Nutrition

It is generally accepted that protein intake should vary between 1.2 and 1.5 g/kg/day, and should certainly not exceed 2.0 g/kg/day except in patients with substantial losses (e.g. extensive burns, GI and/or urinary losses, etc.)

Glucose intakes through artificial nutrition should be less than 6 g/kg/day

lipid intakes between 0.5 to ≤  2 g/kg/day. When oral or enteral intakes are possible, the lipid and carbohydrate requirements are the same as for healthy subjects, i.e. 30-35 % of total calorie intakes as lipids and 50-55% as carbohydrates

• Men: EE (kcal/day) = 66 + (13.7 x gewicht) + (5 x Grösse) − (6.8 x alter)
• Women: EE (kcal/day) = 655 + (9.6 x gewicht) + (1.7 x grösse) − (4.7 x alter)
• pro 1 Grad 10% mehr Kalorienbedarf!

• Adequate oral intakes (more than 80% of the energy target)
• Non-functional gut: anastomotic disruption, lower GI obstruction, gut ischaemia/necrosis
• Generalised peritonitis
• Uncontrolled severe shock states

• Expected period of fast ≤ 5 days, except in severely injured patients
• Abdominal distension/severe protracted diarrhoea
• Localised peritonitis, intra-abdominal abscess, active upper GI tract haemorrhage
• Coma with risk of aspiration (especially gastric feeding)
• Very short bowel (less than 70 cm) or high output fistulae
• Electrolytes or fluid or substrate intolerance (kidney, heart, liver failure)
• Terminal disease
• Dementia, agitation, confusion

• Adequate oral intake
• Enteral nutrition feasible and covering more than 60% of the energy target within the three days following admission
• Uncontrolled severe shock states