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Vol. 35. Núm. S1.
Recomendaciones para el Soporte Nutricional del paciente crítico
Páginas 77-80 (Noviembre 2011)
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Vol. 35. Núm. S1.
Recomendaciones para el Soporte Nutricional del paciente crítico
Páginas 77-80 (Noviembre 2011)
DOI: 10.1016/S0210-5691(11)70016-X
Acceso a texto completo
Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Paciente neurocrítico
Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): Neurocritical patient
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acostesc@gmail.com

Autor para correspondencia.
, I. Herrero Meseguerb, R. Conejero García-Quijadac
a Hospital General Universitario, Alicante, España
b Hospital Universitario de Bellvitge, Barcelona, España
c Hospital Universitario San Juan, Alicante, España
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Bibliografía
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Resumen

El enfermo neurocrítico precisa un soporte nutricional especializado debido a su intenso catabolismo y a un prolongado período de ayuno. La vía de administración nutricional preferente es la gastrointestinal, particularmente la vía gástrica, siendo alternativas la vía transpilórica o la nutrición mixta enteral-parenteral en caso de no obtener un volumen nutricional eficaz superior al 60%.

El aporte calórico total oscila entre 20–30kcal/kg/día, según el período de evolución clínica en que se encuentre, con un aporte proteico superior al 20% de las calorías totales (hiperproteico). El inicio del aporte nutricional debe ser precoz.

La incidencia de complicaciones gastrointestinales es superior al enfermo crítico en general, siendo el aumento del residuo gástrico el más frecuente.

Debe establecerse un estrecho control de la glucemia, manteniéndose por debajo de 150mg/dl como en el resto de los enfermos críticos.

Palabras clave:
Paciente neurocrítico
Traumatismo craneoencefálico
Nutrición precoz
Hiperglucemia
Abstract

Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteralparenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained.

Total calore intake ranges from 20–30kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early.

The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complicat ion being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150mg/dL.

Keywords:
Neurocritical patient
Traumatic brain injury
Early nutrition
Hyperglycemia
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SEMICYUC: Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias. SENPE: Sociedad Española de Nutrición Parenteral y Enteral.

Copyright © 2011. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
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