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Protein requirements, morbidity and mortality in critically ill patients: fundamentals and applications.
Cunha, Haroldo Falcão Ramos da; Rocha, Eduardo Eiras Moreira da; Hissa, Monica.
Afiliação
  • Cunha HF; Nutritional Therapy Services, Clínica São Vicente - Rio de Janeiro, Brazil. haroldo.cunha@unimedrioempreendimentos.com.br
Rev Bras Ter Intensiva ; 25(1): 49-55, 2013 Mar.
Article em En, Pt | MEDLINE | ID: mdl-23887760
Recent evidence suggests that a negative protein balance secondary to severe disease is associated with increased morbidity. A loss of total body protein is inevitable in this scenario, even with an aggressive nutritional approach, primarily due to the catabolism of skeletal muscle fibers. The ubiquitin-proteasome system is the primary metabolic and biochemical mechanism involved in this process; paradoxically, this system consumes adenosine triphosphate as its energy source. It is possible that a neutral protein balance in these clinical situations is important for improving outcomes and achieving the caloric goals estimated or measured by indirect calorimetry. Recent studies have suggested that the use of higher protein concentrations in nutritional therapy for critically ill patients may help to reduce mortality. The purpose of this study was to review some of the nutrition therapy principles related to protein metabolism, evaluate the main assertions of the guidelines of specialty societies and review the recent studies that address these issues using critical insights from the authors' clinical experience.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Proteínas / Apoio Nutricional / Necessidades Nutricionais Tipo de estudo: Guideline Limite: Humans Idioma: En / Pt Revista: Rev Bras Ter Intensiva Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Proteínas / Apoio Nutricional / Necessidades Nutricionais Tipo de estudo: Guideline Limite: Humans Idioma: En / Pt Revista: Rev Bras Ter Intensiva Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil