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[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): patient with sepsis].
Med Intensiva 2011; 35 Suppl 1:72-6MI

Abstract

Nutritional metabolic management, together with other treatment and support measures used, is one of the mainstays of the treatment of septic patients. Nutritional support should be started early, after initial life support measures, to avoid the consequences of malnutrition, to provide adequate nutritional intake and to prevent the development of secondary complications such as superinfection or multiorgan failure. As in other critically-ill patients, when the enteral route cannot be used to ensure calorie-protein requirements, the association of parenteral nutrition has been shown to be safe in this subgroup of patients. Studies evaluating the effect of specific pharmaconutrients in septic patients are scarce and are insufficient to allow recommendations to be made. To date, enteral diets with a mixture of substrates with distinct pharmaconutrient properties do not seem to be superior to standard diets in altering the course of sepsis, although equally there is no evidence that these diets are harmful. There is insufficient evidence to recommend the use of glutamine in septic patients receiving parenteral nutrition. However, given the good results and absence of glutamine-related adverse effects in the various studies performed in the general population of critically-ill patients, these patients could benefit from the use of this substance. Routine use of omega-3 fatty acids cannot be recommended until further evidence has been gathered, although the use of lipid emulsions with a high omega-6 fatty acid content should be avoided. Septic patients should receive an adequate supply of essential trace elements and vitamins. Further studies are required before the use of high-dose selenium can be recommended.

Authors+Show Affiliations

Hospital Universitario Virgen del Rocío, Sevilla, España. carlos.ortiz.sspa@juntadeandalucia.esNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Consensus Development Conference
Journal Article
Practice Guideline

Language

spa

PubMed ID

22309758

Citation

Ortiz Leyba, C, et al. "[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): Patient With Sepsis]." Medicina Intensiva, vol. 35 Suppl 1, 2011, pp. 72-6.
Ortiz Leyba C, Montejo González JC, Vaquerizo Alonso C, et al. [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): patient with sepsis]. Med Intensiva. 2011;35 Suppl 1:72-6.
Ortiz Leyba, C., Montejo González, J. C., & Vaquerizo Alonso, C. (2011). [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): patient with sepsis]. Medicina Intensiva, 35 Suppl 1, pp. 72-6. doi:10.1016/S0210-5691(11)70015-8.
Ortiz Leyba C, et al. [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): Patient With Sepsis]. Med Intensiva. 2011;35 Suppl 1:72-6. PubMed PMID: 22309758.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [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): patient with sepsis]. AU - Ortiz Leyba,C, AU - Montejo González,J C, AU - Vaquerizo Alonso,C, AU - ,, PY - 2012/2/8/entrez PY - 2012/3/14/pubmed PY - 2012/6/15/medline SP - 72 EP - 6 JF - Medicina intensiva JO - Med Intensiva VL - 35 Suppl 1 N2 - Nutritional metabolic management, together with other treatment and support measures used, is one of the mainstays of the treatment of septic patients. Nutritional support should be started early, after initial life support measures, to avoid the consequences of malnutrition, to provide adequate nutritional intake and to prevent the development of secondary complications such as superinfection or multiorgan failure. As in other critically-ill patients, when the enteral route cannot be used to ensure calorie-protein requirements, the association of parenteral nutrition has been shown to be safe in this subgroup of patients. Studies evaluating the effect of specific pharmaconutrients in septic patients are scarce and are insufficient to allow recommendations to be made. To date, enteral diets with a mixture of substrates with distinct pharmaconutrient properties do not seem to be superior to standard diets in altering the course of sepsis, although equally there is no evidence that these diets are harmful. There is insufficient evidence to recommend the use of glutamine in septic patients receiving parenteral nutrition. However, given the good results and absence of glutamine-related adverse effects in the various studies performed in the general population of critically-ill patients, these patients could benefit from the use of this substance. Routine use of omega-3 fatty acids cannot be recommended until further evidence has been gathered, although the use of lipid emulsions with a high omega-6 fatty acid content should be avoided. Septic patients should receive an adequate supply of essential trace elements and vitamins. Further studies are required before the use of high-dose selenium can be recommended. SN - 1578-6749 UR - https://www.unboundmedicine.com/medline/citation/22309758/[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_:_patient_with_sepsis]_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0210-5691(11)70015-8 DB - PRIME DP - Unbound Medicine ER -