Elsevier

Medicina Intensiva

Volume 35, Supplement 1, November 2011, Pages 68-71
Medicina Intensiva

Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Paciente politraumatizadoGuidelines 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 polytrauma☆

https://doi.org/10.1016/S0210-5691(11)70014-6Get rights and content

Resumen

El paciente traumatizado puede considerarse el paradigma del paciente crítico que, previamente sano, sufre una agresión que pone su vida en riesgo y que determina una respuesta orgánica en nada diferente a la presente en otro tipo de pacientes. El perfil del paciente traumático ha cambiado, siendo en la actualidad algo más mayores, con índices de masa corporal más elevados y con una mayor comorbilidad. Cuando la agresión es grave, su respuesta metabólica es intensa y condiciona un riesgo nutricional. Por ello, el soporte nutricional precoz, de preferencia enteral, con aporte proporcionado de proteínas y suplementado con glutamina, condiciona ventajas competitivas con otras vías y tipos de fórmulas nutricionales.

La presencia de obesidad y/o lesión medular debe hacernos considerar una disminución proporcionada del aporte calórico diario, evitando la sobrenutrición, aunque en los pacientes con lesión medular es escasa la información disponible.

Abstract

Patients with polytrauma can be viewed as paradigmatic of the critically-ill patient. These previously healthy patients undergo a life-threatening aggression leading to an organic response that is no different from that in other types of patients. The profile of trauma patients has changed and currently corresponds to patients who are somewhat older, with a higher body mass index and greater comorbidity. Severe injuries lead to intense metabolic stress, posing a risk of malnutrition. Therefore, early nutritional support, preferentially through the enteral route, with appropriate protein intake and glutamine supplementation, provides advantages over other routes and types of nutritional formula. To avoid overnutrition, reduced daily calorie intake can be considered in obese patients and in those with medullary lesions. However, little information on this topic is available in patients with medullary lesions.

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    ☆

    SEMICYUC: Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias. SENPE: Sociedad Española de Nutrición Parenteral y Enteral

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