Nutritional therapy, mainly intravenous, has become
widely accepted for patients extremely malnourished or after
surgical interventions when enteral nutrition cannot be
introduced. Adequate supplementation of micro- and macroelements
plays a key role in successful treatment of neoplasms,
chronic surgical disorders and what is especially
important in view of this paper in the treatment of chronic
conditions like diabetes, renal, hepatic and intestinal disease
and HIV/AIDS. In the recent years, thanks to cART,
prevalence of undernutrition among HIV/AIDS patients
in developed countries has decreased but still everyday attention
to nutrition is required to further improve survival
and quality of life (1, 2).
Nutritional therapy is recommended if weight loss has
exceeded 5% during the last three months, if signifi cant
loss of body cell mass (BCM) has occurred (exceeding 5%
in the last three months) or if Body Mass Index (BMI) has
fallen below 18.5kg/m2 (1). BMI is a widely accepted marker
for cardiac risk but it does not reflect metabolism rate as
well as BCM (1). These markers describe a clinical state of
severe malnutrition or wasting, which requires expert clinical
knowledge, monitoring and dose titration of microand
macroelements. In everyday practice, however, minor
deficits or certain lifestyles (drug abuse, homelessness, alcoholism)
may require only minor interventions to halt or
reverse undernutrition.
The etiology of under- and malnutrition, diagnosis, prophylaxis
and treatment are going to be discussed. Intravenous
nutritional therapy is generally instituted only in
cachectic patients or otherwise unable to ingest foods (for
example after surgery or due to neoplastic disease) and is
not going to be discussed.
Nutritional therapy, mainly intravenous, has becomewidely accepted for patients extremely malnourished or aftersurgical interventions when enteral nutrition cannot beintroduced. Adequate supplementation of micro- and macroelementsplays a key role in successful treatment of neoplasms,chronic surgical disorders and what is especiallyimportant in view of this paper in the treatment of chronicconditions like diabetes, renal, hepatic and intestinal diseaseand HIV/AIDS. In the recent years, thanks to cART,prevalence of undernutrition among HIV/AIDS patientsin developed countries has decreased but still everyday attentionto nutrition is required to further improve survivaland quality of life (1, 2).Nutritional therapy is recommended if weight loss hasexceeded 5% during the last three months, if signifi cantloss of body cell mass (BCM) has occurred (exceeding 5%in the last three months) or if Body Mass Index (BMI) hasfallen below 18.5kg/m2 (1). BMI is a widely accepted markerfor cardiac risk but it does not reflect metabolism rate aswell as BCM (1). These markers describe a clinical state ofsevere malnutrition or wasting, which requires expert clinicalknowledge, monitoring and dose titration of microandmacroelements. In everyday practice, however, minordeficits or certain lifestyles (drug abuse, homelessness, alcoholism)may require only minor interventions to halt orreverse undernutrition.The etiology of under- and malnutrition, diagnosis, prophylaxisand treatment are going to be discussed. Intravenousnutritional therapy is generally instituted only incachectic patients or otherwise unable to ingest foods (forexample after surgery or due to neoplastic disease) and isnot going to be discussed.
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