livro de enteral e parenteral

Prévia do material em texto

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Finalmente, a ingestão nutricional deve ser avaliada (por exemplo, protocolo 
hídrico e de alimentos) e terapia nutricional iniciada caso a ingestão seja reduzida.
SGA A:
SGA B: 
SGA C: 
Tabela 1.1: Parâmetros Bioquímicos para a avaliação de desnutrição de proteína:31
 Stratton RJ, Elia M. Who bene�ts from nutritional 
 Waitzberg DL. Ef�cacy of nutritional support: 
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Westerterp KR, Schols AMWJ, Singer P. Energy 
AKE. Recommendations for enteral and parenteral 
(HPN) in adult patients. Clin Nutr. 2009;28:467-479.
Bozzetti F, Arends J, Lundholm K, Micklewright 
Morlion BJ. Water, electrolytes and acid-base 
metabolism. In: Biesalski HK, Fürst P, Kasper H, 
Kluthe R, Pölert W, Puchstein C et al., editors. 
Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R. 1. 
Hepatology and Nutrition (ESPGHAN) and the 
Society of Paediatric Research (ESPR). J.Pediatr.
D-A-CH. Referenzwerte für die Nährstoffzufuhr. 
Frankfurt: Umschau Braus GmbH 
Food and Nutrition Board IoM. Dietary Reference 
Fürst P, Deutz NEP, Boirie Y, Roth E, Soeters PB. 
Arends J, Bodoky G, Bozzetti F et al. ESPEN 
Plauth M, Cabre E, Riggio O et al. ESPEN Guidelines 
Gianotti L, Meier R, Lobo DN et al. ESPEN Guidelines 
McClave SA, Martindale RG, Vanek VW et al. 
Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 
Roth E. Nonnutritive effects of glutamine. J Nutr. 
Newsholme P, Procopio J, Lima MM, Pithon-Curi TC, 
Curi R. Glutamine and glutamate–their central role 
Curi R, Lagranha CJ, Doi SQ et al. Molecular 
mechanisms of glutamine action. J Cell Physiol. 
Biolo G, Fleming RY, Maggi SP, Ngyen TT, Herndon 
DN, Wolfe RR. Inhibition of muscle glutamine 
Fürst P, Albers S, Stehle P. Evidence for a nutritional 
Roth E, Zöch G, Schulz F et al. Amino acid 
Health, Postinjury, Surgery or Infection? J Nutr. 
Biolo G, Zorat F, Antonione R, Ciocchi B. Muscle 
glutamine depletion in the intensive care unit. Int J 
Rodas PC, Rooyackers O, Herbert C, Norberg 
A, Wernerman J. Glutamine and glutathione at 
Dechelotte P, Hasselmann M, Cynober L et al. 
Grif�ths RD, Jones C, Palmer TE. Six-month 
Heyland DK, Dhaliwal R, Drover JW, Gramlich L, 
critically ill adult patients. JPEN. 2003;27:355-373.
on Italian data. Int J Technol Assess Health Care. 
Heyland DK, Schroter-Noppe D, Drover JW et al. 
for improvement? JPEN J Parenter.Enteral Nutr. 
Bolder U, Ebener C, Hauner H et al. Carbohydrates - 
Askanazi J, Nordenstrom J, Rosenbaum SH et al. 
Preiser JC. Glucose control. World Rev Nutr Diet. 
McCowen KC, Malhotra A, Bistrian BR. Stress-induced 
Adolph M, Heller AR, Koch T et al. Lipid emulsions - 
Grimble RF. Fatty acid pro�le of modern lipid 
emulsions: Scienti�c considerations for creating the 
Wanten GJ, Calder PC. Immune modulation 
by parenteral lipid emulsions. Am J Clin Nutr. 
Waitzberg DL, Torrinhas RS, Jacintho TM. New 
parenteral lipid emulsions for clinical use. JPEN J 
in�ammation. Prostaglandins Leukot Essent Fatty 
Calder PC. Hot topics in parenteral nutrition. 
Rationale for using new lipid emulsions in 
Ulrich H, Pastores SM, Katz DP, Kvetan V. Parenteral 
lipid emulsions. World J Surg. 2000;24:1493-1497.
Carlson SE, Salem N, Jr. Essentiality of ω
Simopoulos AP, Kifer RR, Martin RE, Barlow SM, 
editors. World Rev Nutr Diet. Basel: Karger, 1991: 
and term infants: review of clinical studies. Crit Rev 
Calder PC. Use of �sh oil in parenteral nutrition: 
Rationale and reality. Proc Nutr Soc. 2006;65:264-
Calder PC. n-3 fatty acids, in�ammation and 
Ziegler TR. Parenteral Nutrition in the Critically Ill 
Patient. New Engl J Med. 2009;361:1088-1097.
Waitzberg DL, Lotierzo PH, Logullo AF, Torrinhas 
RS, Pereira CC, Meier R. Parenteral lipid emulsions 
and phagocytic systems. Br J Nutr. 2002;87 Suppl 
Roulet M, Detsky AS, Marliss EB et al. A controlled 
Piper SN, Schade I, Beschmann RB, Maleck WH, 
Boldt J, Rohm KD. Hepatocellular integrity after 
parenteral nutrition: comparison of a �sh-oil-
oil-based lipid emulsion. Eur J Anaesthesiol. 
Antebi H, Mansoor O, Ferrier C et al. Liver function 
comparison of 2 fat emulsions. JPEN J Parenter 
Tovey SJ, Benton KG, Lee.H.A. Hypophosphataemia 
Bene�cial effect of coinfusing a lipid emulsion on 
venous patency. JPEN. 1989;13:647-640.
practical considerations. JPEN. 2009;33:548-562.
treatment. Eur J Clin Nutr. 2008;62:687-694.
in critically ill burned patients. J Trace Elem Med 
Heyland DK, Dhaliwal R, Suchner U, Berger MM. 
Manzanares W, Dhaliwal R, Jiang X, Murch L, Heyland 
2012;25:R66 (ePub ahead of print).
AAES-JORGENSEN E., Physiol Rev. 1961 Jan;41:1-51.
Simopoulos AP, Leaf A, Salem N Jr. Prostaglandins 
Stechmiller JK. Understanding the role of 
cutaneous wound healing. J Wound Care. 2011 
Jun;20(6):287-93.
parenteral nutrition (HPN) in adult patients. Staun 
M, Pironi L, Bozzetti F, Baxter J, Forbes A, Joly F, 
Jeppesen P, Moreno J, Hébuterne X, Pertkiewicz M, 
Mühlebach S, Shenkin A, Van Gossum A; ESPEN. Clin 
Adolph M, Heller AR, Koch T et al. Lipid emulsions –
 
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28,30
1.
2.
3.
�ve hospitals. Am J Health Syst Pharm. 1997;54:904-
30.
Pittiruti M, Hamilton H, Bif� R, Mac�e J, Pertkiewicz 
10. 
de�ned total parenteral nutrition formulation in 
20. 
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Hartl W, Jauch KW, Parhofer K, Rittler P. 
2004;19:274-283.
AKE. Recommendations for enteral and parenteral 
Clin Nutr. 2009;28:387-400.
2009;33:277-316.
Mirtallo JM, Dasta JF, Kleinschmidt KC, Varon J. 
Current applications, safety pro�le, and clinical 
Adolph M, Heller AR, Koch T et al. Lipid emulsions – 
2011;91:543-563.
Kelly DA. Liver complications of pediatric parenteral 
nutrition - epidemiology. Nutrition. 1998153.
Kelly DA. Preventing parenteral nutrition liver 
disease. Early Hum Dev. 2010;86:683-687.
Schlotzer E. Bene�cial effects of �sh oil–based lipid 
2011: 419-432.
6 
.
 
 
 
112
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Tendência para aumentar a relação de 
Proteína: Gordura: Glicose de 50:50 e 
60:40 ou até 70:30 das calorias não 
proteicas (C)
Fornecimento de 
ácidos graxos 
essenciais (7-10 g/
dia, correspondendo 
a 14-20 g de 
gordura LCT de óleo 
de soja e 30-40 g de 
gordura LCT de óleo 
de oliva/soja (C).
1. Bozzetti F, Forbes A. The ESPEN clinical practice 
guidelines on Parenteral Nutrition: Present status 
and perspectives for future research. Clin Nutr. 
2009;28:359-364.
2. Singer P, Berger MM, Van den BGet al. ESPEN 
Guidelines on Parenteral Nutrition: intensive care. 
Clin Nutr. 2009;28:387-400.
3. Gianotti L, Meier R, Lobo DN et al. ESPEN Guidelines 
on Parenteral Nutrition: pancreas. Clin Nutr. 
2009;28:428-435.
4. Cano N, Aparicio M, Brunori G et al. ESPEN guidelines 
on parenteral nutrition: Adult renal failure. Clin 
Nutr. 2009414-.
5. Bozzetti F, Arends J, Lundholm K, Micklewright 
A, Zurcher G, Muscaritoli M. ESPEN Guidelines on 
Parenteral Nutrition: non-surgical oncology. Clin 
Nutr. 2009;28:445-454.
6. Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann 
A, Bozzetti F. ESPEN Guidelines on Parenteral 
Nutrition: surgery. Clin Nutr. 2009;28:378-386.
7. Staun M, Pironi L, Bozzetti F et al. ESPEN Guidelines 
on Parenteral Nutrition: home parenteral nutrition 
(HPN) in adult patients. Clin Nutr. 2009;28:467-479.
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