Table Of Content17
Update in Intensive Care
and Emergency Medicine
Edited by J.-L.Vincent
D. W. Wilmore Y. A. Carpentier (Eds.)
Metabolic Support
of the Critically
III Patient
With 89 Figures and 68 Tables
Springer-Verlag
Berlin Heidelberg New York
London Paris Tokyo
Hong Kong Barcelona
Budapest
Series Editor
Prof. Dr. Jean-Louis Vincent
Clinical Director, Department of Intensive Care, Erasme Hospital
Free University of Brussels, Route de Lennik 808
1070 Brussels, Belgium
Volume Editors
Prof. Dr. Douglas W. Wilmore
Laboratory for Surgical Metabolism,
Brigham and Women's Hospital
75 Francis Street, Boston Massachussetts 02115, USA
Prof. Dr. Yvon A. Carpentier
L. Deloyers Laboratory for Experimental Surgery,
Free University of Brussels, Avenue J. Wybran 40,
1070 Brussels, Belgium
ISBN-13:978-3-642-85013-4 e-ISBN-13:978-3-642-85011-0
DOl: 10.1007/978-3-642-85011-0
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© Springer-Verlag Berlin Heidelberg 1993
Softcover reprint of the hardcover 1st edition 1993
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the absence of a specific statement, that such names are exempt from the relevant pro
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tive user must check its accuracy by consulting other pharmaceutical literature.
19/3130-54321 0 - Printed on acid-free paper
Contents
Monitoring Compositional Changes
and Biochemical Functions
Measuring Body Composition in Intensive Care Patients
(G.L.Hill, D.Monk, and L.D.Plank) ............ 3
Applications of Magnetic Resonance Spectroscopy
to Nutrition and Metabolism
(D. O. Jacobs and M. K. Robinson) .............. 19
Muscle Function and Energetics
(K. N. Jeejeebhoy) ........ . . ....... 46
Muscle Intracellular Ions during Malnutrition
and Refeeding
(c. Pichard, D. Slosman, and A. G. Dulloo) . . . . . . .. 63
Estimation of Peroxidative Damage
(H. Esterbauer) . . . . . . . . . . . . . . . . . . . . . . . . .. 80
What Type of Metabolic Support?
Does Indirect Calorimetry Reflect Energy Expenditure
in the Critical III Patient?
(R. Chiolero, D. Bracco, and J. P. Revelly) . . . . . . . .. 95
Are We Giving Unbalanced Amino Acid Solutions?
(P. Furst and P. Stehle) ..................... 119
Anabolic Drive in Critically III Patients:
Pros and Cons a Prevailing Glucose System
(G. Iapichino and D. Radrizzani) ..... . ........ 137
Are Present Fat Emulsions Appropriate?
(Y. A. Carpentier) ........................ 157
VI Contents
Organ Specific Nutrients and Associated Therapy
Effects of Enteral Nutrients on the Critically III Gut
(J. L Lew and J. L. Rombeau) . . . . . . . . . . . . . . . 175
Nutrition of some Cells of the Immune System
and its Importan~e in the Response to Trauma
(E.A Newsholme) . . . . . . . . . . . . . .. . ...... 198
The Impact of Nutrition on Muscle Tissue
in Critical Illness
(J. Wemerman, P. Garlick, and E. Vinnars) . .215
Enhancing Wound Healing in Severely Burned Patients
(D. A Gilpin, M.l. Muller, and D. N. Hemdon) . . 236
Organ Specific Nutrients and Associated Therapy:
Growth Factors - Growth Hormone
(L.S. Young, T.AByme, and D. W. Wilmore) ........ 252
Preventing Complications
Parenteral versus Enteral Nutrition
(G. P. Zaloga) ........... . . ...... 267
The Importance of the Gut as a Central Organ
in the Pathogenesis of MOF
(M. P. Fink) . . . . . . . . . . . . . . . . . . . . . . . . 294
Altering Bowel Contents with Lactulose
and other Substances prevents Endotoxemia
(P.AM. van Leeuwen, M.A:Boermeester,
and A P.J.Houdijk) ............. . . .. 306
Metabolic Support: Modulation of Purine Metabolism
(J.M.Boeynaems) ................... . .. 320
Metabolic Responses to Anti-Cytokine Thera'pies
(S. F. Lowry) .................. . . . . . 333
The Maintenance of Antioxidant Defenses
during Inflammation
(R. F. Grimble) .......................... 347
Contents VII
DiseaselNutrients Interactions
Acute Renal Failure in the ICU:
Approaches to Nutritional Support
(D. Bihari, 1. Mitchell, and R. Chang) ............. 367
Nutritional Support in Liver Disease
(E. Lerebours) ............ . .. 377
Nutrition and Metabolism in Acute Respiratory Failure
(J. Takala) .......................... . 390
Nutritional Complications associated with Chemotherapy
and Irradiation in Cancer Treatment
(T. R. Ziegler) . . . . . . . . . . . . . . . . . . . . . . . 407
Nutrition in Sepsis
(F. B. Cerra) ....................... 427
Subject Index ......................... 439
List of Contributors
Bihari D. Chiolero R.
Department of Intensive Care, Intensive Care Unit, CHU Vaudois,
Guy's Hospital, St Thomas Street, 1011 Lausanne, Switzerland
London SEI 9RT, United Kingdom
Dulloo A.G.
Boermeester M.A. Institute of Physiology, University
Department of Surgery, Free Hospital, Geneva, Switzerland
University Hospital, De Boelelaan
1117,1081 HV Amsterdam,
Esterbauer H.
The Netherlands
Institute of Biochemistry,
University of Graz, Schubertstrasse 1,
Boeynaems J. M.
8010 Graz, Austria
Institute of Interdisciplinary
Research, School of Medicine, Free
University of Brussels, 808 Route Fink M.P.
de Lennik, 1070 Brussels, Belgium Division of Trauma and Surgical
Critical Care, Beth Israel Hospital,
Bracco D. 330 Brookline Avenue, Boston
Institute of Physiology, University MA 02215, USA
of Lausanne, Lausanne, Switzerland
Furst P.
Byrne T.A. Institute for Biological Chemistry
Laboratories of Nutrition and and Nutrition, University of
Metabolism, Brigham and Women's Hohenheim, Garbenstrasse 30,
Hospital, 75 Francis Street, Boston 70599 Stuttgart, Germany
MA 02115, USA
Garlick P.
Carpentier Y. A.
Rowett Research Institute,
L. Deloyers Laboratory for
Aberdeen, Scotland,
Experimental Surgery and Clinical
United Kingdom
Nutrition Unit, Free University of
Brussels, 40 Avenue J. Wybran,
1070 Brussels, Belgium Gilpin D.A.
Shriners Burns Institute, 815
Cerra F.B. Market Street, Galveston
Department of Critical Care and TX 77550-2725, USA
Clinical Nutrition, University of
Minnesota, Minneapolis MN 55455, Grimble R. F.
USA Department of Human Nutrition,
University of Southampton,
Chang R. Biomedical Sciences Building,
Department of Intensive Care, Bassett Crescent East,
Guy's Hospital, St. Thomas Street, Southampton S09 3TU,
London SEl 9RT, United Kingdom United Kingdom
X List of Contributors
Herndon D. N. Muller M.I.
Shriners Burns Institute, Shriners Burns Institute,
815 Market Street, Galveston 815 Market Street, Galveston
TX 77550-2725, USA TX 77550-2725, USA
Hill G. L. Newsholme E. A.
Department of Surgery, Auckland Department of Biochemistry,
Hospital, Auckland 3, New Zealand University of Oxford, South Park
Road, Oxford OX1 3QU,
Houdijk A. P. I. United Kingdom
Department of Surgery, Free
University Hospital, De Boelelaan Pichard C.
1117,1081 HV Amsterdam, Clinical Nutrition Dietetics,
The Netherlands Division of Gastroenterology,
University Hospital, Geneva,
Iapichino G. Switzerland
Intensive Care Unit, Ospedale
Maggiore, Via F. Sforza 33, Plank L.D.
20122 Milano, Italy Department of Surgery, Auckland
Hospital, Auckland 3, New Zealand
Iacobs D. O.
Radrizzani D.
Division of General and
Intensive Care Unit, Ospedale
Gastrointestinal Surgery, Brigham
Maggiore, Via F. Sforza 33,
and Women's Hospital, 75 Francis
20122 Milano, Italy
Street, Boston MA 02115, USA
Revelly I. P.
Ieejeebhoy K. N.
Intensive Care Unit, Department
Department of Medicine, St
of Anesthesiology, University
Michaels Hospital, 30 Bond Street,
Hospital, Lausanne, Switzerland
Toronto Ontario, Canada
Robinson M. K.
Lerebours E.
Division of General and
Service des Maladies de I' Appareil
Gastrointestinal Surgery, Brigham
Digestif et de la Nutrition, Hopital
and Women's Hospital, 75 Francis
Charles Nicolle, 1 rue de Germont,
Street, Boston MA 02115, USA
76031 Rouen, France
Rombeau I. L.
Lew I.!. Department of Surgery, University
Department of Surgery, University Hospital, 4 Silverstein Pavilion,
Hospital, 4 Silverstein Pavilion, Philadelphia P A 19104, USA
Philadelphia PA 19104, USA
Slosman D.
Lowry, S.F. Department of Nuclear Medicine,
Department of Surgery, New York University Hospital, Geneva,
Hospital-Cornell Medical Center, Switzerland
525 E. 68th Street, New York
NY 10021, USA Stehle P.
Institute for Biological Chemistry
Mitchell I. and Nutrition,; University of
Department of Intensive Care, Hohenheim, Garbenstrasse 30,
Guy's Hospital, St Thomas Street, 70599 Stuttgart, Germany
London SE1 9RT, United Kingdom
Takala I.
MonkD. Department of Intensive Care,
Department of Surgery, Auckland Kuopio University Hospital,
Hospital, Auckland 3, New Zealand 70210 Kuopio, Finland
List of Contributors XI
Van Leeuwen P. A. M. Young L.S.
Department of Surgery, Free Laboratories of Nutrition and
University Hospital, De Boelelaan Metabolism, Brigham and Women's
1117,1081 HV Amsterdam, Hospital, 75 Francis Street, Boston
The Netherlands MA 02115, USA
Vinnars E. Zaloga G.P.
Kabi Pharmacia Infusion, Section of Critical Care,
112 87 Stockholm, Sweden Department of Anesthesiology,
Bowman Gray School of Medicine,
Wernerman 1. Medical Center Boulevard, Winston
Department of Anesthesiology, Salem NC 27157-1009, USA
Metabolic Research Laboratory,
Karolinska Institute, St Goran's Ziegler T. R.
Hospital, 112 81 Stockholm, Sweden Department of Medicine, Brigham
and Women's Hospital, Joslin
Wilmore D. W. Diabetes Center, 1 Joslin Place,
Laboratories of Nutrition and Boston MA 02215, USA
Metabolism, Brigham and Women's
Hospital, 75 Francis Street, Boston
MA 02115, USA
Abbreviations
AIDS Acquired immuno-deficiency syndrome
ARDS Adult respiratory distress syndrome
ATP Adenosine triphosphate
BCCA Branched-chain amino acids
BCM Body cell mass
BPI Bactericidal/permeability increasing protein
BW Body weight
CNS Central nervous system
COPD Chronic obstructive pulmonary disease
DNA Deoxyribonucleic acid
ECW Extracellular water
EE Energy expenditure
EN Enteral nutrition
FA Fatty acids
GALT Gut associated lymphoid tissue
GH Growth hormone
GI Gastro-intestinal
GSH Gluthatione
HDL High density lipoprotein
HPLC Human plasma lipid chromatography
ICU Intensive care unit
ICW Intracellular water
IFN Interferon-
IGF Insulin-like growth factor
IL Interleukin
IV Intravenous
LBP Lipopolysaccharide binding protein
LDH Lactate dehydrogenase
LDL Low density lipoproteins
LPS Lipopolysaccharide
