-nd) |
| Knowledge areas / Categories: | Health Sciences --> Surgery |
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