{"id":4222,"date":"2023-04-05T08:48:43","date_gmt":"2023-04-05T06:48:43","guid":{"rendered":"http:\/\/berlin-boehm.de\/Kanty\/?p=4222"},"modified":"2023-04-05T08:48:45","modified_gmt":"2023-04-05T06:48:45","slug":"praeoperative-ernaehrung","status":"publish","type":"post","link":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222","title":{"rendered":"Pr\u00e4operative Ern\u00e4hrung"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-7acc1372e522d1472d3487e02738ae1c\">\n.flex_column.av-av_one_full-7acc1372e522d1472d3487e02738ae1c{\nbackground-color:#22689e;\n}\n<\/style>\n<div  class='flex_column av-av_one_full-7acc1372e522d1472d3487e02738ae1c av_one_full  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  first flex_column_div  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad\">\n#top .av-special-heading.av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad{\nmargin:20px 20px 20px 20px;\npadding-bottom:0;\ncolor:#ffffff;\n}\nbody .av-special-heading.av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad .av-special-heading-tag{\npadding:5px 5px 5px 5px;\n}\n.av-special-heading.av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad .special-heading-inner-border{\nborder-color:#ffffff;\n}\n.av-special-heading.av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-lg3bvlby-1300dad20e4f3cb3bb691ed9f86b83ad av-special-heading-h3 custom-color-heading blockquote classic-quote  avia-builder-el-1  avia-builder-el-no-sibling '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Pr\u00e4operative Ern\u00e4hrung<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><\/div><div  class='hr av-av_hr-91d7ccd583a503147498e120fee2ff9b hr-default  avia-builder-el-2  el_after_av_one_full  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><\/p>\n<section  class='av_textblock_section av-lg3bvrt9-7b3b29e8fb51b766a9946f238f8e6090 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><h4>Malnutrition<\/h4>\n<p>Fr\u00fcher wurden viele Patienten bereits pr\u00e4operativ parenteral ern\u00e4hrt, um den Ern\u00e4hrungszustand zu verbessern und postoperativen Komplikationen vorzubeugen. Mittlerweile ist hinreichend gesichert, dass davon Patienten mit einer ausgepr\u00e4gten Malnutrition profitieren. Diese liegt dann vor, wenn der Patient in den letzten Monaten mehr als 15 % seines Gewichtes verloren hat, der Albuminspiegel im Serum geringer als 30 g\/l bzw. der Proteinspiegel geringer als 60 g\/l sind oder der Body Mass Index (BMI) weniger als 17 betr\u00e4gt. Der BMI ist insgesamt ein gutes Ma\u00df, um Unter- oder \u00dcbergewicht einzusch\u00e4tzen. Er berechnet sich nach: BMI = Gewicht [kg]\/(Gr\u00f6\u00dfe)2 [m2]. Wenn ein Patient nach einer dieser drei Kriterien stark mangelern\u00e4hrt ist, dann sollte er pr\u00e4operativ entweder enteral oder parenteral optimal ern\u00e4hrt werden, wobei ihm f\u00fcr mindestens 7 bis 10 Tage 30\u201335 kcal\/kg KG\/Tag zugef\u00fchrt werden.<\/p>\n<h4>Pr\u00e4operative zus\u00e4tzliche Ern\u00e4hrung<\/h4>\n<p>Aufgrund konsumierender Erkrankungen oder durch die belastende Diagnostik (einschlie\u00dflich abf\u00fchrender Ma\u00dfnahmen) sind viele Patienten vor gro\u00dfen viszeralchirurgischen Eingriffen relativ mangelern\u00e4hrt, ohne dass sie die oben genannten Kriterien erf\u00fcllen. Eine parenterale Ern\u00e4hrung ist bei diesen Patienten zwar nicht erforderlich, aber eine zus\u00e4tzliche Alimentation mit N\u00e4hrl\u00f6sungen sollte unbedingt erwogen werden. Dazu bieten sich z. B. proteinreiche Trinkl\u00f6sungen an, von denen \u00fcber den Tag verteilt ca. 750 ml\/Tag zus\u00e4tzlich zum Essen getrunken werden sollten. Der Zusatz von Arginin, Omega-3-Fetts\u00e4uren und Ribonukleotiden hat sich in einigen Studien als vorteilhaft erwiesen. Vor gro\u00dfen Eingriffen am \u00d6sophagus, Magen und Pankreas wegen eines Malignoms erhalten die Patienten die N\u00e4hrl\u00f6sung Oral IMPACT\u00ae f\u00fcr 5-7 Tage. Sie enth\u00e4lt 303 kcal pro 74 g Pulver und ist reich an Arginin, RNS-Nukleotiden und Omega-3-Fetts\u00e4uren.<\/p>\n<h4>Pr\u00e4operative enterale Ern\u00e4hrung<\/h4>\n<p>Der Patient ohne Darmvorbereitung und ohne St\u00f6rung im Gastrointestinaltrakt sollte 6 Stunden vor der Operation nichts mehr essen. Er sollte nach Belieben eine klare kalorienhaltige Fl\u00fcssigkeit bis 2 Stunden vor der Operation trinken.<\/p>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[34],"tags":[],"class_list":["post-4222","post","type-post","status-publish","format-standard","hentry","category-chirurgie"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pr\u00e4operative Ern\u00e4hrung - Berliner Gelassenheit<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pr\u00e4operative Ern\u00e4hrung - Berliner Gelassenheit\" \/>\n<meta property=\"og:url\" content=\"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222\" \/>\n<meta property=\"og:site_name\" content=\"Berliner Gelassenheit\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-05T06:48:43+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-05T06:48:45+00:00\" \/>\n<meta name=\"author\" content=\"Bartholom\u00e4us B\u00f6hm\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Bartholom\u00e4us B\u00f6hm\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"3\u00a0Minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222#article\",\"isPartOf\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222\"},\"author\":{\"name\":\"Bartholom\u00e4us B\u00f6hm\",\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#\\\/schema\\\/person\\\/e7bb56a842d02bb40f4663709bf5242d\"},\"headline\":\"Pr\u00e4operative Ern\u00e4hrung\",\"datePublished\":\"2023-04-05T06:48:43+00:00\",\"dateModified\":\"2023-04-05T06:48:45+00:00\",\"mainEntityOfPage\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222\"},\"wordCount\":818,\"publisher\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#\\\/schema\\\/person\\\/e7bb56a842d02bb40f4663709bf5242d\"},\"articleSection\":[\"Chirurgie\"],\"inLanguage\":\"de\"},{\"@type\":\"WebPage\",\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222\",\"url\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222\",\"name\":\"Pr\u00e4operative Ern\u00e4hrung - Berliner Gelassenheit\",\"isPartOf\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#website\"},\"datePublished\":\"2023-04-05T06:48:43+00:00\",\"dateModified\":\"2023-04-05T06:48:45+00:00\",\"breadcrumb\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222#breadcrumb\"},\"inLanguage\":\"de\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/4222#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Startseite\",\"item\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pr\u00e4operative Ern\u00e4hrung\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#website\",\"url\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/\",\"name\":\"Berliner Gelassenheit\",\"description\":\"Heiterkeit und Widerspr\u00fcche\",\"publisher\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#\\\/schema\\\/person\\\/e7bb56a842d02bb40f4663709bf5242d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"de\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#\\\/schema\\\/person\\\/e7bb56a842d02bb40f4663709bf5242d\",\"name\":\"Bartholom\u00e4us B\u00f6hm\",\"logo\":{\"@id\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/#\\\/schema\\\/person\\\/image\\\/\"},\"description\":\"Prof. Dr. med. Dr. phil. Bartholom\u00e4us B\u00f6hm LL.M B.A. M.A B.Sc Chirurg, Philosoph, Jurist, Soziologe \u00d6konom, Kulturwissenschaftler\",\"sameAs\":[\"http:\\\/\\\/berlin-boehm.de\"],\"url\":\"http:\\\/\\\/berlin-boehm.de\\\/Kanty\\\/archive\\\/author\\\/barthoberlin-boehm-de\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Pr\u00e4operative Ern\u00e4hrung - Berliner Gelassenheit","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222","og_locale":"de_DE","og_type":"article","og_title":"Pr\u00e4operative Ern\u00e4hrung - Berliner Gelassenheit","og_url":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222","og_site_name":"Berliner Gelassenheit","article_published_time":"2023-04-05T06:48:43+00:00","article_modified_time":"2023-04-05T06:48:45+00:00","author":"Bartholom\u00e4us B\u00f6hm","twitter_card":"summary_large_image","twitter_misc":{"Verfasst von":"Bartholom\u00e4us B\u00f6hm","Gesch\u00e4tzte Lesezeit":"3\u00a0Minuten"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222#article","isPartOf":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222"},"author":{"name":"Bartholom\u00e4us B\u00f6hm","@id":"http:\/\/berlin-boehm.de\/Kanty\/#\/schema\/person\/e7bb56a842d02bb40f4663709bf5242d"},"headline":"Pr\u00e4operative Ern\u00e4hrung","datePublished":"2023-04-05T06:48:43+00:00","dateModified":"2023-04-05T06:48:45+00:00","mainEntityOfPage":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222"},"wordCount":818,"publisher":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/#\/schema\/person\/e7bb56a842d02bb40f4663709bf5242d"},"articleSection":["Chirurgie"],"inLanguage":"de"},{"@type":"WebPage","@id":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222","url":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222","name":"Pr\u00e4operative Ern\u00e4hrung - Berliner Gelassenheit","isPartOf":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/#website"},"datePublished":"2023-04-05T06:48:43+00:00","dateModified":"2023-04-05T06:48:45+00:00","breadcrumb":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222#breadcrumb"},"inLanguage":"de","potentialAction":[{"@type":"ReadAction","target":["http:\/\/berlin-boehm.de\/Kanty\/archive\/4222"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/berlin-boehm.de\/Kanty\/archive\/4222#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Startseite","item":"http:\/\/berlin-boehm.de\/Kanty\/"},{"@type":"ListItem","position":2,"name":"Pr\u00e4operative Ern\u00e4hrung"}]},{"@type":"WebSite","@id":"http:\/\/berlin-boehm.de\/Kanty\/#website","url":"http:\/\/berlin-boehm.de\/Kanty\/","name":"Berliner Gelassenheit","description":"Heiterkeit und Widerspr\u00fcche","publisher":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/#\/schema\/person\/e7bb56a842d02bb40f4663709bf5242d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/berlin-boehm.de\/Kanty\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"de"},{"@type":["Person","Organization"],"@id":"http:\/\/berlin-boehm.de\/Kanty\/#\/schema\/person\/e7bb56a842d02bb40f4663709bf5242d","name":"Bartholom\u00e4us B\u00f6hm","logo":{"@id":"http:\/\/berlin-boehm.de\/Kanty\/#\/schema\/person\/image\/"},"description":"Prof. Dr. med. Dr. phil. Bartholom\u00e4us B\u00f6hm LL.M B.A. M.A B.Sc Chirurg, Philosoph, Jurist, Soziologe \u00d6konom, Kulturwissenschaftler","sameAs":["http:\/\/berlin-boehm.de"],"url":"http:\/\/berlin-boehm.de\/Kanty\/archive\/author\/barthoberlin-boehm-de"}]}},"_links":{"self":[{"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/posts\/4222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/comments?post=4222"}],"version-history":[{"count":1,"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/posts\/4222\/revisions"}],"predecessor-version":[{"id":4223,"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/posts\/4222\/revisions\/4223"}],"wp:attachment":[{"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/media?parent=4222"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/categories?post=4222"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/berlin-boehm.de\/Kanty\/wp-json\/wp\/v2\/tags?post=4222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}