Ebook Oxford textbook of critical care (2/E): Part 2
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Ebook Oxford textbook of critical care (2/E): Part 2
SECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2r and Adam M Deane202 The metabolic and nutritional response to critical illness 956 Linda-Jayne Motcram and Gavin G. LaveryCHAPTER 201Normal physiology of nutritionAnnika Reintam Blaser and Adam M. DeaneKey point*♦Ingested carbohydrate, glycogenolysis, and gluconeogenesis are essential for function Ebook Oxford textbook of critical care (2/E): Part 2 of brain and anaerobic tissues that depend on glucose as their main energy source.♦Fat is the most energy-rich nutrient, but most of ingested lipidsEbook Oxford textbook of critical care (2/E): Part 2
will be stored in adipose tissue because the oxidative capacity for lipids is low.♦During periods of inadequate energy delivery, ingested or endogenouSECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2) is the largest component of total dally energy requirements, even In the case of very high physical activity or acute illness.♦Daily energy requirements range from 1800 to 2800 kcal/ day or 25 to 30 kcal/kg body weight (BW)/day roughly— carbohydrates should provide 55-60%. lipids 25-30%, and prote Ebook Oxford textbook of critical care (2/E): Part 2ins 10-15%.Body compositionWater (approximately 60% in adult males and 50% in females 11 ]), protein, minerals, and fat are the mam components of humaEbook Oxford textbook of critical care (2/E): Part 2
n body. Essential fat is contained in bone marrow, the heart, lungs, liver, spleen, kidneys, intestines, muscles, and central nervous system. Fat locaSECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2l further divides FFM into body cell mass and extracellular mass [2|. Lean body mass is an indirect estimation of the weight of bones, muscles, ligaments. and internal organs. which can be calculated using various equations |3|.Direct methods of assessing body composition, such as skinfolds, bioelec Ebook Oxford textbook of critical care (2/E): Part 2trical impedance analysis, and hydrostatic weighing are not routinely used in the critically 111.Estimation of nutritional statusBody inass index (B.MEbook Oxford textbook of critical care (2/E): Part 2
I) = weight (kg)/height (m) and provides a rough estimation of nutritional status [2|. A limitation of B.M1 IS that the calculation does not distinguiSECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2bidity and mortality |2|. In persons >60 years old being slightly heavier (BMI 26-27) Is associated with the longer life expectancy |2).While being underweight is associated with poorer outcomes in the critically ill, obesity does not appear to be harmful (and may be beneficial) (4|.Estimation of th Ebook Oxford textbook of critical care (2/E): Part 2e ideal body weight [5) is often inaccurate, but the range may be useful and can be calculated (Brocas Index):(Height (cm) -100) ± 15% for tvomen or 1Ebook Oxford textbook of critical care (2/E): Part 2
0% for men |eqn 1)Clinical examination and laboratory testsGeneral clinical examination of skin. hair. eyes. gums, tongue, bones, muscles, and thyroidSECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2mphocyte count, glucose, serum albumin, prealbumin, transferrin, total protein measurements, and calculation of nitrogen balance have limitations, but have been used. Nitrogen balance is considered the most dynamic nutritional indicator.Essential nutrients: substrate and energy metabolismEssential n Ebook Oxford textbook of critical care (2/E): Part 2utrients are substances that are not synthesized (or are synthesized in too small amounts) within the body and must, therefore, be ingested or adminisEbook Oxford textbook of critical care (2/E): Part 2
tered. They include essential fatty acids, essential ammo acids, vitamins, and dietary minerals.EnergyEnergy is derived from three major categories ofSECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2irements to maintain stable weight can be estimated, using calculations or measured using calorimetry.Oxidative (burning for energy) and non-oxidative (storage, synthesis) substrate metabolism occur to a diflerent extent according to the type of macronutrient and state of energy stores [2|. Respirat Ebook Oxford textbook of critical care (2/E): Part 2ory quotient (RQ) is used to describe oxidative substrate metabolism.CarbohydratesCarbohydrates are compounds comprised of carbon, hydrogen, and oxygeEbook Oxford textbook of critical care (2/E): Part 2
n. Depending on the composition of these molecules, carbohydrates are divided into mono-, di-, oligo-, and polysaccharides. While carbohydrates are noSECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam Blaser Ebook Oxford textbook of critical care (2/E): Part 2ch, whereas tn animals It is Stored as glycogen.SECTION 7NutritionPart 7.1 Physiology 950Part 7.2 Nutritional failure 060PART 7.1Physiology201 Normal physiology of nutrition 95?Annika Reincam BlaserGọi ngay
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