| F
r e s e n i u s |
| K
a b i |
| Normalan
metabolizam |
| Katabolizam |
| Pedijatrija
1-12 god. |
| Diabetes
mellitus |
| Hepatična
insuficijencija |
| Renalna
insuficijencija |
| Kritična
oboljenja |
| Onkologija |
| Malapsorpcija |
| Povećane
energetske potrebe |
| Disfagija |
| |
|
METABOLIZAM
> minerali i vitamini > antioskidansi
Preporučene
doze iz literature za suplementaciju antioskidansima kod teško oboljelih
pacijenata. (Vrijedi za jedinice intenzivne
njege)
| na
dan |
Galban
Rodriguez
2000 |
Berger&Shenkin
(2000) |
Borhani&Helton
2000 |
| Vit
A |
3,3
mg (najbolje B-karoten) |
1-2
mg |
|
| Vit
E |
364-
910 mg |
150
- 200 mg |
910
mg |
| Vit
C |
2000 |
250
- >1000 |
>
1000 mg |
| Selenijum |
100
mikrograma |
100-
500 mg |
|
| Cink |
50
mg |
10
- 40 mg |
|
U kliničkim studijama, izuzetno teško oboljelim pacijentima, su davani sljedeći
nivoi antioksidanasa:
| |
enteralno/oralno |
parenteralno |
| B-karoten
(mg) |
0,5-
30 |
|
| Vit
E (mg) |
1,2
- 1456 |
12
-400 mg |
| Vit
C (mg) |
96
- 1127 |
1000
- 3000 |
| Selenijum
(mg) |
500
- 600 mikrograma |
59
- 1000 mg |
| Cink
(mg) |
|
13
- 30 mg |
Najviši
tolerirani nivo unosa za antioksidanse. Prema :
Food and Nutrition Board, Američkog instiuta za medicinu, US 2000, 2002.
| Životna
dob godine |
Vit
E
(mg) |
Vit
C
(mg) |
Selenijum
(mg) |
Cink
(mg) |
B
-karotenoidi
(mg) |
UL
9-13 |
600
|
1200 |
280 |
23 |
bez
podataka |
| 14-18 |
800
|
1800 |
400 |
34 |
bez
podataka |
| >18 |
1000 |
2000 |
400 |
40 |
bez
podataka |
odrasli
(NOAEL) |
250
mg/kg t.t. |
2000 |
800 |
40 |
bez
podataka |
UL
(upper intake levels) - tolerirani gornji nivo unosa, maksimalna količina
nutritiva koja nema štetnih osljedica. Baziran je na osnovu:
NOAEL (no observed adverse effect level) - podaci o najvišem nivou
unosa za koji nije zabilježen popratni neželjeni efekat kod ljudi.
Literatura:
- Baines
M, Lack of effectiveness of short-term intravenous micronutrient nutrition
in restoring plasma antioxidant status after surgery. Clin Nutr, 2002
Apr; Vol. 21 (2), pp. 145-50;
- Berger
MM, Copper, selenium, zinc, and thiamine balances during continuous
venovenous hemodiafiltration in critically ill patients. Am J Clin Nutr,
2004 Aug; Vol. 80 (2), pp. 410-6;
- Berger
MM, Influence of selenium supplements on the post-traumatic alterations
of the thyroid axis: a placebo-controlled trial. Intensive Care Med,
2001 Jan; Vol. 27 (1), pp. 91-100;
- Berger
MM, Trace elements in trauma and burns. Curr Opin Clin Nutr Metab Care,
1998 Nov; Vol. 1 (6), pp. 513-7;
- Berger
MM, Trace element supplementation modulates pulmonary infection rates
after major burns: a double-blind, placebo-controlled trial., Am J Clin
Nutr, 1998 Aug; Vol. 68 (2), pp. 365-71;
- Borhani
NO Exposure to trace elements and cardiovascular disease., Circulation,
1981 Jan; Vol. 63 (1), pp. 260A-263A;
- Bulger
EM, Nutrient antioxidants in gastrointestinal diseases., Gastroenterol
Clin North Am, 1998 Jun; Vol. 27 (2), pp. 403-19;
- Galbán
Rodríguez CJ; Early enteral nutrition and immunonutrition] Nutrición
enteral precoz e inmunonutrición, Nutr Hosp, 2000; Vol. 15 Suppl 1,
pp. 75-85;
- Gidden
F, Clinical micronutrition. Nurs Times, 1997 Jun 18-24; Vol. 93 (25),
pp. suppl 1-6;
- Helton
WS, Nutritional issues in hepatobiliary surgery., Liver Dis, 1994 May;
Vol. 14 (2), pp. 140-57;
- Manning
EM, Nutritional assessment in the critically ill., Crit Care Clin, 1995
Jul; Vol. 11 (3), pp. 603-34;
- Mishra
V, Markers of oxidative damage, antioxidant status and clinical outcome
in critically ill patients., Ann Clin Biochem, 2005 Jul; Vol. 42 (Pt
4), pp. 269-76;
- Shenkin
A, Micronutrients in the severely-injured patient. Proc Nutr Soc, 2000
Aug; Vol. 59 (3), pp. 451-6;
- Shenkin
A, Micronutrients and outcome., Nutrition, 1997 Sep; Vol. 13 (9), pp.
825-8;
- Shenkin
A, Trace elements and inflammatory response: implications for nutritional
support., Nutrition, 1995 Jan-Feb; Vol. 11 (1 Suppl), pp. 100-5;
- The
A.S.P.E.N. 2000 Research Workshop: Nutrition Support in Transplantation.
(eng) By Helton WS, JPEN J Parenter Enteral Nutr, 2001 May-Jun; Vol.
25 (3), pp. 111-3
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