In einer prospektiven Studie an Patienten mit Schädel-Hirn-Trauma wurden Untersuchungen zum Ausmaß der Proteinkatabolie unter einer kombinierten enteral-parenteralen Ernährung mit hohem Eiweiβanteil ( > 2,0 g EW/kg KG) durchgeführt. Bei 10 nichtmoribunden männlichen Schwerverletzten wurden über 8 Tage die Ausscheidung des Gesamt-N, Kreatinins und 3-Methylhistidins bestimmt. Die Patienten erhielten ein nach dem Körpergewicht modifiziertes parenteral-enterales Ernährungsregime, das für einen Patienten von 70 kg Gewicht eine tägliche Zufuhr von 470 g KH, 170 g Aminosäuren/ Protein, 45 g Fett (3040 kcal/Tag = 12700 kJ/Tag mit 112 kcal/g N = 468 kJ/g N) vorsah. Die klinisch-chemischen Parameter zeigten eine beachtliche Eiweißkatabolie und einen deutlich gesteigerten Muskelstoffwechsel an. Das untersuchte Ernährungsregime war somit nicht in der Lage, die Stickstoffbilanz auszugleichen und den Verbrauch körpereigener Substanz zu verhindern.

Keywords:
Schädel-Hirn-Trauma, Kombinierte enteral-parenterale Ernährung, Proteinkatabolie
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© 1983 S. Karger AG, Basel
1983
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