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Ziel dieser Arbeit ist es, die nicht-energetische Bedeutung der klassischen Energietrager Kohlenhydrate und Fette im Rahmen parenteraler Ernahrungskonzepte darzustellen. Basierend auf der pharmakologischen Funktion dieser Nahrsubstrate im Kontext der pathophysiologischen Veranderungen des Organ- und Intermediarstoffwechsels definiert sich eine Ernahrungsstrategie, die versucht, eine differenzierte, auf einzelne Krankheitsbilder abgestimmte Nahrstoffzufuhr durchzufuhren.

The object of this review is to demonstrate the non-nutritional importance of carbohydrates and fat as they represent the classic energy carriers in parenteral nutrition. Concerning the pathophysiological changes of organ metabolism and intermediary metabolism as well as the pharmacological function of this nutritive substrates it is necessary to adjust parenteral nutrition strategy to various clinical pictures. The major goals of parenteral applicated carbohydrates are to avoid hyperglycemia, to return the increased hepatic glucose production during trauma and sepsis back to normal, and to reduce protein catabolism. Realizing this goals the dosage of glucose infusion underlies close metabolic borders depending on the present disease. Because of favourable effects of hepatic glucose and protein metabolism, xylitol, a non-glucose polyol, represents an useful alternative energy source to glucose. The non-energetic nutrition therapy with fat consists of application of the essential fatty acids linoleic and alpha-linolenic acid and considers the immunmodulatory effects of various fatty acids as precursors in the eicosanoid metabolism. As demonstrated at the organ systems of liver and lung this pharmacological effects of any lipid infusion might influence specific organ functions.