Fortschritte in Der Parenteralen Ernährung
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Erniihrungsprobleme wurden in der klinischen Medizin lange Zeit hindurch nur am Rande behandelt. In der Regel wurden sie im Zusammenhang mit Stoffwechselerkran- kungen besprochen und fanden daher das Interesse nur weniger Spezialisten. Uber den Stoffwechsel im StreB oder in der postoperativen Phase und tiber die hieraus sich ergebenden Erniihrungsprobleme dagegen war kaum etwas bekannt. Vor 15 lahren etwa befaBten sich nur einige wenige, kleine Arbeitsgruppen in der Welt mit Fragen der parenteralen und der ktinstlichen Erniihrung. Anfangs nahm die Klinik von diesen Arbeiten kaum Kenntnis. Dies iinderte sich jedoch sehr rasch, als die Klinik lernte, aus den Ergebnissen dieser Arbeiten in immer gr6Berem Umfang Nutzen zu ziehen. Heute hat die ktinstliche Erniihrung ebenso wie die parenterale Erniihrung ihren festen Platz in der Medizin. Ftir die tiigliche Arbeit am Krankenbett sind die modernen Erniihrungsformen oft genug ein entscheidender Bestandteil der Therapie. Unstreitig sind manche groBe Eingriffe der modernen Chirurgie ohne eine exakt bilanzierte Erniihrung - gleichgtiltig, ob auf oralem oder parenteralem Wege, ob halb- oder voIlsynthetisch - nicht erfolgreich durchfUhrbar. Die entscheidenden Anregungen und Entwicklungen gingen von Arbeitsgruppen in Schweden, den USA und in Deutschland aus. Sie schufen die Grundlagen der modernen Erniihrungsformen und gewannen wesentliche Erkenntnisse tiber regelmiiBig auftretende StoffwechselstOrungen im Gefolge chirurgischer Eingriffe, nach Verbrennungen, nach Herzinfarkten oder anderen StreBsituationen. Zwischen diesen Arbeitsgruppen bestanden schon fruhzeitig enge Kontakte, die schlieBlich zur Grundung der Internationalen GeseIlschaft fUr Parenterale Erniihrung fUhrten.
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