際際滷

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Osnovi na klinicka nutricija, enteralna & parenteralna

Stojan Nikoli
Stojan Nikoli

Fresenius Kabi portfolio za klinicka ishrana

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仆仂于亳 仆舒 亠仆亠舒仍仆舒 亳 仗舒亠仆亠舒仍仆舒 亳舒仆舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 1
亞舒亳仆舒 亠仆舒仍仆舒 弌仂仆亟舒 弌仂仆亟舒 舒仍仆仂 -> 舒仍仆亳 亟仂亟舒仂亳 仆舒 亳舒仆舒舒 (ONS) 亠亳亠仆舒 于亠仆从舒 丶亠仆舒仍仆舒 于亠仆从舒 丿仂 亠 从仍亳仆亳从舒 仆亳亳舒? 舒亠仆亠舒仍仆舒 亳 亠仆亠舒仍仆舒 仆亳亳舒 舒亠仆亠舒仍仆舒 亳亳舒 仆亠舒仍仆舒 亳亳舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 2 从仂 仂仄舒从仂 仆从亳仂仆亳舒, 从仂亳亳 亞仂. Grecu I World Rev Nutr Diet 2013, 105:21-31
舒亳亠仆亳 亰舒 从仂亳 亠 仆舒仄亠仆亠舒 EN 丐仄仂从舒 从舒亠从亳舒, 仂仗从亳舒 仆舒 亞仂仆亳仂 丐, 亠仄仂 亳仍亳 舒亟亳仂 亠仆亠亳 仂仄舒, 从舒舒弍仂仍亳亰舒仄, 仗仂仍亳舒仄舒, 亳亰亞仂亠仆亳亳 仂仆仂于舒 弍仂仍亠, 仗舒仆从亠舒亳仆舒 亳仆亳亳亠仆亳舒, 亳仆亟仂仄 仆舒 从舒亠仆仂 亠于仂, HIV / AIDS 亠 & 仗仂仂仗亠舒亳于仆舒 仆亳亳舒, 亳仆亟仂仄 仆舒 从舒亠仆仂 亠于仂 舒从亳仆仂仆仂于舒 弍仂仍亠, 仄仍亳仗仆舒 从仍亠仂亰舒, 舒仗仂仗仍亠从亳舒 丶亳亳仆舒 亳弍仂亰舒, 亠亠弍舒仍仆亳 亰舒弍仂仍于舒舒, 亠仍亳舒仆舒 弍仂仍亠, 从舒亠从亳舒, 从仂仆于舒仍亠亠仆亳舒 仆从仂仍仂亞亳舒 仆亠仆亰亳于仆舒 仆亠亞舒 丱 丱亳亞亳舒 亠于仂仍仂亞亳舒 亠亟亳舒亳舒 亠亳舒亳舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 3 亰仆亠仄仂亠仆仂, 舒从仂仗亠仆亳舒, 亞弍亳仂从 仆舒 舒仗亠亳, 仗仂亠仄亠于舒舒 仆舒 亞仂仍舒亠仂
亳亳于仆舒 亠舒仗亳舒 亠 亳仆亟亳亳舒仆舒 仂仄舒仍仆舒 亳舒仆舒 + ONS1 舒仍亳 亠 仄仂亢仆舒 仂舒仍仆舒 仆亳亳舒? 1ONS: 舒仍仆亳 亟仂亟舒仂亳 仆舒 亳舒仆舒 2GI: 舒仂亳仆亠亳仆舒仍仆舒 3PN: 舒亠仆亠舒仍仆舒 仆亳亳舒 4 TPN: 丐仂舒仍仆舒 仗舒亠仆亠舒仍仆舒 仆亳亳舒 弌仂仆亟舒 NO TPN4 弌仂仆亟舒+PN3 PARTLY 舒仍亳 GI2 舒从 仆从亳仂仆亳舒 仂仂亟于亠仆仂? 亰弍仂 仆舒 仆亳亳于仆舒 亠舒仗亳舒 个仆从亳舒 仆舒 亠于舒舒 & 仗舒亳舒 仆舒 舒仗仍亳从舒亳舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 4
丿仂 亠 亠仆亠舒仍仆舒 仆亳亳舒? 亟仄亳仆亳舒亳舒 仆舒 亠仆舒 亳舒仆舒 仂舒仍仆仂 亳仍亳 仗亠从 仂仆亟舒 于仂 亞舒仂亳仆亠亳仆舒仍仆亳仂 舒从 仄仗亳 亰舒 舒仆亠亠 舒亰舒仍仆亳 / 亠从舒仆亳 仂仆亟亳 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 5
丿仂 亠 亠仆亠舒仍仆舒 仆亳亳舒? 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 19.11.2017 6 弍亳仆舒 舒仆舒? 仍亠亠仆 仗仂亳亰于仂亟? 丱舒仆舒 亰舒 舒仂仆舒亳? 丐仂舒 亠 亠亳从舒仆舒 仗仂亟亟从舒 亰舒 从亳亳仆仂 亳仍亳 仂仆亳仆仂 弍仂仍仆亳 仗舒亳亠仆亳 仂 仄舒仍仆亳亳舒 Source: 87452883 | Thinkstock, 495950860 | Thinkstock, NASA
舒仍仆亳亳舒 舒仍亳 亠 亠仍亠于舒仆仆舒 于仂 亰亟舒于于仂仂? 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 19.11.2017 7
11/19/2017 8 Fresenius-Kabi 亳仂亳舒 仆仂于舒亠 仆仂于舒 仆舒 舒仄舒亠于从舒舒 从仂仄仗舒仆亳舒 亠 Dr. E. Fresenius 舒亠仆亠舒仍仆舒 亳舒仆舒, HES 舒亰于仂 仆舒 亳仆仂于舒亳于亠仆 舒于仂 亰舒 仆舒亟仂从仆舒亟于舒 亠 仆舒 亠仆仂亳 于仂 从于舒 (HES) 1971/721962195514621912 舒亰于仂 仆舒 亳仆亰亳仂仆亳 舒于仂亳 亳 仆亳于仆仂 仗仂亳亰于仂亟于仂 仆亰亳从亳 舒于仂亳 Intralipid速 于舒舒 仄舒仆舒 亠仄仍亰亳舒 仂亟 舒仆舒 仆舒 Kabi Vitrum 1979 仆亠舒仍仆舒 亳舒仆舒 亠舒于于舒亠 仆舒 仗于亳仂 亞仂仂于 仗亠仗舒舒 亰舒 亳舒仆舒 仗亠从 仂仆亟舒, Fresubin速
Fresubin速-40 亞仂亟亳仆亳 亠仆亠舒仍仆舒 仆亳亳舒 1975 Fresubin速 instant, high-molecular powder diet with different flavours 1997 Fresenius Energan plus Sonde, the first high-caloric fibre- rich tube feed in Germany 1979 Fresubin速 fl端ssig (meaning liquid), one of the first ready-to-use sterile tube feeds 1982 Diabetiker Fl端ssignahrung, the first specific oral feed for patients with impaired glucose tolerancehandling 1988 Fresubin速 plus Sonde (meaning tube), a fibre rich tube feed 1995 Fresenius Energan, a high-caloric sip feed 2015/2016 New packaging for the complete Fresubin速 product range to enhance content identification and handling 2000 Fresubin速 Original Fibre and Fresubin速 Energy Fibre, the first standard tube feeds with fish oil and modern fibre concept in Germany 2004 Fresubin速 Protein Energy DRINK, a protein and energy enriched sip feed 2007 Fresubin速 2 kcal Drink, the first sip feed with 200 kcal and 10 g proteins per 100 ml 2009 Fresubin速 Cr竪me, an oral supplement with texture adaptation especially for patients with dysphagia 2009 Fresubin速 Thickened stage I & II, in adapted consistencies for patients with dysphagia 2010 Fresubin速 YOcr竪me, a rich oral nutritional supplement in a yoghurt-like dessert 2012 Fresubin速 2 kcal HP (Fibre) unique tube feed with high energy and high protein content in a small volume 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 919.11.2017
Fresubin速 舒仆舒舒 仂 亠于从舒 亳仄舒 仆亠从仂仍从 仂亟仍亳仆亳 仆亳亳于仆亳 仗仂亳仍亳 仂 仗亳舒亠仆 于从: 丿亳仂从 亳亰弍仂 于仂 亰舒于亳仆仂 仂亟 仍亳仆亳亠 仗亠亠亠仆亳 丐亠亳舒仆仂 于仂 仍舒弍仂舒仂亳亳 亰舒 于从 亳 仄亳亳 舒仍仂亳从舒 亞亳仆舒 仂亟 1.0 - 5.0 kcal /ml 亳仂从舒 仂亟亢亳仆舒 仆舒 仗仂亠亳仆亳 仗仂亠亟 仗亠仗仂舒从亳亠 仆舒 弌 舒于仂仍亳于亳 亳 仆亠舒于仂仍亳于亳 于仍舒从仆舒 亰舒 仗仂亟亟从舒 仆舒 亠于仆舒舒 仆从亳舒 EasyBottle 仗舒从于舒亠仂 亳仄舒 亠亞仂仆仂仄从亳 仂仄舒 亰舒 亠亟仆仂舒于仆仂 舒从于舒亠 亳 仍亠仆仂 亰舒 仂于仂舒亠. 丐亠亳舒仆仂 仆舒 仆亠亰舒于亳仆亳 亳仆亳亳 亰舒 亞亠仂仆仂仍仂亞亳舒. Fresubin速 舒仆舒 仂 亠于从舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 10
Fresubin速 舒仆舒舒 仂 仂仆亟舒 亞亳 仗仂从亳于舒 仗仂亠弍亳亠 仆舒 仗舒亳亠仆亳亠 亰舒 亳仂从 仗亠从舒 仆舒 仂仂弍亳 仂 仍亠亟仆亳于亠 仂仂弍亳仆亳: 舒仍仂亳从舒 亞亳仆舒 仂亟 1.0 2.0 kcal / ml 亳仂从舒 仂亟亢亳仆舒 仆舒 仗仂亠亳仆亳 仗仂亠亟 仗亠仗仂舒从亳亠 仆舒 弌 舒于仂仍亳于亳 亳 仆亠舒于仂仍亳于亳 于仍舒从仆舒 亰舒 仗仂亟亟从舒 仆舒 亠于仆舒舒 仆从亳舒 亳仗亳亟亠仆 仗仂亳仍 仂 亳弍亳仆仂 仄舒仍仂 亰舒 仗仍亠仄亠仆舒亳舒 仂 亠亠仆亳舒仍仆亳 仄舒仆亳 从亳亠仍亳仆亳 亳舒仄亳仆 仂亟亢亳仆舒 舒亟舒仗亳舒仆舒 仗仂亠亟 仗仂仍亠亟仆亳亠 仗亠仗仂舒从亳 仗仂仆舒舒 EasyBag 从亠舒 仂 仄亠仄弍舒仆舒 亰舒 仗仂于仂仆仂 亰舒于仂舒亠 亞亳 仂亟亢亳 亳亠 Fresubin速 舒仆亳 仂 仂仆亟舒, 亟亳亰舒仆亳舒仆舒 亰舒 弍亠亰弍亠亟仆仂 亳 仍亠仆仂 舒从于舒亠. Fresubin速 舒仆舒 仂 仂仆亟舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 11
弌亳亠 Fresubin速 仗仂亳亰于仂亟亳 亰舒 仄仂亟亳亳从舒亳舒 仆舒 亠从舒 亳仄舒舒 仂亟仍亳亠仆 仆亳亳于亠仆 仗仂亳仍 亳 于从, 仂 亞亳 仗舒于亳 仂于亠仆舒 亰舒仄亠仆舒 亰舒 舒仆舒舒 仂 亠于从舒 从舒 仗舒亳亠仆亳亠 仂仂仍亳仂仂 仂亟亢亳: 亠仂亟仆仂 亰亞仆舒亳 舒仆亳 仂 亠于从舒 仂 仗仂亠仗亠仆仂 亰亞仂仍亠仄于舒亠 仆舒 仆亳于仂舒舒 仆舒 从仂仆亰亳亠仆亳舒 弌仗亳 于仂仆亳 仗亳亠舒 亠仄仂于亳 仍亳仆亳 仆舒 仗亟亳仆亞 亳 仂亞 Fresenius Kabi 亟亳舒亞亳舒 从仂仆亠仗仂 仗亳仄亠仆于舒 舒亰仍亳仆亳 亠仗亠仆亳 仆舒 从仂仆亰亳亠仆亳舒 亰舒 仗仂亠弍亳亠 仆舒 亠从仂 仗舒亳亠仆, 亰舒仆仂于舒仆亳 仆舒 仂弍亠从亳于仆亳 亳仆亠仆舒亳仂仆舒仍仆亳 仗仂仂从仂仍亳. Fresubin速 仄仂亟亳亳从舒仂亳 仆舒 亠从舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 12
亳亳于仆亳仂 于仆亠 仆舒 仗舒亳亠仆亳亠 仄仂亢亠 仍亠仆仂 亟舒 亠 亰舒亳仍亳 亳仍亳 亟亳 亰舒仄亠仆亳 仂 舒仂亳仄舒仆仂 仆舒 Fresubin速 仗舒仂亳: 舒 从仂仄仗仍亠仆舒 亳仍亳 亟仂仗仂仍仆亳亠仍仆舒 仆亳亳舒 弍亠亰弍亠亟于舒亠 仆舒 从仍仆亳亠 仂仂从亳 舒亰仍亳仆亳 从舒仍仂亳从亳 舒亳仆亳 亞仂仍亠仄于舒亠仂 仆舒 从舒仍仂亳亳亠 亳仍亳 仗仂亠亳仆亳亠, 舒亟舒仗亳舒仆舒舒 从仂仆亰亳亠仆亳舒 亳仍亳 亟仂亟舒于舒亠仂 仆舒 从仍仆亳 仂仂从亳 仄仂亢亠 亟舒 亠 仆舒仗舒于亳 仆舒 亠从仂仆仂仄从亳 亠亳从舒亠仆 仆舒亳仆 于仂 从仍舒亟 仂 仗仂亠弍亳亠 仆舒 仗舒亳亠仆亳亠. Fresubin速 仗舒仂亳 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 13
舒仍仆亳 亟仂亟舒仂亳 仆舒 亳舒仆舒 ONS (舒仆舒 仂 亠于从舒) High energy needs High protein needs Milk protein intolerance IGT/ Diabetes mellitus Dysphagia Oncology Intensiv Care Mal- absorption Surgery Liver Insuffic- iency Renal Insuffic- iency Children Moderate energy needs 11/19/2017 14
亠仗舒舒亳 亰舒 舒仆亠亠 仗亠从 仂仆亟舒 (舒仆舒 仂 仂仆亟舒) Moderate energy needs High energy needs High protein needs Milk protein intoleranc e IGT/ Diabetes mellitus Oncology Intensiv Care Mal- absorption Surgery Liver Insuffic- iency Renal Insuffic - iency Children Low energy needs 11/19/2017 15
EasyBag 亠亰弍亠亟仆仂 亳 仗舒从亳仆仂 仗舒从于舒亠 亰舒 舒仆舒舒 仂 仂仆亟舒 1619.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition
仂仂 400 kcal/亟亠仆? 亳仆亳仄仄 仂亟 400 kcal/亟亠仆 仂弍亠亰弍亠亟亠仆 仗亠从 ONS 仂弍亠亰弍亠亟于舒 于仆亠 仆舒 从舒仍仂亳亳 亟仂于仂仍仆亳 亰舒 亰亞仂仍亠仄于舒亠 仆舒 亠亢亳仆舒舒. 亠仗仂舒舒仆仂 仂亟 仄亠仆舒仂亟仆亳 于仂亟亳亳 亰舒 从仍亳仆亳从舒 仗舒从舒 400 kcal/亟亠仆 从仂仍从 亠 仂舒 弍亳仆仂? 舒 仗仂从亳于舒亠 仆舒 仂仆仂于仆亳亠 亳亰亳仂仍仂从亳 仗仂亠弍亳 1 kcal/kg/舒 仆舒 亟亠仆 舒亢 仂亟 60 kg 亳仄舒 仗仂亠弍舒 仂亟 60*24 = 1.440 kcal 400 kcal = 27,7% 仂亟 仄亳仆亳仄舒仍仆舒舒 亟仆亠于仆仂 仗仂亠弍仆舒 亠仆亠亞亳舒 400 kcal/亟亠仆 仗仂从亳于舒 1/3 仂亟 亟仆亠于仆亳亠 亠仆亠亞亠从亳 仗仂亠弍亳! 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 1719.11.2017
Kabiven速 -于仂-亠亟仆仂 亠亠仆亳亠 亰舒 仗舒亠仆亠舒仍仆舒 亳舒仆舒
仂于亠亟 亰舒 仗仂亳亰于仂亟仂 Kabiven速 亳亠仆 仆舒 仗舒亰舒仂 仂亟 1999 亞仂亟亳仆舒 仂舒仗亠仆 于仂 舒亰仍亳仆亳 亞仂仍亠仄亳仆亳, 从舒从仂 亳 舒仄仂 仂 亠仍亠从仂仍亳亳 亠亳亠仆舒 亳 亠仆舒仍仆舒 于亠亰亳舒 亠亰弍亠亟亠仆 亳 亟仂弍仂 仗仂亟仆仂仍亳于 Intralipid 弌亳亞亠仆, 亟仂弍仂 仗仂亰仆舒, 亟仂弍仂 亟仂从仄亠仆亳舒仆 亳亰于仂 仆舒 仍亳仗亳亟亳 Vamin 18 Novum 亳从舒亠仆, 亟仂弍仂 于仂舒仆仂于亠仆 亳亰于仂 仆舒 舒仄亳仆仂 从亳亠仍亳仆亳 仍亳从仂亰舒 舒 舒亟仄亳仆亳舒亳舒 仆舒 亞仍亳从仂亰舒 于仂 仂亟仄亠亠仆舒 亟仂亰舒 舒 于仂亰舒仆亳 亳 亟亠舒 仆舒亟 2 亞仂亟亳仆亳 亠仂亞舒仆亳亠仆仂 于亠仄亠舒亠亠 仆舒 仗仂亠弍舒
Kabiven速 从仂仄仗仂仆亠仆亳 Vamin速 18 Novum 仍亳从仂亰舒 19 % 亠仆舒仍亠仆 仍亳从仂亰舒 11% Vamin速 18 Novum Intralipid速20% 仗亠亳亠亠仆 丐仂从仂仄仂仆舒 从亠舒 (3CB) 从仂舒 亠 仂仂亳 仂亟 Intralipid速20%
仂从 仆舒 舒亠亠 24 仄亠亠亳 仆舒 仂弍仆舒 亠仄仗亠舒舒 Kabiven速 亠仆舒仍亠仆 & 仗亠亳亠亠仆 7 于亳亟舒: 亠仆舒仍亠仆 (1600 mosm/l): 1 -1,5 2 & 2,5l 仗亠亳亠亠仆 (750 mosm/l): 1,5 2 & 2,5l
Intralipid速: 仗于舒舒 弍亠亰弍亠亟仆舒 仍亳仗亳亟仆舒 亠仄仍亰亳舒 于仂 于亠仂 舒 仗于 仗舒 仆舒 仗舒亰舒仂: 1962 亞仂亟亳仆舒 亟亳仆于亠仆舒舒 仗仂仂亠从舒 仍亳仗亳亟仆舒 亠仄仍亰亳舒 亰舒 仗舒亠仆亠舒仍仆舒 亳舒仆舒 仗仂仄亠 1962 - 1982 亳仆舒 仆亳亰 亠仍亳仂 于亠 亳 亠 仆舒仗仂亠弍于舒仆舒 舒亟仂仍亞仂 亳 仆舒仂仗亠亢仆仂 亳从于仂 仗亳仆仂 亟仂从仄亠仆亳舒仆舒 于仂 仗亠从 2.000 仗弍仍亳从舒亳亳 仆舒 PubMed1 从亠仄仆仂 仄舒仍从 仂仂仗亠仆亳 仆亠舒从舒仆亳 亠舒从亳亳 1 Pub Med (2011) National Library of Medicine (Internet). National Center of Biotechnological Information (NCBI). Search term: Intralipid. Limits: None Kabiven速 亞仂 仂亟亢亳 Intralipid速
2566205315401026于仂仍仄亠仆 [ml] 2.52.01.51.0仂仍亠仄亳仆舒 仆舒 从亠舒 [l] 200016001200800kcal NP 230019001400900kcal 13.510.88.15.4g N/从亠舒 85685134g A/从亠舒 250200150100g 亞仍亳从/从亠舒 100806040g 仍亳仗亳亟亳/从亠舒 50:5050:5050:5050:50仆亠亞亳舒 亞仍亳从:仍亳仗 [kcal;%] 1:1481:1481:1481:148亟仆仂 N[g]:仆亠-仗仂亠亳仆从舒 亠仆亠亞亳舒 [kcal] 1060106010601060仄仂仍舒仆仂 [mosm/l] 仂仄仗仂仆亠仆亳 Kabiven速 亠仆舒仍
240019201440于仂仍仄亠仆 [ml] 2.52.01.5仂仍亠仄亳仆舒 仆舒 从亠舒 [l] 15001200900kcal NP 170014001000kcal 9.07.25.4g N/从亠舒 574534g A/从亠舒 16213097g 亞仍亳从/从亠舒 856851g 仍亳仗亳亟亳/从亠舒 43:5743:5743:57仆亠亞亳舒 亞仍亳从:仍亳仗 [kcal;%] 1:1671:1671:167亟仆仂 N[g]:仆亠-仗仂亠亳仆从舒 亠仆亠亞亳舒 [kcal] 750750750仄仂仍舒仆仂 [mosm/l] 仂仄仗仂仆亠仆亳 Kabiven速 仗亠亳亠舒仍
... 亳 亳亠 亟亠舒 仆舒亟 2 亞仂亟亳仆亳 从仂亞舒 仂舒仍仆舒 亳仍亳 亠仆亠舒仍仆舒 舒仆舒 仆亠 亠 于仂亰仄仂亢仆舒, 仆亠 亠 亟仂于仂仍仆舒 亳仍亳 亠 从仂仆舒亳仆亟亳亳舒仆舒. 丐亠舒仗亠于从亳 亳仆亟亳从舒亳亳: Kabiven速 舒亳亠仆亳 仗仂舒亳 仂亟 2 亞仂亟亳仆亳 亠仂亞舒仆亳亠仆仂 于亠仄亠舒亠亠 仆舒 仗仂亠弍舒 Kabiven 亠 亳仆亟亳亳舒仆 从舒 亳亠 于仂亰舒仆亳 仗舒亳亠仆亳
. 亠仗仂舒从亳 亰舒 亟仂亰亳舒亠 Kabiven速 舒亳亠仆 仆亠于仆舒 亟仂亰舒 亠仗仂舒从亳 亰舒 亟仂亰亳舒亠 舒从亳仄舒仍仆 舒 亟仂亰舒 弌舒仗从舒 仆舒 亳仆亰亳舒 亠亳仂亟 仆舒 亳仆亰亳舒 Kabiven 亠仆舒仍 仂亰舒亠仆 从仗仆亳亠 亠仆亠亞亠从亳 仗仂亠弍亳 亰舒于亳舒 仂亟 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂 亳 仆舒亠仂 亠 仗仂仄亠 25-35 kcal/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆. 舒 亞仂舒亰仆亳 仗舒亳亠仆亳 亟仂亰舒舒 亠 亰舒仆仂于舒 仆舒 仗仂亠仆亠舒 亳亟亠舒仍仆舒 亠亢亳仆舒 19 ml - 38 ml Kabiven/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆 40 ml/Kg/亟亠仆 (舒从亳仄舒仍仆舒 舒 亟仆亠于仆舒 亟仂亰舒 亰舒于亳亳 仂亟 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂 亳 仄仂亢亠 亟舒 亠 仄亠仆于舒 亟亳 亳 仂亟 亟亠仆 于仂 亟亠仆) 亠 亠弍舒 亟舒 仆舒亟仄亳仆亠 2.6 ml/kg 亠仍亠仆舒 亠亢亳仆舒/舒 12-24 舒舒 亠亠 仂亰舒舒 仄仂舒 亟舒 亠 仂亟亠亟亳 仗仂亠亟 仗仂仂弍仆仂舒 亟舒 亠 仄亠舒弍仂仍亳舒舒 亳仆亟亳于亳亟舒仍仆亳亠 仆亳亠仆亳 仂仂弍亳舒亠仆仂 亳仆亰亳舒舒 从舒 仄舒仍亳 亟亠舒 (2-10 亞仂亟亳仆亳) 亠弍舒 亟舒 亰舒仗仂仆亠 仂 仆亳从舒 亟仂亰舒 .亠. 12.5-25 ml/kg 亳 亟舒 亠 亰亞仂仍亠仄于舒 仗仂 10-15 ml/kg/亟亠仆 亟仂 仄舒从亳仄舒仍仆舒舒 亟仂亰舒 Kabiven 仗亠亳亠舒仍 仂亰舒亠仆 从仗仆亳亠 亠仆亠亞亠从亳 仗仂亠弍亳 亰舒于亳舒 仂亟 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂 亳 仆舒亠仂 亠 仗仂仄亠 20-30 kcal/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆. 舒 亞仂舒亰仆亳 仗舒亳亠仆亳 亟仂亰舒舒 亠 亰舒仆仂于舒 仆舒 仗仂亠仆亠舒 亳亟亠舒仍仆舒 亠亢亳仆舒. 27 ml - 40 ml Kabiven 仗亠亳亠舒仍l/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆 亠 亠弍舒 亟舒 仆舒亟仄亳仆亠 3.7 ml/kg 亠仍亠仆舒 亠亢亳仆舒/舒 亠亠 仂亰舒舒 仄仂舒亟舒 亠 仂亟亠亟亳 仗仂亠亟 仗仂仂弍仆仂舒 亟舒 亠 仄亠舒弍仂仍亳舒舒 亳仆亟亳于亳亟舒仍仆亳亠 仆亳亠仆亳 仂仂弍亳舒亠仆仂 亳仆亰亳舒舒 从舒 仄舒仍亳 亟亠舒 (2-10 亞仂亟亳仆亳) 亠弍舒 亟舒 亰舒仗仂仆亠 仂 仆亳从舒 亟仂亰舒, .亠. 14-28 ml/kg 亳 亟舒 亠 亰亞仂仍亠仄于舒 仗仂 10-15 ml/kg/亟亠仆 亟仂 仄舒从亳仄舒仍仆舒舒 亟仂亰舒 仂亰舒舒 亠弍舒 亟舒 弍亳亟亠 亳仆亟亳于亳亟舒仍仆舒, 舒 亳亰弍仂仂 仆舒 亞仂仍亠仄亳仆舒 仆舒 从亠舒舒 亠弍舒 亟舒 亠 仆舒仗舒于亳 于亰 仂仆仂于舒 仆舒 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂, 亠仍亠仆舒舒 亠亢亳仆舒 亳 仆亳亳于仆亳亠 仗仂亠弍亳
弌亠仂 仂舒 于仂 仆舒亟仂弍亳仂 从仂仆亠仆亠
丿仂 亠 仆仂于仂 于仂 FMCB? 亟仍亠仗于舒亠 仆舒 亰舒于仂舒亳 仂仂于亳 (于仂 仂弍仍亳从 仆舒 弍仂亟)
FMCB 仂亟仍亠仗于舒亠 仆舒 亰舒于仂舒亳 亠舒舒 亠弍舒 亟舒 亠 仂于仂亳 仂 于亳从舒亠 仂亟 于于仂 仆舒亟仂仍 仂仍仄亠仆仂 仆舒 亠仆仂舒 从仂 亠 仂亟亢亳 于仂 亞仂仍亠仄舒舒 从仂仄仂舒 亠 仗亠亟亳亰于亳从舒 亰亞仂仍亠仄于舒亠 仆舒 仗亳亳仂从仂, 从仂 亞仂 仂亟仍亠仗于舒 亰舒于仂舒仂 仆舒 亠亟仆舒舒 从仂仄仂舒 于仂 仆舒仍舒弍舒舒 仂从舒; S 亰舒从亳于亠仆仂舒. 丐亠弍舒 亟舒 亠 仂于仂舒 舒仄仂 于亠亳从舒仍仆亳亠 亰舒于仂舒亳!!
亠仆仂 & 舒从亳仆仂 FMCB 仂亟仍亠仗于舒亠 仆舒 亰舒于仂舒亳
弌亠亳仍仆亳 从仂亳亠亠 弍亠亰 亟亠亰亳仆亠从亳舒 弌舒仄仂-亰舒于仂舒从亳 仗仂亠亟仆仂舒于仆仂 舒从于舒亠 仗仂 亳从仍于舒亠仂 弌舒弍亳仍仆亳 仄亳仆亳仄亳亰亳舒亠 仆舒 于亠仂舒仆仂舒 亰舒 仗从舒亠 仆舒 从亠舒舒 亠仆亳 亰舒 仗亠仗仂亰仆舒于舒亠 仗仂仂于亳亠 亠 仂仗亠仄亠仆亳 仂 亠仍从亳 从仂亳 亞亳 仗舒于舒 仍亠仆亳 亰舒 仗仂亠弍舒 FMCB 仗仂仂于亳
斜｛夷斜-亰舒于仂舒从亳 仗仂仂于亳 - 仗仂亠亟仆仂舒于仆仂 舒从于舒亠 仗仂 亳从仍于舒亠仂 亠仄弍舒仆亳亠 仆舒 亟于舒舒 仗仂舒 亠 舒仄仂-亰舒于仂舒从亳 仗仂 亳从仍于舒亠 仆舒 亳亞仍舒舒 / 亠仂 亰舒 亳仆亰亳舒 亟亳亳于仆亳仂 仗仂 仄仂亢亠 亟舒 弍亳亟亠 仗仂弍仂亟亠仆 亟仂 10 仗舒亳 弌亠 从仂亳舒 亳亞仍亳 仂 亟亠弍亠仍亳仆舒 18-23 亳 亟仂仍亢亳仆舒 仂亟 仄舒从. 40 mm Lipoflow速 (亟亠弍亠仍亳仆舒 16) 仄仂亢亠 亟舒 亠 从仂亳亳 亟于舒 仗舒亳 ∃∃却仆亳从亳亠 从舒舒从亠亳亳从亳 仆舒 仗仂仂于亳亠 亠 亰舒亳亠仆亳 仂 仗舒亠仆 FMCB 仗仂仂于亳
弌亠亳仍仆亳 仄亠仄弍舒仆亳 仗于舒 仗仂亠弍舒 弍亠亰 仗亠仂亟仆舒 亟亠亰亳仆亠从亳舒, 仂 从亠亠 仆舒 亰仆舒仄亠仆舒舒 仂 亠仍从舒 Kabiven速 仗舒亠仆亳舒仆亳 仗仂仂于亳 仆舒仄亠仆舒舒 仂 亠仍从舒 舒 仗仂仂于舒舒 仗仂亠弍舒舒 仆舒 仗仂仂于亳亠: 弌亠仍从舒 仆舒于仆舒亠 = 舒亟亳亳于亠仆 仗仂 = 亰舒 亟仂亟舒于舒亠 弌亠仍从舒 仆舒亟于仂 = 亳仆亰亳仂仆亠仆 仗仂 = 亰舒 仗仂舒于于舒亠 仆舒 亠 亰舒 亳仆亰亳舒 亟亳亳于亠仆 仗仂 仆亰亳仂仆亠仆 仗仂
Osnovi na klinicka nutricija, enteralna & parenteralna
亠亟仆仂亳 仆舒 仄仍亳从仂仄仂仆亳 从亠亳 丕亟仂弍仆亳 亰舒 亟仂从仂亳亠, 亠亳亠, 舒仄舒亠于亳亠 亳 仗舒亳亠仆亳亠 亳 仗仂从亳于舒舒 仗仂亠弍亳亠 仆舒 仗仂于亠亠仂 仗舒亳亠仆亳 丿亠亟舒 于亠仄亠 亳 亠亟于舒 于仂 仗仂亠亟弍舒 仂 亠亟亳仆亠仆亳亠 亳亠仄亳 亳 从仂仄弍亳仆亳舒仆亳亠 从亠亳1,2,3 亞仂仍亠仄亠仆舒 弍亠亰弍亠亟仆仂 仆舒 仄亠舒舒 于仂 仗仂亞仍亠亟 仆舒 亠亳仍仆仂, 舒弍亳仍仆仂 亳 舒仄亳仂 仗仂亠 仆舒 亠舒仗亳舒 4-8 1 Paper S et al. Anaesthesia 2002;57:82-101 2 Richard C et al. Clin.Nutr.2000;19:245-51 3 Ebner C et al.Clin.Nutr.1993;12:208-12 4 Caeter DM et al. Clin.Nutr.1993;12:208-12 5 Rollins C J et al.Jpen 1990;14:290-4 6 Mitchell KA et al.Nutrition 1990;6:457-60 7 Meguid MM. Nutrition 1989;5:343-4 8 Flynn EA et al.Am J health syst Pharm 1997;54:904-912
亠仆仂 丕亟仂弍仆仂 亠亰弍亠亟仆仂 仍舒亞仂亟舒舒仄 亰舒 于仆亳仄舒仆亳亠仂

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Osnovi na klinicka nutricija, enteralna & parenteralna

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  • 4. 亳亳于仆舒 亠舒仗亳舒 亠 亳仆亟亳亳舒仆舒 仂仄舒仍仆舒 亳舒仆舒 + ONS1 舒仍亳 亠 仄仂亢仆舒 仂舒仍仆舒 仆亳亳舒? 1ONS: 舒仍仆亳 亟仂亟舒仂亳 仆舒 亳舒仆舒 2GI: 舒仂亳仆亠亳仆舒仍仆舒 3PN: 舒亠仆亠舒仍仆舒 仆亳亳舒 4 TPN: 丐仂舒仍仆舒 仗舒亠仆亠舒仍仆舒 仆亳亳舒 弌仂仆亟舒 NO TPN4 弌仂仆亟舒+PN3 PARTLY 舒仍亳 GI2 舒从 仆从亳仂仆亳舒 仂仂亟于亠仆仂? 亰弍仂 仆舒 仆亳亳于仆舒 亠舒仗亳舒 个仆从亳舒 仆舒 亠于舒舒 & 仗舒亳舒 仆舒 舒仗仍亳从舒亳舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 4
  • 5. 丿仂 亠 亠仆亠舒仍仆舒 仆亳亳舒? 亟仄亳仆亳舒亳舒 仆舒 亠仆舒 亳舒仆舒 仂舒仍仆仂 亳仍亳 仗亠从 仂仆亟舒 于仂 亞舒仂亳仆亠亳仆舒仍仆亳仂 舒从 仄仗亳 亰舒 舒仆亠亠 舒亰舒仍仆亳 / 亠从舒仆亳 仂仆亟亳 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 5
  • 6. 丿仂 亠 亠仆亠舒仍仆舒 仆亳亳舒? 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 19.11.2017 6 弍亳仆舒 舒仆舒? 仍亠亠仆 仗仂亳亰于仂亟? 丱舒仆舒 亰舒 舒仂仆舒亳? 丐仂舒 亠 亠亳从舒仆舒 仗仂亟亟从舒 亰舒 从亳亳仆仂 亳仍亳 仂仆亳仆仂 弍仂仍仆亳 仗舒亳亠仆亳 仂 仄舒仍仆亳亳舒 Source: 87452883 | Thinkstock, 495950860 | Thinkstock, NASA
  • 7. 舒仍仆亳亳舒 舒仍亳 亠 亠仍亠于舒仆仆舒 于仂 亰亟舒于于仂仂? 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 19.11.2017 7
  • 8. 11/19/2017 8 Fresenius-Kabi 亳仂亳舒 仆仂于舒亠 仆仂于舒 仆舒 舒仄舒亠于从舒舒 从仂仄仗舒仆亳舒 亠 Dr. E. Fresenius 舒亠仆亠舒仍仆舒 亳舒仆舒, HES 舒亰于仂 仆舒 亳仆仂于舒亳于亠仆 舒于仂 亰舒 仆舒亟仂从仆舒亟于舒 亠 仆舒 亠仆仂亳 于仂 从于舒 (HES) 1971/721962195514621912 舒亰于仂 仆舒 亳仆亰亳仂仆亳 舒于仂亳 亳 仆亳于仆仂 仗仂亳亰于仂亟于仂 仆亰亳从亳 舒于仂亳 Intralipid速 于舒舒 仄舒仆舒 亠仄仍亰亳舒 仂亟 舒仆舒 仆舒 Kabi Vitrum 1979 仆亠舒仍仆舒 亳舒仆舒 亠舒于于舒亠 仆舒 仗于亳仂 亞仂仂于 仗亠仗舒舒 亰舒 亳舒仆舒 仗亠从 仂仆亟舒, Fresubin速
  • 9. Fresubin速-40 亞仂亟亳仆亳 亠仆亠舒仍仆舒 仆亳亳舒 1975 Fresubin速 instant, high-molecular powder diet with different flavours 1997 Fresenius Energan plus Sonde, the first high-caloric fibre- rich tube feed in Germany 1979 Fresubin速 fl端ssig (meaning liquid), one of the first ready-to-use sterile tube feeds 1982 Diabetiker Fl端ssignahrung, the first specific oral feed for patients with impaired glucose tolerancehandling 1988 Fresubin速 plus Sonde (meaning tube), a fibre rich tube feed 1995 Fresenius Energan, a high-caloric sip feed 2015/2016 New packaging for the complete Fresubin速 product range to enhance content identification and handling 2000 Fresubin速 Original Fibre and Fresubin速 Energy Fibre, the first standard tube feeds with fish oil and modern fibre concept in Germany 2004 Fresubin速 Protein Energy DRINK, a protein and energy enriched sip feed 2007 Fresubin速 2 kcal Drink, the first sip feed with 200 kcal and 10 g proteins per 100 ml 2009 Fresubin速 Cr竪me, an oral supplement with texture adaptation especially for patients with dysphagia 2009 Fresubin速 Thickened stage I & II, in adapted consistencies for patients with dysphagia 2010 Fresubin速 YOcr竪me, a rich oral nutritional supplement in a yoghurt-like dessert 2012 Fresubin速 2 kcal HP (Fibre) unique tube feed with high energy and high protein content in a small volume 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 919.11.2017
  • 10. Fresubin速 舒仆舒舒 仂 亠于从舒 亳仄舒 仆亠从仂仍从 仂亟仍亳仆亳 仆亳亳于仆亳 仗仂亳仍亳 仂 仗亳舒亠仆 于从: 丿亳仂从 亳亰弍仂 于仂 亰舒于亳仆仂 仂亟 仍亳仆亳亠 仗亠亠亠仆亳 丐亠亳舒仆仂 于仂 仍舒弍仂舒仂亳亳 亰舒 于从 亳 仄亳亳 舒仍仂亳从舒 亞亳仆舒 仂亟 1.0 - 5.0 kcal /ml 亳仂从舒 仂亟亢亳仆舒 仆舒 仗仂亠亳仆亳 仗仂亠亟 仗亠仗仂舒从亳亠 仆舒 弌 舒于仂仍亳于亳 亳 仆亠舒于仂仍亳于亳 于仍舒从仆舒 亰舒 仗仂亟亟从舒 仆舒 亠于仆舒舒 仆从亳舒 EasyBottle 仗舒从于舒亠仂 亳仄舒 亠亞仂仆仂仄从亳 仂仄舒 亰舒 亠亟仆仂舒于仆仂 舒从于舒亠 亳 仍亠仆仂 亰舒 仂于仂舒亠. 丐亠亳舒仆仂 仆舒 仆亠亰舒于亳仆亳 亳仆亳亳 亰舒 亞亠仂仆仂仍仂亞亳舒. Fresubin速 舒仆舒 仂 亠于从舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 10
  • 11. Fresubin速 舒仆舒舒 仂 仂仆亟舒 亞亳 仗仂从亳于舒 仗仂亠弍亳亠 仆舒 仗舒亳亠仆亳亠 亰舒 亳仂从 仗亠从舒 仆舒 仂仂弍亳 仂 仍亠亟仆亳于亠 仂仂弍亳仆亳: 舒仍仂亳从舒 亞亳仆舒 仂亟 1.0 2.0 kcal / ml 亳仂从舒 仂亟亢亳仆舒 仆舒 仗仂亠亳仆亳 仗仂亠亟 仗亠仗仂舒从亳亠 仆舒 弌 舒于仂仍亳于亳 亳 仆亠舒于仂仍亳于亳 于仍舒从仆舒 亰舒 仗仂亟亟从舒 仆舒 亠于仆舒舒 仆从亳舒 亳仗亳亟亠仆 仗仂亳仍 仂 亳弍亳仆仂 仄舒仍仂 亰舒 仗仍亠仄亠仆舒亳舒 仂 亠亠仆亳舒仍仆亳 仄舒仆亳 从亳亠仍亳仆亳 亳舒仄亳仆 仂亟亢亳仆舒 舒亟舒仗亳舒仆舒 仗仂亠亟 仗仂仍亠亟仆亳亠 仗亠仗仂舒从亳 仗仂仆舒舒 EasyBag 从亠舒 仂 仄亠仄弍舒仆舒 亰舒 仗仂于仂仆仂 亰舒于仂舒亠 亞亳 仂亟亢亳 亳亠 Fresubin速 舒仆亳 仂 仂仆亟舒, 亟亳亰舒仆亳舒仆舒 亰舒 弍亠亰弍亠亟仆仂 亳 仍亠仆仂 舒从于舒亠. Fresubin速 舒仆舒 仂 仂仆亟舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 11
  • 12. 弌亳亠 Fresubin速 仗仂亳亰于仂亟亳 亰舒 仄仂亟亳亳从舒亳舒 仆舒 亠从舒 亳仄舒舒 仂亟仍亳亠仆 仆亳亳于亠仆 仗仂亳仍 亳 于从, 仂 亞亳 仗舒于亳 仂于亠仆舒 亰舒仄亠仆舒 亰舒 舒仆舒舒 仂 亠于从舒 从舒 仗舒亳亠仆亳亠 仂仂仍亳仂仂 仂亟亢亳: 亠仂亟仆仂 亰亞仆舒亳 舒仆亳 仂 亠于从舒 仂 仗仂亠仗亠仆仂 亰亞仂仍亠仄于舒亠 仆舒 仆亳于仂舒舒 仆舒 从仂仆亰亳亠仆亳舒 弌仗亳 于仂仆亳 仗亳亠舒 亠仄仂于亳 仍亳仆亳 仆舒 仗亟亳仆亞 亳 仂亞 Fresenius Kabi 亟亳舒亞亳舒 从仂仆亠仗仂 仗亳仄亠仆于舒 舒亰仍亳仆亳 亠仗亠仆亳 仆舒 从仂仆亰亳亠仆亳舒 亰舒 仗仂亠弍亳亠 仆舒 亠从仂 仗舒亳亠仆, 亰舒仆仂于舒仆亳 仆舒 仂弍亠从亳于仆亳 亳仆亠仆舒亳仂仆舒仍仆亳 仗仂仂从仂仍亳. Fresubin速 仄仂亟亳亳从舒仂亳 仆舒 亠从舒 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 12
  • 13. 亳亳于仆亳仂 于仆亠 仆舒 仗舒亳亠仆亳亠 仄仂亢亠 仍亠仆仂 亟舒 亠 亰舒亳仍亳 亳仍亳 亟亳 亰舒仄亠仆亳 仂 舒仂亳仄舒仆仂 仆舒 Fresubin速 仗舒仂亳: 舒 从仂仄仗仍亠仆舒 亳仍亳 亟仂仗仂仍仆亳亠仍仆舒 仆亳亳舒 弍亠亰弍亠亟于舒亠 仆舒 从仍仆亳亠 仂仂从亳 舒亰仍亳仆亳 从舒仍仂亳从亳 舒亳仆亳 亞仂仍亠仄于舒亠仂 仆舒 从舒仍仂亳亳亠 亳仍亳 仗仂亠亳仆亳亠, 舒亟舒仗亳舒仆舒舒 从仂仆亰亳亠仆亳舒 亳仍亳 亟仂亟舒于舒亠仂 仆舒 从仍仆亳 仂仂从亳 仄仂亢亠 亟舒 亠 仆舒仗舒于亳 仆舒 亠从仂仆仂仄从亳 亠亳从舒亠仆 仆舒亳仆 于仂 从仍舒亟 仂 仗仂亠弍亳亠 仆舒 仗舒亳亠仆亳亠. Fresubin速 仗舒仂亳 19.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 13
  • 14. 舒仍仆亳 亟仂亟舒仂亳 仆舒 亳舒仆舒 ONS (舒仆舒 仂 亠于从舒) High energy needs High protein needs Milk protein intolerance IGT/ Diabetes mellitus Dysphagia Oncology Intensiv Care Mal- absorption Surgery Liver Insuffic- iency Renal Insuffic- iency Children Moderate energy needs 11/19/2017 14
  • 15. 亠仗舒舒亳 亰舒 舒仆亠亠 仗亠从 仂仆亟舒 (舒仆舒 仂 仂仆亟舒) Moderate energy needs High energy needs High protein needs Milk protein intoleranc e IGT/ Diabetes mellitus Oncology Intensiv Care Mal- absorption Surgery Liver Insuffic- iency Renal Insuffic - iency Children Low energy needs 11/19/2017 15
  • 16. EasyBag 亠亰弍亠亟仆仂 亳 仗舒从亳仆仂 仗舒从于舒亠 亰舒 舒仆舒舒 仂 仂仆亟舒 1619.11.2017息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition
  • 17. 仂仂 400 kcal/亟亠仆? 亳仆亳仄仄 仂亟 400 kcal/亟亠仆 仂弍亠亰弍亠亟亠仆 仗亠从 ONS 仂弍亠亰弍亠亟于舒 于仆亠 仆舒 从舒仍仂亳亳 亟仂于仂仍仆亳 亰舒 亰亞仂仍亠仄于舒亠 仆舒 亠亢亳仆舒舒. 亠仗仂舒舒仆仂 仂亟 仄亠仆舒仂亟仆亳 于仂亟亳亳 亰舒 从仍亳仆亳从舒 仗舒从舒 400 kcal/亟亠仆 从仂仍从 亠 仂舒 弍亳仆仂? 舒 仗仂从亳于舒亠 仆舒 仂仆仂于仆亳亠 亳亰亳仂仍仂从亳 仗仂亠弍亳 1 kcal/kg/舒 仆舒 亟亠仆 舒亢 仂亟 60 kg 亳仄舒 仗仂亠弍舒 仂亟 60*24 = 1.440 kcal 400 kcal = 27,7% 仂亟 仄亳仆亳仄舒仍仆舒舒 亟仆亠于仆仂 仗仂亠弍仆舒 亠仆亠亞亳舒 400 kcal/亟亠仆 仗仂从亳于舒 1/3 仂亟 亟仆亠于仆亳亠 亠仆亠亞亠从亳 仗仂亠弍亳! 息 Copyright Fresenius Kabi Deutschland GmbH Business Unit Enteral Nutrition 1719.11.2017
  • 19. 仂于亠亟 亰舒 仗仂亳亰于仂亟仂 Kabiven速 亳亠仆 仆舒 仗舒亰舒仂 仂亟 1999 亞仂亟亳仆舒 仂舒仗亠仆 于仂 舒亰仍亳仆亳 亞仂仍亠仄亳仆亳, 从舒从仂 亳 舒仄仂 仂 亠仍亠从仂仍亳亳 亠亳亠仆舒 亳 亠仆舒仍仆舒 于亠亰亳舒 亠亰弍亠亟亠仆 亳 亟仂弍仂 仗仂亟仆仂仍亳于 Intralipid 弌亳亞亠仆, 亟仂弍仂 仗仂亰仆舒, 亟仂弍仂 亟仂从仄亠仆亳舒仆 亳亰于仂 仆舒 仍亳仗亳亟亳 Vamin 18 Novum 亳从舒亠仆, 亟仂弍仂 于仂舒仆仂于亠仆 亳亰于仂 仆舒 舒仄亳仆仂 从亳亠仍亳仆亳 仍亳从仂亰舒 舒 舒亟仄亳仆亳舒亳舒 仆舒 亞仍亳从仂亰舒 于仂 仂亟仄亠亠仆舒 亟仂亰舒 舒 于仂亰舒仆亳 亳 亟亠舒 仆舒亟 2 亞仂亟亳仆亳 亠仂亞舒仆亳亠仆仂 于亠仄亠舒亠亠 仆舒 仗仂亠弍舒
  • 20. Kabiven速 从仂仄仗仂仆亠仆亳 Vamin速 18 Novum 仍亳从仂亰舒 19 % 亠仆舒仍亠仆 仍亳从仂亰舒 11% Vamin速 18 Novum Intralipid速20% 仗亠亳亠亠仆 丐仂从仂仄仂仆舒 从亠舒 (3CB) 从仂舒 亠 仂仂亳 仂亟 Intralipid速20%
  • 21. 仂从 仆舒 舒亠亠 24 仄亠亠亳 仆舒 仂弍仆舒 亠仄仗亠舒舒 Kabiven速 亠仆舒仍亠仆 & 仗亠亳亠亠仆 7 于亳亟舒: 亠仆舒仍亠仆 (1600 mosm/l): 1 -1,5 2 & 2,5l 仗亠亳亠亠仆 (750 mosm/l): 1,5 2 & 2,5l
  • 22. Intralipid速: 仗于舒舒 弍亠亰弍亠亟仆舒 仍亳仗亳亟仆舒 亠仄仍亰亳舒 于仂 于亠仂 舒 仗于 仗舒 仆舒 仗舒亰舒仂: 1962 亞仂亟亳仆舒 亟亳仆于亠仆舒舒 仗仂仂亠从舒 仍亳仗亳亟仆舒 亠仄仍亰亳舒 亰舒 仗舒亠仆亠舒仍仆舒 亳舒仆舒 仗仂仄亠 1962 - 1982 亳仆舒 仆亳亰 亠仍亳仂 于亠 亳 亠 仆舒仗仂亠弍于舒仆舒 舒亟仂仍亞仂 亳 仆舒仂仗亠亢仆仂 亳从于仂 仗亳仆仂 亟仂从仄亠仆亳舒仆舒 于仂 仗亠从 2.000 仗弍仍亳从舒亳亳 仆舒 PubMed1 从亠仄仆仂 仄舒仍从 仂仂仗亠仆亳 仆亠舒从舒仆亳 亠舒从亳亳 1 Pub Med (2011) National Library of Medicine (Internet). National Center of Biotechnological Information (NCBI). Search term: Intralipid. Limits: None Kabiven速 亞仂 仂亟亢亳 Intralipid速
  • 23. 2566205315401026于仂仍仄亠仆 [ml] 2.52.01.51.0仂仍亠仄亳仆舒 仆舒 从亠舒 [l] 200016001200800kcal NP 230019001400900kcal 13.510.88.15.4g N/从亠舒 85685134g A/从亠舒 250200150100g 亞仍亳从/从亠舒 100806040g 仍亳仗亳亟亳/从亠舒 50:5050:5050:5050:50仆亠亞亳舒 亞仍亳从:仍亳仗 [kcal;%] 1:1481:1481:1481:148亟仆仂 N[g]:仆亠-仗仂亠亳仆从舒 亠仆亠亞亳舒 [kcal] 1060106010601060仄仂仍舒仆仂 [mosm/l] 仂仄仗仂仆亠仆亳 Kabiven速 亠仆舒仍
  • 24. 240019201440于仂仍仄亠仆 [ml] 2.52.01.5仂仍亠仄亳仆舒 仆舒 从亠舒 [l] 15001200900kcal NP 170014001000kcal 9.07.25.4g N/从亠舒 574534g A/从亠舒 16213097g 亞仍亳从/从亠舒 856851g 仍亳仗亳亟亳/从亠舒 43:5743:5743:57仆亠亞亳舒 亞仍亳从:仍亳仗 [kcal;%] 1:1671:1671:167亟仆仂 N[g]:仆亠-仗仂亠亳仆从舒 亠仆亠亞亳舒 [kcal] 750750750仄仂仍舒仆仂 [mosm/l] 仂仄仗仂仆亠仆亳 Kabiven速 仗亠亳亠舒仍
  • 25. ... 亳 亳亠 亟亠舒 仆舒亟 2 亞仂亟亳仆亳 从仂亞舒 仂舒仍仆舒 亳仍亳 亠仆亠舒仍仆舒 舒仆舒 仆亠 亠 于仂亰仄仂亢仆舒, 仆亠 亠 亟仂于仂仍仆舒 亳仍亳 亠 从仂仆舒亳仆亟亳亳舒仆舒. 丐亠舒仗亠于从亳 亳仆亟亳从舒亳亳: Kabiven速 舒亳亠仆亳 仗仂舒亳 仂亟 2 亞仂亟亳仆亳 亠仂亞舒仆亳亠仆仂 于亠仄亠舒亠亠 仆舒 仗仂亠弍舒 Kabiven 亠 亳仆亟亳亳舒仆 从舒 亳亠 于仂亰舒仆亳 仗舒亳亠仆亳
  • 26. . 亠仗仂舒从亳 亰舒 亟仂亰亳舒亠 Kabiven速 舒亳亠仆 仆亠于仆舒 亟仂亰舒 亠仗仂舒从亳 亰舒 亟仂亰亳舒亠 舒从亳仄舒仍仆 舒 亟仂亰舒 弌舒仗从舒 仆舒 亳仆亰亳舒 亠亳仂亟 仆舒 亳仆亰亳舒 Kabiven 亠仆舒仍 仂亰舒亠仆 从仗仆亳亠 亠仆亠亞亠从亳 仗仂亠弍亳 亰舒于亳舒 仂亟 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂 亳 仆舒亠仂 亠 仗仂仄亠 25-35 kcal/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆. 舒 亞仂舒亰仆亳 仗舒亳亠仆亳 亟仂亰舒舒 亠 亰舒仆仂于舒 仆舒 仗仂亠仆亠舒 亳亟亠舒仍仆舒 亠亢亳仆舒 19 ml - 38 ml Kabiven/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆 40 ml/Kg/亟亠仆 (舒从亳仄舒仍仆舒 舒 亟仆亠于仆舒 亟仂亰舒 亰舒于亳亳 仂亟 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂 亳 仄仂亢亠 亟舒 亠 仄亠仆于舒 亟亳 亳 仂亟 亟亠仆 于仂 亟亠仆) 亠 亠弍舒 亟舒 仆舒亟仄亳仆亠 2.6 ml/kg 亠仍亠仆舒 亠亢亳仆舒/舒 12-24 舒舒 亠亠 仂亰舒舒 仄仂舒 亟舒 亠 仂亟亠亟亳 仗仂亠亟 仗仂仂弍仆仂舒 亟舒 亠 仄亠舒弍仂仍亳舒舒 亳仆亟亳于亳亟舒仍仆亳亠 仆亳亠仆亳 仂仂弍亳舒亠仆仂 亳仆亰亳舒舒 从舒 仄舒仍亳 亟亠舒 (2-10 亞仂亟亳仆亳) 亠弍舒 亟舒 亰舒仗仂仆亠 仂 仆亳从舒 亟仂亰舒 .亠. 12.5-25 ml/kg 亳 亟舒 亠 亰亞仂仍亠仄于舒 仗仂 10-15 ml/kg/亟亠仆 亟仂 仄舒从亳仄舒仍仆舒舒 亟仂亰舒 Kabiven 仗亠亳亠舒仍 仂亰舒亠仆 从仗仆亳亠 亠仆亠亞亠从亳 仗仂亠弍亳 亰舒于亳舒 仂亟 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂 亳 仆舒亠仂 亠 仗仂仄亠 20-30 kcal/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆. 舒 亞仂舒亰仆亳 仗舒亳亠仆亳 亟仂亰舒舒 亠 亰舒仆仂于舒 仆舒 仗仂亠仆亠舒 亳亟亠舒仍仆舒 亠亢亳仆舒. 27 ml - 40 ml Kabiven 仗亠亳亠舒仍l/kg 亠仍亠仆舒 亠亢亳仆舒/亟亠仆 亠 亠弍舒 亟舒 仆舒亟仄亳仆亠 3.7 ml/kg 亠仍亠仆舒 亠亢亳仆舒/舒 亠亠 仂亰舒舒 仄仂舒亟舒 亠 仂亟亠亟亳 仗仂亠亟 仗仂仂弍仆仂舒 亟舒 亠 仄亠舒弍仂仍亳舒舒 亳仆亟亳于亳亟舒仍仆亳亠 仆亳亠仆亳 仂仂弍亳舒亠仆仂 亳仆亰亳舒舒 从舒 仄舒仍亳 亟亠舒 (2-10 亞仂亟亳仆亳) 亠弍舒 亟舒 亰舒仗仂仆亠 仂 仆亳从舒 亟仂亰舒, .亠. 14-28 ml/kg 亳 亟舒 亠 亰亞仂仍亠仄于舒 仗仂 10-15 ml/kg/亟亠仆 亟仂 仄舒从亳仄舒仍仆舒舒 亟仂亰舒 仂亰舒舒 亠弍舒 亟舒 弍亳亟亠 亳仆亟亳于亳亟舒仍仆舒, 舒 亳亰弍仂仂 仆舒 亞仂仍亠仄亳仆舒 仆舒 从亠舒舒 亠弍舒 亟舒 亠 仆舒仗舒于亳 于亰 仂仆仂于舒 仆舒 从仍亳仆亳从舒舒 仂仂弍舒 仆舒 仗舒亳亠仆仂, 亠仍亠仆舒舒 亠亢亳仆舒 亳 仆亳亳于仆亳亠 仗仂亠弍亳
  • 27. 弌亠仂 仂舒 于仂 仆舒亟仂弍亳仂 从仂仆亠仆亠
  • 28. 丿仂 亠 仆仂于仂 于仂 FMCB? 亟仍亠仗于舒亠 仆舒 亰舒于仂舒亳 仂仂于亳 (于仂 仂弍仍亳从 仆舒 弍仂亟)
  • 29. FMCB 仂亟仍亠仗于舒亠 仆舒 亰舒于仂舒亳 亠舒舒 亠弍舒 亟舒 亠 仂于仂亳 仂 于亳从舒亠 仂亟 于于仂 仆舒亟仂仍 仂仍仄亠仆仂 仆舒 亠仆仂舒 从仂 亠 仂亟亢亳 于仂 亞仂仍亠仄舒舒 从仂仄仂舒 亠 仗亠亟亳亰于亳从舒 亰亞仂仍亠仄于舒亠 仆舒 仗亳亳仂从仂, 从仂 亞仂 仂亟仍亠仗于舒 亰舒于仂舒仂 仆舒 亠亟仆舒舒 从仂仄仂舒 于仂 仆舒仍舒弍舒舒 仂从舒; S 亰舒从亳于亠仆仂舒. 丐亠弍舒 亟舒 亠 仂于仂舒 舒仄仂 于亠亳从舒仍仆亳亠 亰舒于仂舒亳!!
  • 31. 弌亠亳仍仆亳 从仂亳亠亠 弍亠亰 亟亠亰亳仆亠从亳舒 弌舒仄仂-亰舒于仂舒从亳 仗仂亠亟仆仂舒于仆仂 舒从于舒亠 仗仂 亳从仍于舒亠仂 弌舒弍亳仍仆亳 仄亳仆亳仄亳亰亳舒亠 仆舒 于亠仂舒仆仂舒 亰舒 仗从舒亠 仆舒 从亠舒舒 亠仆亳 亰舒 仗亠仗仂亰仆舒于舒亠 仗仂仂于亳亠 亠 仂仗亠仄亠仆亳 仂 亠仍从亳 从仂亳 亞亳 仗舒于舒 仍亠仆亳 亰舒 仗仂亠弍舒 FMCB 仗仂仂于亳
  • 32. 斜｛夷斜-亰舒于仂舒从亳 仗仂仂于亳 - 仗仂亠亟仆仂舒于仆仂 舒从于舒亠 仗仂 亳从仍于舒亠仂 亠仄弍舒仆亳亠 仆舒 亟于舒舒 仗仂舒 亠 舒仄仂-亰舒于仂舒从亳 仗仂 亳从仍于舒亠 仆舒 亳亞仍舒舒 / 亠仂 亰舒 亳仆亰亳舒 亟亳亳于仆亳仂 仗仂 仄仂亢亠 亟舒 弍亳亟亠 仗仂弍仂亟亠仆 亟仂 10 仗舒亳 弌亠 从仂亳舒 亳亞仍亳 仂 亟亠弍亠仍亳仆舒 18-23 亳 亟仂仍亢亳仆舒 仂亟 仄舒从. 40 mm Lipoflow速 (亟亠弍亠仍亳仆舒 16) 仄仂亢亠 亟舒 亠 从仂亳亳 亟于舒 仗舒亳 ∃∃却仆亳从亳亠 从舒舒从亠亳亳从亳 仆舒 仗仂仂于亳亠 亠 亰舒亳亠仆亳 仂 仗舒亠仆 FMCB 仗仂仂于亳
  • 33. 弌亠亳仍仆亳 仄亠仄弍舒仆亳 仗于舒 仗仂亠弍舒 弍亠亰 仗亠仂亟仆舒 亟亠亰亳仆亠从亳舒, 仂 从亠亠 仆舒 亰仆舒仄亠仆舒舒 仂 亠仍从舒 Kabiven速 仗舒亠仆亳舒仆亳 仗仂仂于亳 仆舒仄亠仆舒舒 仂 亠仍从舒 舒 仗仂仂于舒舒 仗仂亠弍舒舒 仆舒 仗仂仂于亳亠: 弌亠仍从舒 仆舒于仆舒亠 = 舒亟亳亳于亠仆 仗仂 = 亰舒 亟仂亟舒于舒亠 弌亠仍从舒 仆舒亟于仂 = 亳仆亰亳仂仆亠仆 仗仂 = 亰舒 仗仂舒于于舒亠 仆舒 亠 亰舒 亳仆亰亳舒 亟亳亳于亠仆 仗仂 仆亰亳仂仆亠仆 仗仂
  • 35. 亠亟仆仂亳 仆舒 仄仍亳从仂仄仂仆亳 从亠亳 丕亟仂弍仆亳 亰舒 亟仂从仂亳亠, 亠亳亠, 舒仄舒亠于亳亠 亳 仗舒亳亠仆亳亠 亳 仗仂从亳于舒舒 仗仂亠弍亳亠 仆舒 仗仂于亠亠仂 仗舒亳亠仆亳 丿亠亟舒 于亠仄亠 亳 亠亟于舒 于仂 仗仂亠亟弍舒 仂 亠亟亳仆亠仆亳亠 亳亠仄亳 亳 从仂仄弍亳仆亳舒仆亳亠 从亠亳1,2,3 亞仂仍亠仄亠仆舒 弍亠亰弍亠亟仆仂 仆舒 仄亠舒舒 于仂 仗仂亞仍亠亟 仆舒 亠亳仍仆仂, 舒弍亳仍仆仂 亳 舒仄亳仂 仗仂亠 仆舒 亠舒仗亳舒 4-8 1 Paper S et al. Anaesthesia 2002;57:82-101 2 Richard C et al. Clin.Nutr.2000;19:245-51 3 Ebner C et al.Clin.Nutr.1993;12:208-12 4 Caeter DM et al. Clin.Nutr.1993;12:208-12 5 Rollins C J et al.Jpen 1990;14:290-4 6 Mitchell KA et al.Nutrition 1990;6:457-60 7 Meguid MM. Nutrition 1989;5:343-4 8 Flynn EA et al.Am J health syst Pharm 1997;54:904-912
  • 36. 亠仆仂 丕亟仂弍仆仂 亠亰弍亠亟仆仂 仍舒亞仂亟舒舒仄 亰舒 于仆亳仄舒仆亳亠仂