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Nutritional support of critically ill patients is a major treatment modality which will enhance recovery and shorten convalescence. New knowledge has emphasized that much of the organ dysfunction associated with sepsis and altered blood flow is related to oxidative injury. Specific nutrients are highly effective in counteracting these effects and their early administration may attenuate cellular damage and multi-organ failure. Patient outcome may also be enhanced by the route of feeding, administration of newer nutrient combinations, utilization of evolving methods of monitoring and the use of growth factors. This new knowledge has evolved to a new area of metabolic support which is addressed for the first time by a group of international experts. The topics presented and general conclusions are of major importance to the practitioners in this field, for they show, for the first time, a departure from the more traditional approaches of nutritional support in patients with life-threatening diseases.
List of contents
Monitoring Compositional Changes and Biochemical Functions.- Measuring Body Composition in Intensive Care Patients.- Applications of Magnetic Resonance Spectroscopy to Nutrition and Metabolism.- Muscle Function and Energetics.- Muscle Intracellular Ions during Malnutrition and Refeeding.- Estimation of Peroxidative Damage.- What Type of Metabolic Support?.- Does Indirect Calorimetry Reflect Energy Expenditure in the Critical Ill Patient?.- Are We Giving Unbalanced Amino Acid Solutions?.- Anabolic Drive in Critically Ill Patients: Pros and Cons a Prevailing Glucose System.- Are Present Fat Emulsions Appropriate?.- Organ Specific Nutrients and Associated Therapy.- Effects of Enteral Nutrients on the Critically Ill Gut.- Nutrition of some Cells of the Immune System and its Importance in the Response to Trauma.- The Impact of Nutrition on Muscle Tissue in Critical Illness.- Enhancing Wound Healing in Severely Burned Patients.- Organ Specific Nutrients and Associated Therapy: Growth Factors - Growth Hormone.- Preventing Complications.- Parenteral versus Enteral Nutrition.- The Importance of the Gut as a Central Organ in the Pathogenesis of MOF.- Altering Bowel Contents with Lactulose and other Substances prevents Endotoxemia.- Metabolic Support: Modulation of Purine Metabolism.- Metabolic Responses to Anti-Cytokine Therapies.- The Maintenance of Antioxidant Defenses during Inflammation.- Disease/Nutrients Interactions.- Acute Renal Failure in the ICU: Approaches to Nutritional Support.- Nutritional Support in Liver Disease.- Nutrition and Metabolism in Acute Respiratory Failure.- Nutritional Complications associated with Chemotherapy and Irradiation in Cancer Treatment.- Nutrition in Sepsis.
