Terapia nutricional enteral e parenteral: complicações em pacientes críticos - uma revisão de literatura

Content Provider	Semantic Scholar
Author	Castrao, Deyse Lúcy Luiz E Freitas, Magda Marques De Zaban, Ana Lúcia Ribeiro Salomon
Copyright Year	2009
Abstract	Objetivos: Identificar as principais complicacoes decorrentes das terapias enteral e parenteral utilizadas em pacientes criticos internados em Unidades de Terapia Intensiva, bem como a influencia dessas complicacoes na evolucao clinica do paciente. Metodos: Levantamento bibliografico em livros didaticos e em artigos cientificos publicados no periodo de 1998 a 2008. Resultados e Discussao: A nutricao enteral, apesar de seus beneficios, apresenta riscos de complicacoes mecânicas, infecciosas, metabolicas e gastrintestinais, sendo estas as mais prevalentes. A nutricao parenteral e a alternativa quando o trato gastrintestinal nao pode ser utilizado. Nesta via, ha riscos de complicacoes infecciosas, mecânicas e metabolicas. As complicacoes da terapia nutricional originam um balanco energetico negativo, podendo agravar a desnutricao e o quadro clinico do paciente, com aumento da incidencia de infeccoes e da mortalidade, alem de aumentar os dias de internacao e os custos hospitalares. Conclusao: A terapia nutricional e fundamental ao paciente critico, podendo aumentar sua sobrevida, entretanto, nao e isenta de riscos. A nutricao enteral apresenta como principais complicacoes diarreia e volume residual gastrico alto. Na nutricao parenteral, a complicacao predominante e a hiperglicemia. Nao ha consenso sobre qual metodo apresenta maiores riscos; sabe-se, porem, que a via enteral e preferivel por ser mais fisiologica e ter menos custos. Deve-se ter atencao ao manejo da terapia nutricional, pois as complicacoes sao capazes de interferir negativamente na recuperacao do paciente, podendo causar obito. Deste modo, torna-se essencial a formacao de equipes multidisciplinares e o estabelecimento de protocolos de conduta, a fim de prevenir ou minimizar essas complicacoes. Objectives: Identify the main complications of the nutritional therapies applied to critical patients admitted to Intensive Care Units, as well as the influence of such complications in the clinical status of the patient. Methods: Bibliographic research on textbooks and scientific articles published in the period from 1998 to 2008. Results and Discussion: Despite the benefits of Enteral Nutrition, it presents risks of mechanical, infectious, metabolic and gastrointestinal complications, of which the later are the most prevalent. The parenteral nutrition is the alternative when the gastrointestinal tract can not be used. This route imposes risks of infectious, mechanical and metabolic complications. The complications of nutritional therapy lead to a negative energetic balance, which can worsen malnutrition and patients' clinical status, increasing the incidence of infections and mortality, as well as length of hospital stay and costs. Conclusion: The nutritional support is essential, but it is not riskless. The enteral nutrition presents major complications such as diarrhea and high residual volume in the stomach. In parenteral nutrition the main complication is hyperglycemia. There is no consensus on which method presents greater risks. It is known, however, that enteral route is preferable because it is more physiological and has lower costs. It should be given special attention in the management of nutritional support, because complications are able to interfere negatively in patients' clinical course and may cause death. Thus, the composition of multidisciplinary teams and the creation of protocols of conduct is essential in order to preventor minimize these complications.
Starting Page	65
Ending Page	74
Page Count	10
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://www.escs.edu.br/pesquisa/revista/2009Vol20_1art07terapianutricional.pdf
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article