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Sample records for appraisal enteral nutrition

  1. Pediatric enteral nutrition.

    Science.gov (United States)

    Axelrod, David; Kazmerski, Kimberly; Iyer, Kishore

    2006-01-01

    Common to all pediatric patients receiving enteral nutrition is the inability to consume calories orally. This is often secondary to issues of inadequate weight gain, inadequate growth, prolonged feeding times, weight loss, a decrease in weight/age or weight/height ratios, or a persistent triceps skinfold thickness <5% for age. Enteral nutrition requires enteral access. In the neonatal period the nasoenteric route is usually used. In pediatric patients requiring long-term enteral access, surgically, endoscopically, or radiologically placed percutaneous feeding tubes are common. Jejunal feeding tubes are used in pediatric patients with gastric feeding intolerance or persistent gastroesophageal reflux. Low-profile enteral access devices are preferred by most pediatric patients because of their cosmetic appearance. For most children, a standard pediatric polypeptide enteral formula is well tolerated. There are specialized pediatric enteral formulas available for patients with decreased intestinal length, altered intestinal absorptive capacity, or altered pancreatic function. Weaning patients from tube feeding to oral nutrition is the ultimate nutrition goal. A multidisciplinary approach to patients with short bowel syndrome will maximize the use of enteral nutrition while preserving parenteral nutrition for patients with true enteral nutrition therapy failure.

  2. Advantages of enteral nutrition over parenteral nutrition

    OpenAIRE

    Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra

    2013-01-01

    It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

  3. [Modular enteral nutrition in pediatrics].

    Science.gov (United States)

    Murillo Sanchís, S; Prenafeta Ferré, M T; Sempere Luque, M D

    1991-01-01

    Modular Enteral Nutrition may be a substitute for Parenteral Nutrition in children with different pathologies. Study of 4 children with different pathologies selected from a group of 40 admitted to the Maternal-Childrens Hospital "Valle de Hebrón" in Barcelona, who received modular enteral nutrition. They were monitored on a daily basis by the Dietician Service. Modular enteral nutrition consists of modules of proteins, peptides, lipids, glucids and mineral salts-vitamins. 1.--Craneo-encephalic traumatisms with loss of consciousness, Feeding with a combination of parenteral nutrition and modular enteral nutrition for 7 days. In view of the tolerance and good results of the modular enteral nutrition, the parenteral nutrition was suspended and modular enteral nutrition alone used up to a total of 43 days. 2.--55% burns with 36 days of hyperproteic modular enteral nutrition together with normal feeding. A more rapid recovery was achieved with an increase in total proteins and albumin. 3.--Persistent diarrhoea with 31 days of modular enteral nutrition, 5 days on parenteral nutrition alone and 8 days on combined parenteral nutrition and modular enteral nutrition. In view of the tolerance and good results of the modular enteral nutrition, the parenteral nutrition was suspended. 4.--Mucoviscidosis with a total of 19 days on modular enteral nutrition, 12 of which were exclusively on modular enteral nutrition and 7 as a night supplement to normal feeding. We administered proteic intakes of up to 20% of the total calorific intake and in concentrations of up to 1.2 calories/ml of the final preparation, always with a good tolerance. Modular enteral nutrition can and should be used as a substitute for parenteral nutrition in children with different pathologies, thus preventing the complications inherent in parenteral nutrition.

  4. Enteral nutrition - child - managing problems

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  5. [Fiber and enteral nutrition].

    Science.gov (United States)

    Gómez Candela, C; de Cos Blanco, A I; Iglesias Rosado, C

    2002-01-01

    Dietary fibre is a mixture of various substances and is essential for maintaining appropriate intestinal functionality and it is currently considered to be a necessary part of a healthy diet. Current recommendations for fibre consumption by adults range from 20 to 35 g/day. Enteral nutrition is an emerging therapeutic variation in both hospital and domestic settings. To a great extent, this development has been made possible thanks to the design of new formulas that adapt better and better to the clinicla conditions or our patients. The type of fibre used in these preparations varies greatly. Some have only one source of fibre while others use differnet combinations. There are currently 32 formulas available on the Spanish market, without counting the modules or specific preparations of individual types of fibre. Despite the enormous advances in the knowledge of the beneficial effects of fibre, the fact of the matter is that enteral nutrition that we routinely prescribe in normal clinical practice does not contain fibre. The are several explanations for this, perhaps the most plausible is that these formulas may lead to problems in their administration and tolerance. It is necessary to choose the correct calibre of catheter and define the best infusion method and timing. Another difficulty may be the gastrointestinal tolerance of the formulas containing fibre. No large-scale problems of intolerance have however been described in healthy volunteers nor in patients with acute or chronic pathologies, although it is of fundamental importance to monitor the rhythm of depositions in all patients with enteral nutrition (EN) and ensure proper intake of liquids, which would also be useful to prevent occlusion of the catheter. The theoretical benefits of EN with fibre with a view to maintaining or improving normal intestinal structure and function are very varied. Nonetheless, it has noit yet been possible to prove many of these effects in controlled clinical trials. At the

  6. Meat-based enteral nutrition

    Science.gov (United States)

    Derevitskay, O. K.; Dydykin, A. S.

    2017-09-01

    Enteral nutrition is widely used in hospitals as a means of nutritional support and therapy for different diseases. Enteral nutrition must fulfil the energy needs of the body, be balanced by the nutrient composition and meet patient’s nutritional needs. Meat is a source of full-value animal protein, vitamins and minerals. On the basis of this research, recipes and technology for a meat-based enteral nutrition product were developed. The product is a ready-to-eat sterilised mixture in the form of a liquid homogeneous mass, which is of full value in terms of composition and enriched with vitamins and minerals, consists of particles with a size of not more than 0.3 mm and has the modified fat composition and rheological characteristics that are necessary for passage through enteral feeding tubes. The study presents experimental data on the content of the main macro- and micro-nutrients in the developed product. The new product is characterised by a balanced fatty acid composition, which plays an important role in correction of lipid metabolism disorders and protein-energy deficiency, and it is capable of satisfying patients’ daily requirements for vitamins and the main macro- and microelements when consuming 1500-2000 ml. Meat-based enteral nutrition can be used in diets as a standard mixture for effective correction of the energy and anabolic requirements of the body and support of the nutritional status of patients, including those with operated stomach syndrome.

  7. ENFit Enteral Nutrition Connectors.

    Science.gov (United States)

    Guenter, Peggi; Lyman, Beth

    2016-12-01

    New enteral connectors are now available based on the development of standards using the International Organization of Standardization process to prevent misconnections between systems that should not connect. Enteral devices with the new patient access connectors, called ENFit, are being now introduced for the purpose of improving patient safety. Transitioning to these new connectors poses benefits and challenges for facilities or agencies implementing these new devices. Information from appropriate resources should be sought by clinicians who need to partner with their suppliers and clinical organizations to see how best to meet these challenges.

  8. What Is Enteral Nutrition?

    Science.gov (United States)

    ... Associated With Gastrostomy Tube Removal in Patients With Dysphagia After Stroke https://t.co/Nb8mhfE80m #NCP Expediting Transition to Home Parenteral Nutrition With Fast-Track Cycling https://t.co/Vab2SQflYM # ...

  9. [Enteral nutrition in burn patients].

    Science.gov (United States)

    Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P

    1992-01-01

    Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

  10. Technical aspects of enteral nutrition.

    OpenAIRE

    Keymling, M

    1994-01-01

    Advances in technical aspects of enteral feeding such as the manufacture of tubes from polyurethane or silicone have helped promote the science of enteral nutrition. Nasoenteral tubes have few complications, apart from a high unwanted extubation rate and some reluctance from patients because of cosmetic unacceptability. Needle jejunostomy has low morbidity but can only be placed at laparotomy. Percutaneous gastrotomy (in all its different guises) has been established as a low risk procedure a...

  11. Enteral nutrition in critical patients

    OpenAIRE

    Botello Jaimes, Jhon Jairo; Medico Cuidado Intensivo Clínica San Marcel / Jefe de Urgencias y Unidad de Cuidado Especial Clínica San Marcel / Docente Medicina Interna y Cuidado Intensivo Universidad de Manizales / Docente Internado de Urgencias y de PROFUNDIZACION Urgencias, Cuidado Intermedio e Intensivo Universidad de Caldas / Docente del programa de enfermería Universidad Católica de Manizales / Instructor Internacional / Director Fundación Versalles / Candidato a Magíster en Educación Docencia. Envío co rrespondencia:. Avenida Alberto Mendoza No 93-25 - Clínica San Marcel.; González Rincón, Alejandra; Enfermería Universidad Católica de Manizales. Miembro directivo Fundación Versalles. Miembro Correspondiente Asociación Colombiana de Trauma y Miembro Activo de la Sociedad Panamericana de Trauma. Envío correspondencia: alejita_gonzalez12@ hotmail.com . Calle 50 No 24-14 – Fundación Versalles.

    2010-01-01

    Nutritional support in critically ill patients is of vital importance for its impact on morbidity, hospital stay and preservation of tissue mass among others. It must ensure nutritional support to all critically ill patients enterally ideally by reduced bacterial translocationand stimulation of the function of the intestinal villi. In recent years we have studied immunonutrients as glutamine, arginine, fatty acids and nucleotides with promising effects (Immune response, Intestinal barrier or ...

  12. Enteral Nutrition and Acute Pancreatitis: A Review

    NARCIS (Netherlands)

    Spanier, B.W.M.; Bruno, M.J.; Mathus-Vliegen, E.M.H.

    2011-01-01

    Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English

  13. Enteral nutrition and acute pancreatitis: A review

    NARCIS (Netherlands)

    B.W.M. Spanier (Marcel); M.J. Bruno (Marco); E.M.H. Mathus-Vliegen (Elisabeth)

    2011-01-01

    textabstractIntroduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of

  14. Enteral Nutrition and Acute Pancreatitis: A Review

    NARCIS (Netherlands)

    B.W.M. Spanier; M.J. Bruno; E.M.H. Mathus-Vliegen

    2011-01-01

    Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English

  15. [New nutrients in enteral nutrition].

    Science.gov (United States)

    Vázquez Martínez, C

    2000-01-01

    1. Medical and surgical stress (major surgery, sepsis, injuries,...) increases requirements of certain essential nutrients and others considered non-essential or semi-essential. 2. Some nutrients such as glutamine, arginine, omega 3 fatty acids nucleotides, ... have a considerable influence on the immune function (delayed hypersensitivity, lymphocyte sub-population counts, immunological tests,..) and improve certain metabolic and nutritional indices (nitrogen balance, medium and short life proteins,...). For this reason, they are called "immunonutrients" or "immunity regulators". 3. The supply of special enteral formulas for situations of immunological compromise, with the addition of one or more of the nutrients considered today as "immunity regulators" has increased since 1988 in both absolute and percentage terms. 4. These nutrient-enriched enteral formulas improve the rate of infections, reduce the number of days on ventilator equipment, the length of hospital stays for critical patients, with a more marked effect on surgical patients. 5. The evidence seems today to support the use of enriched formulas with critical patients. Nonetheless, some caution must be maintained as it has not been possible to show any reduction in the mortality of the cases studied nor, in short, in the prognosis of patients affected by situations of hypercatabolism and reduced immunity. 6. We feel that their use should, therefore, be carried out in accordance with the protocols and in patients expected to survive, where the evolution reveals severe catabolism unhindered by conventional therapy.

  16. [Indications and practice of enteral nutrition].

    Science.gov (United States)

    Hallay, Judit; Nagy, Dániel; Fülesdi, Béla

    2014-12-21

    Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient's condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy.

  17. Enteral Nutrition and Care of Risky Newborns

    Directory of Open Access Journals (Sweden)

    Ebru Kilicarslan Toruner

    2013-09-01

    Full Text Available Making appropriate and effective enteral feeding is decreasing the morbidity and mortality rates of risky newborns. Most important problems during enteral feeding in risky newborns are realizing the enteral feeding needs late, not following enteral feeding protocols and errors in medical practices (misconnections etc.. The aim of this review article is to describe the gastrointestinal development, nutrition requirements, enteral nutrition, feeding intolerance and care of risky newborns. Increasing the awareness of health care professionals about this topic is promoted the quality of care in risky newborns. [J Contemp Med 2013; 3(3.000: 227-233

  18. [Enteral nutrition in the multiple trauma patient].

    Science.gov (United States)

    Sánchez-Izquierdo Riera, J A; Montejo González, J C

    1992-01-01

    The hypermetabolism that develops in patients with severe polytraumatism has led to the need for an aggressive metabolic-nutritional support from the start. Parenteral Nutrition is the preferred technique in many instances, due to the doubts on the effectiveness of enteral nutrition in the control of the metabolic response and to problems of gastrointestinal tolerance derived from its administration. However, the role of enteral nutrition as an important factor which limits the development of bacterial translocation and the chain of events leading to multiorganic failure appears to be more and more well-established and is an important argument for justifying the early administration of enteral nutrition in these patients. In accordance with the accumulated experience of several authors over the past few years, enteral nutrition may be administered early in polytraumatized patients. This is not only accompanied by the evidence of acceptable gastrointestinal tolerance to the diet, but also by additional advantages compared to parenteral nutrition, such as the maintenance of trophism and immunocompetence of the digestive mucosa, the reduction of septic complications and also greater nutritional effectiveness which can be evaluated by the behaviour of the seric proteins used as nutritional evolution markers. The interest of the different diet formulae which exist at present, for example diets enriched with branched-chain amino acids, diets with added fibre, peptidic diets, specific pulmonary diets or "euglycaemic diets" is evaluated in this review. All these diets may mean an increase in the effectiveness and/or tolerance of enteral nutrition in polytraumatized patients, and also contribute to the handling of specific problems such as "stress" hyperglycaemia or the withdrawal of mechanical ventilation support. The use of specific nutrients for the digestive mucosa, such as glutamine or short chain fatty acids seems to be an important factor in the reduction of

  19. Enteral Nutrition in Dementia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Joanne Brooke

    2015-04-01

    Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

  20. Enteral nutrition in dementia: a systematic review.

    Science.gov (United States)

    Brooke, Joanne; Ojo, Omorogieva

    2015-04-03

    The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

  1. Aspects of enteral nutrition in cancer chemotherapy

    NARCIS (Netherlands)

    Smit, Jitske Martha

    1985-01-01

    This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients

  2. Aspects of enteral nutrition in cancer chemotherapy

    NARCIS (Netherlands)

    Smit, Jitske Martha

    1985-01-01

    This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients wit

  3. Enteral nutrition of the premature infant

    Directory of Open Access Journals (Sweden)

    Su Jin Cho

    2010-01-01

    Full Text Available Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

  4. [Sequential enteral nutrition support for patients with severe cerebral stroke].

    Science.gov (United States)

    Chen, Jiefang; He, Xudong; Zhang, Lisan; Hu, Xingyue

    2013-11-01

    To evaluate the efficacy of sequential enteral nutrition support in patients with severe cerebral stroke. Forty-nine patients with severe cerebral stroke met the inclusion criteria were randomly divided into sequential enteral nutrition group (Group A, n=24) and conventional enteral nutrition group (Group B, n=25). Patients in Group A received short-peptide-based enteral nutrition support first, then gradually transferred to intact protein enteral nutrition. Meanwhile, patients in Group B constantly received intact protein enteral nutrition support. The nutritional indexes and the rate of complications were compared between two groups. The nutritional indexes were decreased in both groups within 4 weeks after admission, but the decreasing levels of hemoglobin and albumin in Group A were significantly lower than those in Group B (P0.05). Sequential enteral nutritional support can improve the nutritional status and decrease the incidence of complications in critical patients with cerebral stroke.

  5. Clinical and nutritional implications of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Beer, W.H.; Fan, A.; Halsted, C.H.

    1985-01-01

    The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value.

  6. [Enteral Nutritional Support in Gastrointestinal and Liver Diseases].

    Science.gov (United States)

    Kim, Eun Ran

    2015-06-01

    Nutritional support is important because malnutrition is a major contributor to increased morbidity and mortality, decreased quality of life, increased length of hospital stay, and higher healthcare costs. Patients with gastrointestinal disease are at an increased risk of nutritional deterioration due to therapeutic dietary restriction, fasting for the diagnostic tests, loss of appetite due to anorexia or altered nutritional requirement caused by the disease itself. Therefore, it is important that gastroenterologists are aware of the nutritional status of patients and plan a treatment strategy considering patient's nutritional status. Enteral nutrition is preferred to parenteral nutrition as it is more physiologic, has fewer complications, help to prevent mucosal atrophy and maintain gut barrier function, which decrease intestinal bacterial translocation. Hence, enteral nutrition has been considered to be the most effective route for nutritional support. In this article, we will review enteral nutrition (oral nutritional supplements, enteral tube feeding) as a treatment for the patients with gastrointestinal, liver and pancreatic disease at risk of malnutrition.

  7. [SHORT BOWEL SYNDROME AND NUTRITIONAL ENTERAL].

    Science.gov (United States)

    Ariadel Cobo, Diana; Pereira Cunill, José Luis; Socas Macías, María; Serrano Aguayo, Pilar; Gómez Liébana, Eulalia; Morales Conde, Salvador; García Luna, Pedro Pablo

    2015-12-01

    The particularity of this case is the nutritional management that has managed to avoid the use of prolonged parenteral nutrition and possible complications by placing jejunal tube at the distal end in patients with short bowel. It is a 34-year-old colecistectomizado complicated with postoperative peritonitis and dehiscence; two years he studied with small bowel obstruction, he was made de-volvulus and was complicated with two leak at different times after the second escape took place jejunostomy side double barreled shotgun level dehiscence, presented high debits by afferent loop of the terminal jejunostomy; during admission, polyurethane probe enteral feeding was inserted by the efferent loop jejunostomy. He received jejunal tube feeding laundry in the efferent loop terminal with decreased weight gain and subsequent reconstruction of intestinal transit debit proximal jejunostomy.

  8. [Sensory evaluation of enteral nutritional supplements].

    Science.gov (United States)

    Granell Vidal, Lina; Sánchez Juan, Carlos; Alfonso García, Antonio

    2014-07-01

    Enteral nutrition (EN) is indicated in patients who, although they may not eat enough food, maintain a sufficient function to receive, digest and absorb nutrients digestive system. Oral Nutritional Supplements (SON) are nutritionally complete or incomplete formulas (depending on whether or not provide all the nutrients needed to serve as the sole source of nutrients), which supplement inadequate oral diet. This study aims to evaluate the organoleptic characteristics of hyperproteic, normoproteic and fiber-enriched oral SON. SON test, carried out at the Department of Endocrinology and Nutrition Consortium Hospital General Universitario de Valencia from October 2012 to February 2013. 137 SON were evaluated in total, of which 47 were hyperproteic, 46 normoproteic and 44 enriched in fiber. Of the SON evaluated in the group of hyperproteic the following 3 SON obtained the best scores: Fresenius Prot Energy Drink® (21,27, vanilla flavor), Avant Standard Nut® (20.3 , strawberry flavor) and Resource® Protein (20.01, chocolate flavor) In the group of normoproteic SON the 3 best rated were: Ensure Plus® (22.3, banana flavor), Ensure Plus® (21.9, peach flavor) and Fresubin Energy Drink® (21, strawberry flavor) In the group of fiber-enriched the 3 SON most appreciated were: 2 Kcal Fresubin Fibre Drink® (23.78, vanilla flavor), Ensure Plus® TwoCal (22.9, banana flavor) and Fortimel Compact® (21.5, strawberry flavor) The study aims to guide clinicians on what SON may be more acceptable to the patient, so that the SON serve their purpose and restore or improve nutritional status, as the SON intervention is safe and cost - effective, since they improve both the functionality and quality of life. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Enteral nutrition. Potential complications and patient monitoring.

    Science.gov (United States)

    Kohn, C L; Keithley, J K

    1989-06-01

    , caloric density, and osmolality; handle feedings in a way that minimizes bacterial contamination. 7. Ongoing nutritional assessments are necessary to provide information about the overall adequacy of the enteral feeding in restoring or maintaining nutrition.

  10. [Update of enteral nutrition at the patient's home].

    Science.gov (United States)

    García-Luna, P P; Parejo Campos, J; Fenoy Macías, J L

    1999-05-01

    Home enteral nutrition is the administration of enteral formulae into the digestive tract using a tube, with the objective of preventing or correcting malnutrition patients who are seen at home. Home enteral nutrition is a type of nutritional support that is growing, that improves the nutritional status of the patient with a lower cost and with a greater quality of life of the family unit than enteral nutrition in the hospital. The prevalence is clearly increasing although the data of the national registers of patients with at home enteral nutrition are under estimated. Patients who are candidates for home enteral nutrition can be all those with an indication for enteral nutrition and whose underlying disease is stabilized or does not require all the technical means of the hospital in a permanent and essential manner. Neoplasias and neurological diseases are those that benefit most from at home enteral nutrition and in all registries each group varies between 30 and 40%. All access routes and all enteral nutrition formulae can be used in patients with home enteral nutrition. The use of percutaneous endoscopic gastrostomies is ever more recommended in patients who need at home enteral nutrition for a period longer than 4 weeks. Since the publication of the Ministerial Order of June 2nd 1998, home enteral nutrition is considered a health care service that can be covered by the Social Security. This order lists a series of disease that are likely to be treated with at home enteral nutrition (in our opinion the list is not complete but it is likely to be changed in the future by an Assessing Committee), and it presents some basic norms that all patients must comply with, regardless of the autonomous community in which they live. Before beginning at home enteral nutrition the training of the patient and/or the family with regard to the management of at home enteral nutrition is essential. The existence of qualified personnel with experience in this nutritional support

  11. Enteral nutrition in malnutrition following gastric resection and cephalic pancreaticoduodenectomy.

    Science.gov (United States)

    Kornowski, A; Cosnes, J; Gendre, J P; Quintrec, Y

    1992-02-01

    Nutritional recovery was studied during continuous enteral nutrition in 29 patients who had developed malnutrition after gastric surgery. Patients were divided into three groups according to the type of surgery involved: total gastrectomy (n = 10), partial gastrectomy (n = 12), or cephalic pancreaticoduodenectomy (n = 7). The evolution of anthropometric and biological nutritional parameters in each group was compared with that observed in a control group of 10 nonoperated anorectic patients. Significant gains in body weight, arm muscle circumference, triceps skinfold, serum transferrin and global nutritional status were observed after 3 to 4 weeks of enteral nutrition in each group, while serum albumin, serum cholesterol, hemoglobin, and total lymphocyte count did not change significantly. No significant difference was observed between the groups. However, weight gain tended to be slower in patients with cephalic pancreaticoduodenectomy. This study confirms that enteral nutrition is an effective method of nutritional repletion after gastrectomy. Enteral nutrition can be used in undernourished gastrectomized patients when dietary measures alone have proven inadequate.

  12. [Home Enteral Nutrition: National Registry 2001].

    Science.gov (United States)

    Planas, M; Castellà, M; García Luna, P P; Parés, R M; Chamorro, J; Camarero, E; Calañas, A J; Bonada, A; Irles, J A; Adrio, G; Jiménez, M; Bobis, M A; Rodríguez, A; Pérez de la Cruz, A; Gómez Enterría, P; Zamarrón, I; Cos, A; Mancha, A; Martínez, I; Martí, E; de Luis, D; Virgili, N; Moreno, J M; Luengo, L M; de la Cuerda, C; Forga, M T; Goenaga, M A; Carrera, J A; Garde, C; Ordóñez, J; Pedrón, C

    2004-01-01

    The NADYA-SENPE Working Group analyzed the registered data of patients on Home Enteral Nutrition (HEN) in our country, during year 2001. The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient's quality of life and progress. All data were processed and analyzed by the coordinating team. Twenty two hospitals participated and 3,458 patients, aged 5.6 +/- 4.0 y for those younger than 14 y, and 67.1 +/- 19.5 y for those older than 14 y, were enrolled. Of these patients, 43.4% were diagnosed with neurological diseases and 33.5% with cancer. The mean time on HEN was 6.5 +/- 4.5 months. Oral nutrition was the preferential route (54.5%), followed by nasoenteral tube (32.3%), and in 13.3% ostomy tubes were placed. Polymeric was the formula composition mainly used (85.9%). Patients were followed (71.1%) by the hospital reference Nutritional Support Unit. The complications related to nutrition included mainly the gastrointestinal (0.16 complications/patient), and the mechanical one (0.15 complications/patient). At the end for the year, 48.3% of the patients were in the HEN program, and in 33.3% HEN was finish due to different reasons. In 22.9% of the patients no, o light, discapacity degree was found. Neurological diseases and cancer were the more frequent diagnoses in HEN patients. Oral access was the higher feeding route due, probably, to the high prevalence of cancer patients. In spite of the elevated prevalence of neurological diseases, a few number of patients, as previous years, were feed with ostomy tube. Due to the few complications observed, HEN is a safe treatment in our country.

  13. Enteral Nutrition in Crohn’s Disease: An Underused Therapy

    Directory of Open Access Journals (Sweden)

    S. Kansal

    2013-01-01

    Full Text Available This paper reviews the literature on the history, efficacy, and putative mechanism of action of enteral nutrition for inflammatory bowel disease in both paediatric and adult patients. It also analyses the reasoning behind the low popularity of exclusive enteral nutrition in clinical practice despite the benefits and safety profile.

  14. Enteral Nutrition in Pancreaticoduodenectomy: A Literature Review

    Directory of Open Access Journals (Sweden)

    Salvatore Buscemi

    2015-04-01

    Full Text Available Pancreaticoduodenectomy (PD is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%–40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE, postoperative pancreatic fistula (POPF, postpancreatectomy hemorrhage (PPH, length of stay and infectious complications. Several studies, especially randomized controlled trial have shown that EN does not increase the rate of DGE. EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications.

  15. A Comparison of Postoperative Early Enteral Nutrition with Delayed Enteral Nutrition in Patients with Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Gongchao Wang

    2015-06-01

    Full Text Available We examined esophageal cancer patients who received enteral nutrition (EN to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3 based on whether they received EN within 48 h, 48 h–72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH, days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019. Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients.

  16. Enteral Nutrition for Adults in the Hospital Setting.

    Science.gov (United States)

    Kozeniecki, Michelle; Fritzshall, Rebecca

    2015-10-01

    In patients unable to tolerate oral intake, multiple options of nutrient delivery are available to the clinician. Administration of enteral nutrition (EN) has long been considered the standard of care for nutrition support among patients unable to meet energy and protein requirements orally. Healthcare practitioners must make careful decisions related to ordering, administering, and monitoring EN therapy. In the hospital setting, the registered dietitian is a key resource in enteral formula selection and method of administration, monitoring for and troubleshooting EN-related complications, and transitioning to oral feeding. The hospital setting also presents many unique challenges in providing optimal nutrition to the enterally fed patient.

  17. [Supplemental parenteral nutrition for intensive care patients: a logical combination with enteral nutrition].

    Science.gov (United States)

    Heidegger, Claudia-Paula; Thibault, Ronan; Berger, Mette M; Pichard, Claude

    2009-12-09

    Undernutrition is a widespread problem in the intensive care and is associated with a worse clinical outcome. Enteral nutrition is the recommended nutritional support in ICU patients. However, enteral nutrition is frequently insufficient to cover protein-energy needs. The initiation of supplemental parenteral nutrition, when enteral nutrition is insufficient, could optimize the nutritional therapy. Such a combination could allow reducing morbidity, length of stay and recovery, as well as improving quality of life and health care costs. Prospective studies are currently underway to test this hypothesis.

  18. [Biological evaluation of a protein mixture intended for enteral nutrition].

    Science.gov (United States)

    Meneses, J Olza; Foulquie, J Porres; Valero, G Urbano; de Victoria, E Martínez; Hernández, A Gil

    2008-01-01

    Enteral nutrition is the best way to feed or supplement the diet when gastrointestinal tract functions of patients are partially or totally preserved. Whenever total enteral nutrition is needed, it represents the only source of nutrients for patients. Thus, it is mandatory to ensure that high biological value proteins are included in enteral formulae. To assess the biological quality of a protein blend constituted by 50% potassium caseinate, 25% whey protein and 25% pea protein intended to be used in enteral nutrition products. Forty Wistar rats (20 male and 20 female), with initial body weight of 51 g, where divided into four groups and feed for 10 days with: casein (Control), experimental protein blend (Experimental), liophylized normo- and hyperproteic enteral nutrition formulae adapted to the animal nutritional requirements (Normoproteic and Hyperproteic). Protein efficiency ratio (PER), apparent digestibility coefficient (ADC), relationship between retained and absorbed nitrogen (R/A) and relationship between retained and consumed nitrogen (R/I) where calculated. Experimental and control groups had similar values for all analysed indices (PER, ADC, R/A and R/I). These indices where also similar between normo and hyperproteic groups, but lower than experimental and control groups, except in PER, where normoproteic group was either similar to control and hiperproteic group. The quality of the protein blend used in this study is high. It is a good protein source to be used in the development of new enteral nutritional products.

  19. Routes for early enteral nutrition after esophagectomy : A systematic review

    NARCIS (Netherlands)

    Weijs, Teus J; Berkelmans, Gijs H K; Nieuwenhuijzen, Grard A P; Ruurda, Jelle P; Hillegersberg, Richard V; Soeters, Peter B; Luyer, Misha D P

    2015-01-01

    BACKGROUND: Early enteral feeding following surgery can be given orally, via a jejunostomy or via a nasojejunal tube. However, the best feeding route following esophagectomy is unclear. OBJECTIVES: To determine the best route for enteral nutrition following esophagectomy regarding anastomotic leakag

  20. Routes for early enteral nutrition after esophagectomy : A systematic review

    NARCIS (Netherlands)

    Weijs, Teus J; Berkelmans, Gijs H K; Nieuwenhuijzen, Grard A P; Ruurda, Jelle P|info:eu-repo/dai/nl/257561021; Hillegersberg, Richard V|info:eu-repo/dai/nl/110706242; Soeters, Peter B; Luyer, Misha D P

    2015-01-01

    BACKGROUND: Early enteral feeding following surgery can be given orally, via a jejunostomy or via a nasojejunal tube. However, the best feeding route following esophagectomy is unclear. OBJECTIVES: To determine the best route for enteral nutrition following esophagectomy regarding anastomotic leakag

  1. American Society for Parenteral & Enteral Nutrition

    Science.gov (United States)

    ... Resources Continuing Education Certification Claim CE Credits Clinical Nutrition Week eLearning Center Professional Development Webinars Calendar of ... Guidelines Clinical Practice Library Standards Malnutrition Awareness Parenteral ... Resources Practice and Research Toolkits Online Store Research ...

  2. [National registry of home enteral nutrition in Spain 2007].

    Science.gov (United States)

    Luengo Pérez, L M; Chicharro, M L; Cuerda, C; García Luna, P P; Rabassa Soler, A; Romero, A; Irles, J A; Penacho, M A; Camarero, E; Martínez Olmos, M A; Calañas, A; Parés, R M; Lecha, M; Gómez Candela, C; Zapata, A; Pérez de la Cruz, A; Luis, D de; Wanden-Berghe, C; Cantón, A; Laborda, L; Matía, P; Martí, E

    2009-01-01

    To communicate the results from the registry of Home-Based Enteral Nutrition of the NADYASENPE group in 2007. We included every patient in the registry with home enteral nutrition any time from January 1st to December 31st of 2007. The number of patients with home enteral nutrition in 2007 was 5,107 (52% male) from 28 different hospitals. 95.4% of them were 15 yr or older, with a mean age of 67.96 +/- 18.12, and 4.2 +/- 3.38 among patients aged 14 yr or less. The most common underlying diseases were neurological (37.8%) and neoplastic diseases (29.3%). Enteral nutrition was administered p.o. in most patients (63.5%), followed by nasogastric tube (25.9%), while gastrostomy was only used in 9.2%. The mean time in enteral nutrition support was 9.4 months and the most common reasons for withdrawal were death (58.7%) and switching to oral intake (32%). Activity was limited in 31.4% of patients and 36.01% were house-bound. Most patients needed partial (26.51%) or total (37.68%) care assistance. Enteral formula was provided by hospitals to 69.14% of patients and by pharmacies to 30.17% of them, while disposable material was provided by hospitals to 81.63% and by Primary Care to the remaining patients. In 2007, there has been an increase of more than 30% of patients registered with home enteral nutrition comparing with 2006, without any big difference in other data, but a higher proportion of patients with enteral nutrition p.o.

  3. [Croatian guidelines for perioperative enteral nutrition of surgical patients].

    Science.gov (United States)

    Zelić, Marko; Bender, Darija Vranesić; Kelecić, Dina Ljubas; Zupan, Zeljko; Cicvarić, Tedi; Maldini, Branka; Durut, Iva; Rahelić, Velimir; Skegro, Mate; Majerović, Mate; Perko, Zdravko; Sustić, Alan; Madzar, Tomislav; Kovacić, Borna; Kekez, Tihomir; Krznarić, Zeljko

    2014-01-01

    Nutritional status of patients significantly affects the outcome of surgical treatment, whether it's about being obese or malnutrition with loss of muscle mass. Inadequate nutritional support in the perioperative period compromises surgical procedures even in patients who are adequately nourished. In this paper, particular attention was paid to malnourished patients, and their incidence in population hospitalized in surgical wards can be high up to 30%. Special emphasis was paid to the appropriateness of preoperative fasting and to the acceptance of new knowledge in this area of treatment. The aim of this working group was to make guidelines for perioperative nutritional support with different modalities of enteral nutrition. The development of these guidelines was attended by representatives of Croatian Medical Association: Croatian Society for Digestive Surgery, Croatian Society for Clinical Nutrition, Croatian Society of Surgery, Croatian Society for Endoscopic Surgery, Croatian Trauma Society and the Croatian Society of Anesthesiology and Intensive Care. The guidelines are designed as a set of questions that arise daily in clinical practice when preparing patients for surgery and after the surgical treatment, which relate to the assessment of nutritional status, perioperative nutritional support, duration of preoperative fasting period and the selection of food intake route. Assessment of nutritional status and the use of different modes of enteral nutrition should enter into standard protocols of diagnosis and treatment in the Croatian hospitals.

  4. Introductory to the ESPEN guidelines on enteral nutrition

    DEFF Research Database (Denmark)

    Lochs, H.; Allison, S.P.; Meier, R.

    2006-01-01

    The ESPEN guidelines on enteral nutrition are the first evidence-based European recommendations for enteral nutrition. They were established by European experts for a variety of disease groups. During guideline development it became evident that terms and definitions in clinical nutrition have been...... used inconsistently depending on medical disciplines as well as regional and personal preferences. Therefore, to increase explanatory accuracy it was necessary to unify them. In this chapter terms and definitions used throughout all guidelines are explained. Additionally answers to more general...

  5. Exclusive enteral nutrition in children with Crohn's disease.

    Science.gov (United States)

    Day, Andrew S; Lopez, Robert N

    2015-06-14

    Exclusive enteral nutrition involves the use of a complete liquid diet, with the exclusion of normal dietary components for a defined period of time, as a therapeutic measure to induce remission in active Crohn's disease (CD). This very efficacious approach leads to high rates of remission, especially in children and adolescents newly diagnosed with CD. This intervention also results in mucosal healing, nutritional improvements and enhanced bone health. Whilst several recent studies have provided further elaboration of the roles of exclusive enteral nutrition in the management of CD, other reports have provided new understanding of the mechanisms by which this intervention acts.

  6. The Use of Enteral Nutrition in the Management of Stroke.

    Science.gov (United States)

    Ojo, Omorogieva; Brooke, Joanne

    2016-12-20

    This article discusses the use of enteral nutrition in the management of stroke. Stroke is a major source of disability, including dysphagia. The clinical manifestation of swallowing difficulties in stroke patients may lead to malnutrition which has implications for health status and clinical outcomes including morbidity, mortality and cost to the health service. The prevalence of malnutrition following an acute stroke could range from 8% to 34%. Therefore, the need to develop and implement the use of enteral nutrition support in stroke patients becomes pertinent. A range of enteral feeding tubes and feeding methods may be used to support stroke patients who are unable to meet their nutritional requirements through oral intake alone, although each of these approaches has its merits and limitations. Based on this review, there is evidence that enteral nutrition support is a useful method of providing nutrition for patients with dysphagia following a stroke in order to enhance their nutritional status and promote their health. However, there are challenges in the use of enteral tube feeding in these patients.

  7. The Use of Enteral Nutrition in the Management of Stroke

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2016-12-01

    Full Text Available This article discusses the use of enteral nutrition in the management of stroke. Stroke is a major source of disability, including dysphagia. The clinical manifestation of swallowing difficulties in stroke patients may lead to malnutrition which has implications for health status and clinical outcomes including morbidity, mortality and cost to the health service. The prevalence of malnutrition following an acute stroke could range from 8% to 34%. Therefore, the need to develop and implement the use of enteral nutrition support in stroke patients becomes pertinent. A range of enteral feeding tubes and feeding methods may be used to support stroke patients who are unable to meet their nutritional requirements through oral intake alone, although each of these approaches has its merits and limitations. Based on this review, there is evidence that enteral nutrition support is a useful method of providing nutrition for patients with dysphagia following a stroke in order to enhance their nutritional status and promote their health. However, there are challenges in the use of enteral tube feeding in these patients.

  8. [Enteral nutrition in maxillofacial surgery patients (1989-1995)].

    Science.gov (United States)

    Orduña Espinosa, R M; Giménez Martínez, R; Luján Selles, J M; Laguna Salguero, J I; Pérez de la Cruz, A J

    1996-01-01

    One of the clearest indications for enteral nutrition is made up by patients who underwent treatment for orofacial pathology. In this way, we have reviewed retrospectively, 321 clinical histories of patients who underwent treatment (orofacial surgery), dividing these according to the pathology; neoplasia or non-neoplasia (173/148), with enteral nutrition 24 hours after the intervention. Data are collected with regard to the tolerance (vomiting, diarrhea), time needed to reach 1.500 kcal/day, need of parenteral nutritional support, transferrin, prealbumin, and albumin quantification at the start of the nutritional therapy, as well as the total duration there of. Globally, the good enteric tolerance of both groups of patients is noted, despite the fact that the oncological group showed a greater degree of protein malnutrition (statistically significant). As for the total duration of the nutrition, this is greater in the neoplasias, probably due to a more aggressive surgery. The results obtained permit modification of the basic enteral nutrition protocol (reduction of the time used to reach the maximum volume), as well as stressing the preoperative and postoperative regulated nutritional evaluation.

  9. Iodine in Enteral and Parenteral Nutrition

    NARCIS (Netherlands)

    Zimmermann, M.B.; Crill, C.M.

    2010-01-01

    Iodine deficiency (ID) has multiple adverse effects on growth and development due to inadequate thyroid hormone production. Methods for assessment of iodine nutrition in individuals include the urinary iodine concentration (UI), thyroid size and thyroid function tests. The UI measured in several rep

  10. [National registry of Home Enteral Nutrition in 2003].

    Science.gov (United States)

    Planas, M; Lecha, M; García Luna, P P; Parés, R M; Chamorro, J; Martí, E; Bonada, A; Irles, J A; Boris, M A; Cardona, D; Zamarrón, I; Calañas, A J; Rodríguez, A; Camarero, E; Pérez de la Cruz, A; Mancha, A; De Luis Román, D; Cos, A; Luengo, L M; Jiménez, M; Bayo, P; Goenaga, M A

    2006-01-01

    To communicate the information available by the NADYA-SENPE Working Group from patients on Home Enteral Nutrition (HEN) in our country during the year 2003. The data were collected through a closed questionnaire included in the web site of the Working Group (www.nadya-senpe.com) available only by the authorized users. Variable included were: epidemiological information, the indication to prescribe this treatment, the access path, the specific nutritional formula used, the treatment duration, the complications and hospital readmission related to the nutritional treatment, the follow-up and the quality of life. We register 3,858 patients that belong to twenty-one hospitals. Mean age from those adults 66.2 +/- 18.9 years, and from those younger than 14, 6.0 +/- 4.3 years. Neurological and neoplasic diseases were the diagnostics more frequents (38.9% and 37.4%, respectively). Oral nutrition was the preferential rout used for the enteral nutrition (54.7%) followed by naso-enteral tube (26.6%), and only in 17.6% we used ostomy tubes. Polymeric was the enteral formula mainly utilized (80.1%). The mean time on HEN was 6.6 +/- 4.3 months; the 28.8% of patients stayed in the treatment for less than 3 months, 21.2 % between 3 and 6 months, and 50.0% more than 6 months. Patients were followed mainly by Nutritional Support Unit from the reference hospital (73.1%). While the reference hospital supplies the material (62.4%), reference hospital pharmacy (46.8%) and public pharmacies (32.0%) provides the enteral formula. Complications related to enteral nutrition included change of enteral tube (44.5%), gastrointestinal complications (30.5%), mechanical complications (21.7%), and the metabolic one (3.3%). These complications were followed by 0.02 hospitalizations/patient. At the end of the year, 54.7% of patients were in the HEN programme, and in 35.2 % HEN was finish due to accept oral conventional alimentation (49.2%) or by deceased of patients (40.9%). While 26.6% of the

  11. Enteral nutrition intolerance in critically ill septic burn patients.

    Science.gov (United States)

    Lavrentieva, Athina; Kontakiotis, Theodore; Bitzani, Militsa

    2014-01-01

    The purpose of this study was to investigate the frequency of enteral feeding intolerance in critically ill septic burn patients, the effect of enteral feeding intolerance on the efficacy of feeding, the correlation between the infection marker (procalcitonin [PCT]) and the nutrition status marker (prealbumin) and the impact of feeding intolerance on the outcome of septic burn patients. From January 2009 to December 2012 the data of all burn patients with the diagnosis of sepsis who were placed on enteral nutrition were analyzed. Septic patients were divided into two groups: group A, septic patients who developed feeding intolerance; group B, septic patients who did not develop feeding intolerance. Demographic and clinical characteristics of patients were analyzed and compared. The diagnosis of sepsis was applied to 29% of all patients. Of these patients 35% developed intolerance to enteral feeding throughout the septic period. A statistically significant increase in mean PCT level and a decrease in prealbumin level was observed during the sepsis period. Group A patients had statistically significant lower mean caloric intake, higher PCT:prealbumin ratio, higher pneumonia incidence, higher Sequential Organ Failure Assessment Maximum Score, a longer duration of mechanical ventilation, and a higher mortality rate in comparison with the septic patients without gastric feeding intolerance. The authors concluded that a high percentage of septic burn patients developed enteral feeding intolerance. Enteral feeding intolerance seems to have a negative impact on the patients' nutritional status, morbidity, and mortality.

  12. Enteral nutrition with simultaneous gastric decompression in critically ill patients.

    Science.gov (United States)

    Gentilello, L M; Cortes, V; Castro, M; Byers, P M

    1993-03-01

    Early enteral nutrition is an important adjunct in the care of critically ill patients. A double-lumen gastrostomy tube with a duodenal extension has been reported to enable early enteral feeding with simultaneous gastroduodenal decompression. We tested the ability of this device to achieve these goals in critically ill patients. Noncomparative, descriptive case series. Surgical intensive care unit in a university hospital. Fifteen consecutive critically ill patients, who, at the time of laparotomy, were assessed likely to need long-term nutritional support and gastric decompression, underwent tube placement. Mean age was 47 +/- 21 yrs. Mean Acute Physiology and Chronic Health Evaluation (APACHE II) and Therapeutic Intervention Scores were 15 +/- 7.3 (SD) and 29 +/- 10.2, respectively, and the mean Injury Severity Score of 11 trauma patients in the group was 27 +/- 7.4. Correct tube positioning was verified by radiograph or endoscopy. Caloric and protein requirements, nutritional parameters, and problems encountered with the device were recorded. The correlation between the volume of feeding port input and suction port output was noted, and this correlation was considered significant if r2 was > or = .5. Only three (20%) of 15 patients reached full enteral nutritional support via the enteral route. None of these patients achieved this level of nutritional support within the first postoperative week. In 67% of the patients, large quantities of enteral feeding solution appeared in the gastroduodenal suction port effluent. When feeding port input was plotted against effluent volume, a correlation coefficient of > .71 (r2 = > or = .5) was found in 40% of the patients. Other complications included: a) excessive gastroduodenal drainage requiring fluid/electrolyte replacement in eight (53.3%) patients; and b) skin ulceration at the tube entrance site in seven (46.7%) patients. These data do not support the use of this device for early enteral feeding and simultaneous

  13. Enteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients

    OpenAIRE

    Pasinato, Valeska Fernandes; Berbigier, Marina Carvalho; Rubin, Bibiana de Almeida; Castro, Kamila; Moraes,Rafael Barberena; Perry, Ingrid Dalira Schweigert

    2013-01-01

    Objective Evaluate the compliance of septic patients' nutritional management with enteral nutrition guidelines for critically ill patients. Methods Prospective cohort study with 92 septic patients, age ≥18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores...

  14. Enteral nutrition in the chronic obstructive pulmonary disease (COPD) patient.

    Science.gov (United States)

    DeBellis, Heather F; Fetterman, James W

    2012-12-01

    Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient's nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient's dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

  15. Document of standardization of enteral nutrition access in adults.

    Science.gov (United States)

    Arribas, Lorena; Frías, Laura; Creus, Gloria; Parejo, Juana; Urzola, Carmen; Ashbaugh, Rosana; Pérez-Portabella, Cleofé; Cuerda, Cristina

    2014-07-01

    The group of standardization and protocols of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) published in 2011 a consensus document SENPE/SEGHNP/ANECIPN/SECP on enteral access for paediatric nutritional support. Along the lines of this document, we have developed another document on adult patients to homogenize the clinical practice and improve the quality of care in enteral access in this age group. The working group included health professionals (nurses, dietitians and doctor) with extensive experience in enteral nutrition and access. We tried to find scientific evidence through a literature review and we used the criteria of the Agency for Health-care Research and Quality (AHRQ) to classify the evidence (Grade of Recommendation A, B or C). Later the document was reviewed by external experts to the group and requested the endorsement of the Scientific and Educational Committee (CCE) and the group of home artificial nutrition (NADYA) of the SENPE. The full text will be published as a monograph number in this journal.

  16. Document of standardization of enteral nutrition access in adults

    Directory of Open Access Journals (Sweden)

    Lorena Arribas

    2014-07-01

    Full Text Available The group of standardization and protocols of the Spanish Society of Parenteral and Enteral Nutrition (SENPE published in 2011 a consensus document SENPE/SEGHNP/ANECIPN/SECP on enteral access for paediatric nutritional support. Along the lines of this document, we have developed another document on adult patients to homogenize the clinical practice and improve the quality of care in enteral access in this age group. The working group included health professionals (nurses, dietitians and doctor with extensive experience in enteral nutrition and access. We tried to find scientific evidence through a literature review and we used the criteria of the Agency for Health-care Research and Quality (AHRQ to classify the evidence (Grade of Recommendation A, B or C. Later the document was reviewed by external experts to the group and requested the endorsement of the Scientific and Educational Committee (CCE and the group of home artificial nutrition (NADYA of the SENPE. The full text will be published as a monograph number in this journal.

  17. Polypharmacy and enteral nutrition in patients with complex chronic diseases

    Science.gov (United States)

    Romero Jiménez, Rosa Mª; Ortega Navarro, Cristina; Cuerda Compés, Cristina

    2017-05-08

    Oral medications are often administered through enteral feeding tubes in patients with complex chronic diseases. It is important to consider possible interactions between drugs and enteral nutrition that might lead to unsuccessful treatment or tube occlusion. These patients become subjects for higher risk of problems and errors such as drug incompatibility with enteral nutrition and inappropriate dosage form selection. It is possible to minimize the risk of tube occlusion and incompatibilities problems by recognizing potential medication errors, selecting the most appropriate drug and dosage form and using appropriate administration techniques. In this context, high-alert medications for patients with chronic diseases deserve special attention. Furthermore, risk exposure should be considered among healthcare professionals and patient caregivers handling hazardous drugs. Therefore, main incompatibility problems between drugs and enteral nutrition have been reviewed, including general recommendations for administration of oral medications through enteral feeding tubes and safe handling of hazardous drugs. Specific recommendations for administration of high-alert medications for patients with chronic diseases are also included.

  18. [Elevated serum lithium concentration due to switch from parenteral nutrition alone to parenteral with enteral nutrition].

    Science.gov (United States)

    Goto, Hidekazu; Tomita, Takashi; Doki, Shotaro; Nakanishi, Rie; Kojima, Chikako; Yoneshima, Mihoko; Yoshida, Tadashi; Tanaka, Katsuya; Kohda, Yukinao

    2015-01-01

    We report a patient with elevated serum lithium concentration caused by switching from parenteral nutrition alone to parenteral with enteral nutrition. A 73-year-old female inpatient was treated with lithium carbonate 600 mg/d for manic episodes of bipolar disorder. Her serum lithium level was maintained at 0.57-0.79 mEq/L. She was administered total parenteral nutrition owing to difficulty in oral intake. Her diet contained 4.8-5.8 g/d of sodium chloride. After this, parenteral with enteral nutrition was initiated. The total sodium chloride intake decreased from 6.3 to 3.0-4.0 g/d following this change. On day 15 after initiation of parenteral with enteral nutrition, her serum lithium level increased to 1.17 mEq/L, which is closer to the upper therapeutic range limit. Therefore enteral nutrition was stopped immediately, and an electrolyte solution was administered instead of enteral nutrition. An antibiotic agent was also simultaneously administered because of infection. The total amount of sodium chloride administered was increased to 7.0 g/d during this treatment. Four days after treatment, the serum lithium level returned to 0.57 mEq/L. This case suggests that administration of appropriate sodium chloride nutrition is important during treatment with lithium carbonate, because disposition of lithium ion is paralleled to that of sodium.

  19. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

    Science.gov (United States)

    Akbulut, Gamze

    2011-07-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

  20. [ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

    Science.gov (United States)

    Escortell Sánchez, Raquel; Reig García-Galbis, Manuel

    2015-10-01

    Objetivo: identificar qué efecto provoca la nutrición enteral en el estado nutricional del cáncer. Método: se realizó una búsqueda con las palabras clave “Cancer” AND “Enteral Nutrition” AND “Supplementation” en cuatro bases de datos documentales: Pubmed, EBSCO, ProQuest y Web of Science. Criterios de inclusión: edad de la muestra, mayores de 18 años; el programa de intervención incluía dieta y empleo o no de suplementación nutricional; ensayos clínicos publicados entre enero de 2004 y diciembre de 2014, en revistas científicas indexadas. Resultados: se han analizado 660 artículos, de los cuales solo han sido incluidos un 2%. El 58% de los programas de intervención son aplicados fuera de España; el 84% de las intervenciones fueron llevadas a cabo en un ambiente hospitalario; el 58% de la muestra está formada por adultos mayores de 54 años; el 33% de las intervenciones fueron multidisciplinares y su duración oscila entre 1 y 4 años. Discusión: se han encontrado pocas intervenciones a nivel nacional y se diferencian en dos tipos: fórmula enteral polimérica exclusiva o mixta junto a inmunonutrición. Conclusión: la nutrición enteral frente a la parenteral y su introducción de forma precoz mejora el estado nutricional del paciente; las fórmulas poliméricas junto a la inmunonutrición ayudan a la reducción del tiempo de hospitalización; los parámetros analíticos se muestran como un patrón de medición a la hora de valorar la mejora en el estado nutricional de los pacientes con cáncer. Se recomienda aumentar la investigación en este campo, sobre todo en niños.

  1. Role of FODMAP content in enteral nutrition-associated diarrhea.

    Science.gov (United States)

    Halmos, Emma P

    2013-12-01

    Gastrointestinal symptoms including diarrhea are common complications of enteral nutrition (EN); however, the cause is unclear. Mode of EN delivery that alters digestion and possibly absorption is suggested to contribute to the high incidence of diarrhea; however, enteral formula is frequently blamed. Most research has focused on fiber-supplemented EN, with a meta-analysis showing that fiber reduces the incidence of diarrhea in non-intensive care unit studies. Other hypotheses include formula osmolality and FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content. FODMAPs are poorly absorbed short-chain carbohydrates that exert an osmotic effect. Dietary FODMAPs have been shown to reduce gastrointestinal symptoms, including diarrhea, in those with irritable bowel syndrome and, given a high-enough dose, will induce a laxative effect in most people. As FODMAPs are commonly added to enteral formula and EN is frequently used as the main source of nutrition, it is reasonable to hypothesize that EN provides more FODMAPs than usual dietary intake and increases risk for developing diarrhea. This hypothesis was assessed through a retrospective study showing that the standard-use enteral formula Isosource 1.5 had a protective effect of developing diarrhea. The only characteristic unique to Isosource 1.5 was the lower FODMAP content as determined through methodologies previously validated for food analysis. Methodologies for application to enteral formulas are currently undergoing formal validation. Once confirmed for application in enteral formula, future directions include FODMAP analysis of specific ingredients to increase understanding of potential problems associated with enteral formula and a randomized, controlled trial investigating the role of formula FODMAP content.

  2. Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Maria Gabriella Gentile

    2012-09-01

    Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  3. [Home enteral nutrition. Annual report 1999. NADYA-SENPE Group].

    Science.gov (United States)

    Gómez Candela, C; Cos Blanco, A I; Iglesias Rosado, C; Planas Vilá, M; Castellá, M; García Luna, P P; Parejo, J; Chamorro Quirós, J; Irles Rocamora, J A; Pérez de la Cruz, A; Carbonell, M D; Parés Marimón, R M; Gómez Enterría, P; Salas, J; Mancha, A; Ferrón Vidán, F; Celador Almaraz, A; Bobis, M A; Martín Peña, G; Martí Bonmatí, E; Morejón, E; Jiménez Sanz, M; Martínez, I; Muñoz, A; de la Rubia Nieto, A; Ordóñez González, J; Tusón Rovira, C; Carrera Macazaga, J A

    2002-01-01

    During 1999, as in previous years, the NADYA-SENPE Group has maintained an annual register of patients with Artificial Nutrition at Home in order to keep up to date our available knowledge of this therapy. The present paper analyzes the results of the sixth National Register of patients under treatment with Enteral Nutrition at Home corresponding to 1999, produced with the co-operation of twenty-three centres in the Spanish national health network. The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication that led to the prescription of nutrition, nutritional treatment, access path, complications and admissions to hospital, follow-up of the treatment, patients' quality of life and progress. All of the data are processed by the co-ordinating team. The Nutrition Unit at La Paz Teaching Hospital in Madrid has acted as the group co-ordinator. During 1999, a total of 2,262 patients at the twenty-three collaborating centres followed treatment with Home Enteral Nutrition (NED in its Spanish acronym). The mean age was 63.6 (19.67 years (males: 57.6%; females: 42.3%). The mean time with nutritional treatment is 5.89 (4.25 months. The neurological alterations (37.5%) and neoplasias (36.8%) were the most frequent indications for NED. Most patients used oral administration (50.7%), the use of artificial routes is less frequent, with 5NG being used on 27.9% and PEG on 12.7%. The polymeric formulas are the ones most commonly used (87.7%). The number of complications recorded amounted to 1,403 episodes, representing 0.62 complications per patient per year, of which 40.8% were gastro-intestinal (0.26 complications per patient per year) and 18.7% were mechanical complications, with only 9 recorded cases of bronchoaspiration. It was necessary to admit patients to hospital on 836 occasions (0.38 admissions per patient), albeit generally for causes not associated with

  4. The Effect of Continuous Enteral Nutrition on Nutrition Indices, Compared to the Intermittent and Combination Enteral Nutrition in Traumatic Brain Injury Patients

    Science.gov (United States)

    Mazaherpur, Sakine; Abdi, Alireza; Pasdar, Yahia; Najafi, Farid

    2016-01-01

    Introduction Nutrition support is one of the most common care, which is undertaken for patients who suffered from Traumatic Brain Injury (TBI) and are admitted in intensive care units. Literature indicates some controversies regarding the appropriate method of nutrition support in these patients. Aim This study was conducted for determining the effect of continuous enteral nutrition on nutrition indices, compared to the intermittent enteral and combination nutrition in TBI patients. Materials and Methods In a randomized clinical trial, 60 TBI patients who were admitted to critical care units of Taleghani Hospital of Kermanshah-Iran in 2010 recruited to the study. The samples were allocated to three groups of continuous enteral nutrition, intermittent enteral nutrition and combination nutrition supports by random sampling. The tool was a researcher-made checklist. The three methods of nutrition support were performed to the participants, then nutrition indices of patients were measured before and during three weeks. Data were analysed using SPSS software, descriptive, and inferential statistics. Results The mean of received energy in the combination group (53.1± 18.3%) was higher than continuous (38.5±19.7%) and intermittent (32.2±14.7%) groups, significantly (p<0.001). The received protein was also greater in combination method (67.7±16.9%) than continuous (31.8±15.1%) and intermittent groups (17.2±10.1%), (p=0.001). The mean of nitrogen balance was improved in continuous method from -4.7± -1.6 to 7.2±5.2, (p<0.001) significantly. Conclusion In this study, received energy of patients was not enough by three methods. However, the continuous method, having a positive effect on nitrogen balance, reducing hypercatabolism and maintaining the total body protein, was preferred to brain injury patients compared with intermittent enteral and parenteral methods that demand more studies. PMID:27891355

  5. Competency-Based Performance Appraisals: Improving Performance Evaluations of School Nutrition Managers and Assistants/Technicians

    Science.gov (United States)

    Cross, Evelina W.; Asperin, Amelia Estepa; Nettles, Mary Frances

    2009-01-01

    Purpose: The purpose of the research was to develop a competency-based performance appraisal resource for evaluating school nutrition (SN) managers and assistants/technicians. Methods: A two-phased process was used to develop the competency-based performance appraisal resource for SN managers and assistants/technicians. In Phase I, draft…

  6. Enteral nutrition in person with Dementia: Indication, effects and benefits

    Directory of Open Access Journals (Sweden)

    Daniela Alves

    2016-04-01

    Full Text Available Objective: This systematic literature review aims to clarify indications for the use of enteral feeding in patients with dementia. Difficulties in feeding patients with dementia may arise at any stage of the disease and may include malnutrition, weight loss, decreased quality of life, among others. Enteral tube feeding by tube may be a way of mitigating the effects, but its benefits are under discussion. Methods: Eight qualitative studies were included: 5 primary sources, 3 systematic literature reviews, published in the 2008-2013 period. Results: Enteral tube feeding in patients with dementia may affect survival/mortality rate (no evidence of benefit, nutritional status (no improvement, functional status and cognitive development (no improvement, aspiration (does not reduce the risk of aspiration, pressure ulcers (no evidence of benefit in ulcers incidence and progression, and quality of life (without hard data in most studies. Conclusion: Evidence on benefits of enteral tube feeding in patients with dementia was not conclusive and may even have the opposite effect. We lack data on the adverse effects of these interventions. Keywords: Palliative care; Dementia; Enteral feeding; Therapeutic use.

  7. Development of clinical application for a nutritional prescription support system for total parenteral/enteral nutrition.

    Science.gov (United States)

    Masuda, Syuzo; Oka, Ryusho; Uwai, Koji; Matsuda, Yumi; Shiraishi, Tadashi; Nakagawa, Yoshito; Shoji, Tohru; Mihara, Chie; Takeshita, Mitsuhiro; Ozawa, Koichiro

    2009-09-01

    One of the important roles of pharmacists as members of a nutrition support team is nutritional prescription support. We developed a nutritional prescription support system (NPSS) that facilitates prescription support and analysis and evaluated its usefulness in nutritional therapy. An NPSS for prescription support and the management of patient information was created. With this NPSS, the nutritional status was assessed, and, on the basis of the results, such variables as the total energy expenditure were calculated. This system allows prescription support for parenteral nutrition (PN) therapy, enteral nutrition (EN) therapy, and the transition period between them. This system was used for 2 representative patients and evaluated. In a malnourished patient receiving oral warfarin, EN solutions were compared by means of the NPSS, and an appropriate EN solution was selected. In addition, the prothrombin time-international normalized ratio was monitored, and favorable results were obtained regarding the adjustment of the warfarin dose and nutritional management. In a patient with aspiration pneumonia, continuous nutritional management to EN from PN therapy was straightforwardly performed with the NPSS. This NPSS allows rapid, comprehensive nutritional management during the transition period to EN from PN therapy, despite these therapies being considered separately in conventional nutritional management. The NPSS is useful for simplifying prescription support and facilitating information sharing among members of a nutrition support team.

  8. Innovative Parenteral and Enteral Nutrition Therapy for Intestinal Failure

    Science.gov (United States)

    Le, Hau D.; Fallon, Erica M.; de Meijer, Vincent E.; Malkan, Alpin D.; Puder, Mark; Gura, Kathleen M.

    2010-01-01

    Children with intestinal failure suffer from insufficient intestinal length or function, making them dependent on parenteral nutrition (PN) for growth and survival. PN and its components are associated with many complications ranging from simple electrolyte abnormalities to life-threatening PN-associated liver disease, which is also called intestinal failure-associated liver disease (ILALD). From a nutrition perspective, the ultimate goal is to provide adequate caloric requirements and make the transition from PN to full enteral Nutrition (EN) successful. Upon review of the literature, we have summarized the most effective and innovative PN and EN therapies for this patient population. Antibiotic-coated catheters and antibiotic or ethanol locks can be implemented, as they appear effective in reducing catheter-related infection and thus further reduce the risk of IFALD. Lipid emulsions should be given judiciously. The use of an omega-3 fatty acid-based formulation should be considered in patients who develop IFALD. Trophic feeding is important for intestinal adaptation, and EN should be initiated early to help wean patients from PN. Long term management of children with IF continues to be an emerging field. We have entered uncharted territory as more children survive complications of IF, including IFALD. Careful monitoring and individualized management to ensure maintenance of growth with avoidance of complications are the keys to successful patient outcomes. PMID:20123271

  9. Enteral nutrition for feeding severely underfed patients with anorexia nervosa.

    Science.gov (United States)

    Gentile, Maria Gabriella

    2012-09-01

    Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water) and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium). In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1) to avoid "refeeding syndrome" caused by a too fast correction of malnutrition; (2) to avoid "underfeeding" caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI) of 11.2 ± 0.7 kg/m(2). The mean BMI increased from 11.2 ± 0.7 kg/m(2) to 17.3 ± 1.6 kg/m(2) and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  10. Enteral refeeding syndrome after long-term total parenteral nutrition

    Institute of Scientific and Technical Information of China (English)

    REN Jian-an; MAO Yao; WANG Ge-fei; WANG Xing-bo; FAN Chao-gang; WANG Zhi-ming; LI Jie-shou

    2006-01-01

    Background Early enteral feeding (EF) may result in fever, elevated white blood cell count, increased serum levels of liver enzymes, and diarrhea. We name the complications "enteral refeeding syndrome", as a subtype of refeeding syndrome, because they are likely to result from long-term lack of lumen nutrition. The aim of this study was to investigate the characteristics of enteral refeeding syndrome after long-term total parenteral nutrition(TPN), and the solution for the disease.Methods We collected the clinical data of 100 patients with gastrointestinal fistula, who were cured from Apirl2001 to July 2002. Their fasting time, daily stool frequency, body temperature, heart rate, respiratory rate, levels of transaminases, alkaline phosphatase (AKP), and γ-glutamylcyclotransferase (γ-GT), white blood cell count,and systemic inflammatory reaction syndrome (SIRS) score were recorded before and 1, 3, 5, 10, and 15 days after EF. Student's t test and analysis of variance were used to analyze the data.Results Of the 100 patients, 56 were cured after selective resection of intestinal fistula, 15 were cured by emergency operation, and 29 recovered spontaneously. The levels of AKP and γ-GT increased significantly on the 3rd day after EF [On the 3rd day after EF, (243.0± 121.6) U/L and (177.2± 109.9) U/L vs. before EF (181.5± 127.5) U/L and (118.4±94.2) U/L, P<0.05], and decreased gradually afterwards. The SIRS scores on the 1st day (1.05±1.08) and 3rd day (0.96± 1.11) after EF were significantly higher than that before EF (0.72±0.84),then decreased to 0.83±0.91, 0.49±0.73 and 0.32±0.60 on the 5th, 10th and 15th days after EF. The number of patients with diarrhea at 1, 3, 5, 10 and 15 days post-EF were 31, 26, 12, 13, and 7, respectively.Conclusions The longer the TPN lasts, the more severe the enteral refeeding syndrome becomes. Continuous EF is effective for the syndrome. Early enteral nutrition is useful in preventing it.

  11. Enteral nutrition: past and future Nutrición enteral: pasado y futuro

    Directory of Open Access Journals (Sweden)

    S. Bengmark

    2004-03-01

    Full Text Available Perioperative nutrition has during the last century been transformed from a tool to provide calorie and nitrogen support to a tool to boost the immune system and increase resistance to complications. Despite all progress in medicine and surgery has perioperative morbidity, rate of infections, thrombosis and development of serosal adhesions remained the same as long as can be judged or at least during the last eighty years. Most prone to develop complications are persons above the age of 65 and persons with depressed immunity. About cighty percent of the immune system is localised in the gastrointestinal tract, which offers great opportunities for modulation through enterar nutrition. As the stomach has a tendency to develop postoperative paralysis, tube feeding is often necessary. Andresen demonstrated already in 1918 the advantages of enteral nutrition, which starts already on the table. Mulholland et al and Rhoads and co-workers demonstrated during the 1940s certain advantages of enteral tube feeding. Also works by Alexander, Fischer, Ryan and their co-workers supported the value of early enteral feeding, and suggested enteral feeding as an effective tool to boost the immune system. it was, however, works published in the early nineties by Moore et al and by Kudsk et al, which made surgeons more aware of the advantages of early enteral nutrition. Major surgery is known to have a high rate of complications. Uninterrupted perioperative nutrition, eg nutrition during the night before, during surgery and immediately after offers a strong tool to prevent complications. lt is essential that the nutrition provides food also for the colon, e.g. fibres and healthy bacteria (probiotics to ferment the fibre and boost the immune system.Durante el último siglo la nutrición perioperatoria ha pasado de ser un mero instrumento para proporcionar calorías y soporte nitrogenado a una herramienta reforzadora del sistema inmunológico aumentando la resistencia

  12. The impact of microbial immune enteral nutrition on the patients with acute radiation enteritis in bowel function and immune status.

    Science.gov (United States)

    Shao, Feng; Xin, Fu-Ze; Yang, Cheng-Gang; Yang, Dao-Gui; Mi, Yue-Tang; Yu, Jun-Xiu; Li, Guo-Yong

    2014-06-01

    The aim of the study was to investigate the effect of microbial immune enteral nutrition by microecopharmaceutics and deep sea fish oil and glutamine and Peptisorb on the patients with acute radiation enteritis in bowel function and immune status. From June 2010 to January 2013, 46 acute radiation enteritis patients in Liaocheng People's Hospital were randomized into the microbial immune enteral nutrition group and the control group: 24 patients in treatment group and 22 patients in control group. The immune microbial nutrition was given to the study group, but not to the control group. The concentration of serum albumin and prealbumin and the number of CD3 (+) T cell, CD4 (+) T cell, CD8 (+) T cell, CD4 (+)/CD8 (+) and natural killer cell of the two groups were detected on the 1, 7 and 14 days after treatment. The arm muscle circumference and triceps skinfold thickness (TSF) were recorded, and the tolerance of the two groups for enteral nutrition and intestinal symptoms was collected and then comparing the two indicators and get results. The tolerance of microbial immune enteral nutrition group about abdominal pain, bloating and diarrhea was better than the control group (P values were 0.018, 0.04 and 0.008 after 7 days; P values were 0.018, 0.015 and 0.002 after 14 days); and the cellular immune parameters were better than the control group((△) P = 0.008,([Symbol: see text]) P = 0.039, (☆) P = 0.032); No difference was found in nutrition indicators. To the patients with acute radiation enteritis, microbial immune enteral nutrition could improve the patient's immune status, and the tolerance of enteral nutrition could be better for the bowel function and the patients' rehabilitation.

  13. Development and Evaluation of a Home Enteral Nutrition Team

    Directory of Open Access Journals (Sweden)

    Sarah Dinenage

    2015-03-01

    Full Text Available The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1 prevention of hospital admission and related transport for ETF related issues; (2 effective management and reduction of waste of feed and thickener; (3 balloon gastrostomy tube replacement by the HEN Team in the patient’s home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

  14. Development and evaluation of a home enteral nutrition team.

    Science.gov (United States)

    Dinenage, Sarah; Gower, Morwenna; Van Wyk, Joanna; Blamey, Anne; Ashbolt, Karen; Sutcliffe, Michelle; Green, Sue M

    2015-03-05

    The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

  15. Effectiveness of enteral and parenteral nutrition in the nutritional management of children with Wilms' tumors.

    Science.gov (United States)

    Rickard, K A; Kirksey, A; Baehner, R L; Grosfeld, J L; Provisor, A; Weetman, R M; Boxer, L A; Ballantine, T V

    1980-12-01

    The effectiveness of enteral and parenteral feeding in supporting a satisfactory nutrition status and/or reversing protein-energy malnutrition was evaluated in nine children, ages 1 to 7 years (eight female), with Wilms' tumors. At the onset of treatment, eight patients received comprehensive enteral nutrition (CEN) which included intense nutritional counseling and oral supplements while one received total parenteral nutrition (TPN). Despite CEN, the initial, intense treatment period was associated with a decreased energy intake (64 +/- 27% Recommended Dietary Allowances), dramatic weight loss (22 +/- 7% by 26 +/- 17 days from the beginning of treatment), decreased skinfold thickness (total lymphocyte count were 3.02 +/- 0.45 g/dl, 155 +/- 40 mg/dl, and, 655 +/- 437/mm3, respectively; all children had abnormal anthropometric measurements and anergy to recall skin test antigens. TPN for 28 or more days supported weight gain (+ 2.44 kg), increased serum albumin (+ 0.58 +/- 0.47 g/dl) and transferrin (+ 76 +/- 34 mg/dl), and reversed anergy despite low total lymphocyte counts. During maintenance treatment, nutritional status was maintained or restored with CEN in the group who responded. These preliminary data document the severity of protein-energy malnutrition which accompanies initial, intense treatment of children with Wilms' tumors, the nutritional and immunological benefits of TPN during continuing intense treatment and the effectiveness of CEN in maintaining a satisfactory nutritional status during maintenance treatment.

  16. Enteral Nutrition for Older Adults in Healthcare Communities.

    Science.gov (United States)

    Posthauer, Mary Ellen; Dorner, Becky; Friedrich, Elizabeth K

    2014-08-01

    Older adults living in healthcare communities (HCCs) have multiple comorbidities and are at increased risk of malnutrition and unintended weight loss. Aging affects nearly every system as well as body composition and structure, causing physiological changes that can affect nutrition status. A significant percentage (56%) of residents who live in nursing facilities require extensive help to eat and have dental problems such as ill-fitting dentures, missing teeth, and swallowing problems, which can lead to inadequate caloric intake and unintended weight loss. Alzheimer disease or dementia is prevalent in both nursing facilities and in assisted living/residential care communities, where it affects 45% of older adults. In cognitively impaired residents, most tube feeding placements occur in the acute care setting and result in significant use of additional healthcare resources, along with high postinsertion mortality rates within 60 days of insertion. Nursing facilities receiving Medicare or Medicaid funding must abide by state and federal regulations and undergo rigorous surveys while balancing complex decisions related to initial placement of feeding tubes. Healthcare professionals must recognize the importance of establishing nutrition treatment goals that are resident centered and that respect the unique values and personal decisions of the older adult. Informed choice, resident-centered care decisions, and the review of living wills and/or advance directives are essential in the decision-making process. After enteral nutrition is started, healthcare practitioners must carefully review the physician's orders and administer and monitor the resident's tolerance, checking for potential complications.

  17. [Home enteral nutrition in Spain: NADYA registry in 2010].

    Science.gov (United States)

    Frías, L; Puiggròs, C; Calañas, A; Cuerda, C; García-Luna, P P; Camarero, E; Rabassa-Soler, A; Irles, J A; Martínez-Olmos, M A; Romero, A; Wanden-Berghe, C; Laborda, L; Vidal, A; Gómez-Candela, C; Penacho, M A; Pérez de la Cruz, A; Lecha, M; Luengo, L M; Suárez, P; de Luis, D; García, Y; Parés, R M; Garde, C

    2012-01-01

    To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2010. We retrieved the data of the patients recorded from January 1st to December 31st 2010. We registered 6,591 patients (51% males) with 6,688 episodes of HEN, from 32 hospitals. Mean age in those younger than 14 yr (4%) was 1 ± 2 yrs (m ± SD) and 69,9 ± 17,8 yrs in those older than 14 yr. The length of HEN was longer than 2 yrs in 76% of the patients. The most frequent underlying disease was neurological disorders 42%, followed by cancer 28% (mostly head and neck cancer 18%). We had information related to the enteral access route in only 626 cases (9,4%), 51% of them used nasogastric tubes, 27% gastrostomies, 10% oral route and 3% jejunostomies. Only 251 episodes were closed during the year, mostly due to patient death 57% and progress to oral diet 14%. The activity level was limited in 29% of the patients and 39% of them were bed- or chairridden. Total or partial help was needed by 68% of the patients. The hospitals and the private pharmacies delivered the enteral formula in 63% and 34% of the cases, respectively. The hospitals and the primary care centres delivered the disposables in 83% and 16% of the cases, respectively. The results of the 2010 HEN registry are similar to those published in previous years regarding the number and characteristics of the patients. We continue finding problems in the entrance of data referred to the enteral access route and the closing of the episodes.

  18. [Enteral nutrition at home: National register for the year 2000].

    Science.gov (United States)

    Planas, M; Castellá, M; García Luna, P P; Chamorro, J; Gómez Candela, C; Carbonell, M D; Irles, J A; Jiménez, M; Morejón, E; Pérez de la Cruz, A; Bobis, M A; Rodríguez Pozo, A; Adrio, G; Salas, J; Calañas, A J; Gómez Enterría, P; Mancha, A; Martí Bonmatí, E; Martínez, I; Celador, A; Camarero, E; Tusón, C; Carrera, J A

    2003-01-01

    Once again, the NADYA-SENPE Working Group analysed the registered data of Home Enteral Nutrition (HEN) in our country, during the year 2000. The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient's quality of life and progress. All data were processed and analysed by the co-ordinating team. Twenty two hospital participated and 2,986 patients, aged 65.1 +/- 19.7 years, were enrolled. Of these patients, 41.2% were diagnosed with neurological diseases and 33.3% with cancer. The mean time on HEN was 6.3 +/- 4.4 months. Oral nutrition was the preferential route (50.8%), followed by nasoenteral tube (30.5%), and in 17.4% ostomy tubes were placed. Polymeric was the formula composition mainly used (83.2%). Patients were followed (70.1%) by the hospital reference Nutritional Support Unit. The complications related to nutrition included the gastrointestinal (0.25 complications/patient), the mechanical one (0.19 complications/patient), and the metabolic (0.007 complications/patient). Feeding tube need to be replaced 0.3 times/patient/year. The readmission rate, for nutritional problems, was observed in 0.03 patients. At the end of the year, 54.9% of the patients were in the HEN program, and in 30.3% HEN was finish due to different reasons. In 21.9% of the patients no, o light, discapacity degree was found. Related to previous years, there is an increment in the number of enrolled patients. Neurological diseases and cancer were the more frequent diagnoses in HEN patients. Oral access was the higher feeding route due, probably, to the high prevalence of cancer patients. In spite of the elevated prevalence of neurological diseases, a few number of patients were feed with ostomy

  19. The role of nutritional assessment and early enteral nutrition for combined pancreas and kidney transplant candidates.

    Science.gov (United States)

    Finlay, Sally; Asderakis, Argiris; Ilham, Adel; Elker, Doruk; Chapman, Dawn; Ablorsu, Elijah

    2017-02-01

    Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor. Therefore, we introduced EEN in our patients. We monitored and recorded nutritional data on 29 PKT recipients who underwent transplantation between Oct 2007 and Jan 2010 without a nutritional assessment or EEN [Monitored Group (MG)] and on 30 PKT recipients between Feb 2010 and Dec 2013 who received a nutritional assessment and EEN (Naso-jejunal feed or oral intake with supplementation, according to their nutritional status) [Fed Group (FG)]. The end-point was to assess patients' daily post-transplant nutritional intake. This was calculated as a percentage of estimated nutritional requirements using the Schofield equation with a 25% added stress factor and relevant activity factor. Following a literature search and realistic targets our aim was to reach >60% requirements: achievement of ≥60% energy requirements by day-7 (7d-60%) and at the time of discharge (total-60%) [13,14]. There was no significant difference between MG and FG patients in cold ischemic time (CIT), recipient-age and donor-age, Length of Stay and donor-creatinine. In contrast, FG patients were less frequently in predialysis status 41.4% vs. 26.7%, p = 0.001; and had higher incidence of BMI Figs. 1 and 2). The FG spent a greater proportion during the first week 66.7% vs. 31%, p = benefit from planned EEN and receive better nutritional support when compared to the patients managed with the historic, reactive approach to nutritional care. Nutritional intake in the first week as well as during the whole admission was superior in patients receiving active EEN despite a more difficult post

  20. ASPEN Safe Practices for Enteral Nutrition Therapy [Formula: see text].

    Science.gov (United States)

    Boullata, Joseph I; Carrera, Amy Long; Harvey, Lillian; Escuro, Arlene A; Hudson, Lauren; Mays, Andrew; McGinnis, Carol; Wessel, Jacqueline J; Bajpai, Sarita; Beebe, Mara Lee; Kinn, Tamara J; Klang, Mark G; Lord, Linda; Martin, Karen; Pompeii-Wolfe, Cecelia; Sullivan, Jackie; Wood, Abby; Malone, Ainsley; Guenter, Peggi

    2017-01-01

    Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

  1. Hospital to home paediatric enteral nutrition--parents need support.

    LENUS (Irish Health Repository)

    Shortall, C

    2015-02-01

    This study assessed the provision of education and support to parents of children on home enteral nutrition (HEN), current dietetic support available and perceived challenges facing parents and carers. From the 39 responses (13%), 29 (83%, n = 35) parents suggested services for HEN need improvement. 29 (74%, n = 39) parents wanted more structured follow up and 22 (56%) would like one person to co-ordinate HEN, education and discharge. 7 parents (18%) reported a need for further education of health care professionals (HCP). Hospital dietitians were the most common HCPs reported to provide support to patients following discharge. Specialist paediatric HEN dietetic services working in a dedicated HEN team, who would provide accurate training and education and liaise with both parents and community care services post discharge should be in place. This would facilitate transfer to community care, reduce hospital re-admissions, outpatient department attendances and costs.

  2. Enteral nutrition as primary therapy in short bowel syndrome.

    Science.gov (United States)

    Booth, I W

    1994-01-01

    The spectacular success of parenteral nutrition in supporting patients during small intestinal adaptation after massive resection, tends to obscure the prolonged periods often needed for such adaptation to take place. After neonatal small intestinal resection for example, it may take more than five years before adaptation is complete. There is therefore a strong argument for examining ways in which adaptation can be facilitated, in particular, by the addition of novel substrates to enteral feeds. Pectin is completely fermented by colonic bacteria to short chain fatty acids. In the rat, addition of pectin to enteral feeds led to a more rapid adaptive response in both the small and large intestine after massive small intestinal resection, although faecal nitrogen losses were increased. In a similar rat model, the provision of 40% of non-protein energy as short chain triglycerides facilitated the adaptive response in the jejunum, colon, and pancreas. The importance of glutamine as a metabolic substrate for the small intestine makes it another potential candidate and some, but not all animal studies, have suggested a therapeutic effect: increasing the glutamine content of feeds to 25% of total amino acids produced enhanced jejunal and ileal hyperplasia, even on a hypocaloric feed, and an improved overall weight gain. Studies in humans are very limited, but such promising results in the experimental animal suggest that this is probably a fruitful area for further study.

  3. [Decrease of the incidence of sepsis syndrome after early enteral nutrition of patients with severe burns].

    Science.gov (United States)

    Pereira, J L; Gómez-Cia, T; Garrido, M; Parejo, J; Jódar, E; Serrano, P; Romero, H; Fraile, J; Franco, A; García-Luna, P P

    1996-01-01

    The objective of this study was to evaluate the effect of early enteral nutrition on the incidence of the septic syndrome as well as its tolerance, in patients with severe burns. We retrospectively studied 64 patients older than 15 years of age, with a greater than 20% burned body surface area. They were divided into 2 groups as a function of the time elapsed between the beginning of Enteral Nutrition and the time of the burning: 23 patients were given Enteral Nutrition within 24 hours after the burn, and in 41 patients the enteral nutrition was started later than 24 hours after sustaining the thermal injury. Both groups were similar with respect to age, sex, percentage of 2nd and 3rd degree burns, incidence of inhalation, and deaths. All patients received the Enteral Nutrition through a nasogastric tube, with administration of a polymeric, hyperprotein and hypocaloric formula through a continuous infusion pump. In our study we saw a reduction of the incidence of the septic syndrome in the patients who received early enteral Nutrition (26%; 6 patients of a total of 23), with respect to those who did non receive early Enteral Nutrition (54%; 22 patients of a total of 41), with a statistical significance of p > 0.05. There were no differences between both groups with respect to the digestive tolerance to Enteral Nutrition. From our study we can deduce that early Enteral Nutrition reduces the incidence of septic complications, without this increasing the digestive intolerance to the same.

  4. Enteral nutrition in patients with dementia and stroke.

    Science.gov (United States)

    Freeman, Cecilia; Ricevuto, Ashleigh; DeLegge, Mark H

    2010-03-01

    Patients suffering from dementia or significant cognitive impairment (SCI) due to neurologic injury routinely receive percutaneous endoscopic gastrostomy (PEG) due to swallowing difficulty or lack of appetite. This review discusses current data and opinion regarding the risks and benefits of PEG in these populations. The current data regarding PEG placement in patients with dementia or SCI due to neurologic injury do not confirm either improvement or worsening of survival. Significant risk factors for poor prognosis after PEG include sex, hypoalbuminemia, age, chronic heart failure, and subtotal gastrectomy. Complications associated with enteral nutrition are minor and easily controlled when managed by a nutritional team. Alternative options for feeding elderly demented patients are available for family members considering PEG. In contrast to previously published data regarding worse clinical outcomes in the dementia and SCI populations receiving PEG, recent data suggest that clinical outcomes in this population are no different than in other patient populations receiving PEG. A prospective, randomized study is needed to ascertain whether PEG is appropriate and beneficial in the dementia/SCI populations.

  5. Management of Hyperglycemia and Enteral Nutrition in the Hospitalized Patient.

    Science.gov (United States)

    Davidson, Patricia; Kwiatkowski, Cynthia Ann; Wien, Michelle

    2015-10-01

    There has been increased attention on the importance of identifying and distinguishing the differences between stress-induced hyperglycemia (SH), newly diagnosed hyperglycemia (NDH), and hyperglycemia in persons with established diabetes mellitus (DM). Inpatient blood glucose control is now being recognized as not only a cost issue for hospitals but also a concern for patient safety and care. The reasons for the increased incidence of hyperglycemia in hospitalized patients include preexisting DM, undiagnosed DM or prediabetes, SH, and medication-induced hyperglycemia with resulting transient blood glucose variability. It is clear that identifying and documenting hyperglycemia in hospitalized patients with and without a previous diagnosis of DM and initiating prompt insulin treatment are important. Agreement on the optimum treatment goals for hyperglycemia remains quite controversial, and the benefits of intensive glucose management may be lost at the cost of hypoglycemia in intensive care unit patients. Nutrition support in the form of enteral nutrition (EN) increases the risk of hyperglycemia in both critical and non-critically ill hospitalized patients. Reasons for beginning a tube feeding are the same whether a person has NDH or DM. What differs is how to incorporate EN into the established insulin management protocols. The risk for hyperglycemia with the addition of EN is even higher in those without a previous diagnosis of DM. This review discusses the incidence of hyperglycemia, the pathogenesis of hyperglycemia, factors contributing to hyperglycemia in the hospitalized patient, glycemic management goals, current glycemic management recommendations, and considerations for EN formula selection, administration, and treatment.

  6. Unplanned Alternatives For Enteral Nutrition In Postsurgical Patients: Three Individual Cases

    OpenAIRE

    Yürüker, S. Savaş; Topgül, Koray; Anadol, A Ziya

    2006-01-01

    Aim: Enteral nutrition in surgical patients is not only physiological but also cheap. On the contrary, parenteral nutrition is more expensive and has several complications. In this report, we present three different cases in which we had to administer long term parenteral nutrition but somehow could be managed by unique applications of enteral nutrition. Patients and Methods: Three patients (one with pancreas cancer, one with gunshot wound and one with mesenteric vascular disease) were ad...

  7. Nutritional analysis of blenderized enteral diets in the Philippines.

    Science.gov (United States)

    Sullivan, Mary M; Sorreda-Esguerra, Pearl; Platon, Maria Bernadette; Castro, Cynthia G; Chou, Nancy R; Shott, Susan; Comer, Gail M; Alarcon, Pedro

    2004-01-01

    The objective of this study was to analyze the nutritional quality and viscosity of blenderized enteral tube feedings (BTFs) from four hospitals in the Philippines. Samples of two different BTFs (one standard and one modified) were collected from each hospital on three separate occasions and analyzed for macronutrients, micronutrients, and viscosity. There was considerable variation among the BTFs for the concentrations of most nutrients measured. For standard BTF samples, the caloric density ranged from 66-123 kcal/100g and the percentages of total weight for protein, carbohydrate, and fat ranged from 1.5-4.0%, 8.6-21.4%, and 0.27-3.40%, respectively. Levels of specific vitamins were undetectable in 10 standard and 15 modified BTF samples. In samples where vitamin levels were detectable, results were: vitamin A, 625-8850 IU/kg; riboflavin, 0.40-5.00 mg/kg; and pyridoxine, 0.14-3.00 mg/kg. Mineral concentrations also varied greatly (eg calcium, 64-524 mg/kg; sodium, 148-886 mg/kg; iron, 3.0-13.7 mg/kg; and zinc, 1.8- 11.5 mg/kg). Correlation coefficients were statistically significant only for carbohydrate (r = 0.48, P = 0.017). Measured values tended to be lower than expected values for all nutrients, although the difference was statistically significant only for calories (P = 0.023). The viscosity of BTF samples ranged from 2.3-45,060 centipoise, excluding three samples that were too viscous for analysis. This study demonstrates that hospital prepared blenderized enteral tube feedings render unpredictable levels of micronutrients and macronutrients and appear likely to deliver less than the desired amounts of nutrients. Additionally, the viscosity of these feedings may be unsuitable for infusion through feeding tubes.

  8. [Proposed profile of omega 3 fatty acids in enteral nutrition].

    Science.gov (United States)

    Sanz París, A; Marí Sanchis, A; García Malpartida, K; García Gómez, M C

    2012-01-01

    We review the international recommendations on oral intake of n-3 fatty acids and their content in the enteral nutrition formulas. Their metabolic actions depend on their metabolization to EPA and DHA. The activity of desaturases catalyzing this process increases with exercise, insulin, estrogens in the fertile women, and peroxisomal proliferators, whereas it decreases with fasting, protein and oligoelements deficiencies, age < 30 years, sedentary lifestyle, cigarette smoking, alcohol, cholesterol, trans and saturated fatty acids, insulin deficiency, and stress hormones (adrenalin and glucocorticoids). Most of the guidelines recommend that 20-35% of the total energy comes from fat, being 7-10% saturated fats, 6-10% polyunsaturated, and 20% monounsaturated, in Spain. The recommendation for n-3 FA is 0.5-2 g/day or 0.5-2% of total caloric intake, with an upper limit of 3 g/day. For n-6 FA, 2.5-10% of total caloric intake, the n-6/n-3 ratio not being well established although most of the guidelines recommend 5:1. The EPA and DHA content should be at least 500 mg per day. Finally, the EPA/DHA ratio is 2:1 in most of them. Standard nutrition formulas present an appropriate fat content, although most of the products containing EPA and DHA exceed the limit of 3 g/day. Among the products with hyperprotein and/or concentrated, only of them contains EPA y DHA. Not all the formulas used for the frail elderly contain EPA or DHA, and in those containing them their concentration may be excessive and with a proportion very dissimilar to that of fish oil.

  9. Home enteral nutrition in Spain: NADYA registry 2011-2012

    Directory of Open Access Journals (Sweden)

    Carmina Wanden-Berghe

    2014-06-01

    Full Text Available Objective: To describe the results of the home enteral nutrition (HEN registry of the NADYA-SENPE group in 2011 and 2012. Material and methods: We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012. Results: There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 ± 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%. Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemist's office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1% during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake. Conclusions: Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route.

  10. Cytokine responses in very low birth weight infants receiving glutamine-enriched enteral nutrition

    NARCIS (Netherlands)

    A. van den Berg; R.M. van Elburg; L. Vermeij; A. van Zwol; G.R. van den Brink; J.W.R. Twisk; E.E.S. Nieuwenhuis; W.P.F. Fetter

    2009-01-01

    Objective: Very low birth weight (VLBW) infants receiving glutamine-enriched enteral nutrition may present with a lower infection rate, which may result from enhanced antimicrobial innate or Th1 cytokine responses. We investigated whether glutamine-enriched enteral nutrition in VLBW infants increase

  11. [Enteral nutrition in patients with ileostomies and jejunostomies].

    Science.gov (United States)

    Zarković, M; Milićević, M

    1995-01-01

    Jejuno- and ileostomy are common surgical procedures. Due to shortening of effective bowel length intestinal failure, or short bowel syndrome develops. Degree of intestinal failure depends upon 1. resection length, 2. resection location, 3. function of the bowel remnant, stomach, pancreas and liver, 4. adaptive capabilities of the bowel remnant and 5. the disease that was cause of the surgery. In majority of these patients adequate nutrition can be achieved using enteral nutrition. Water and mineral absorption differs between jejunum and ileum. Jejunal mucosa is permeable to sodium and water, causing jejunal content to be isoosmolar to plasma. When sodium concentration in jejunal content is less than 90 mmol/l secretion of sodium into the lumen occurs. Ileal sodium absorption takes place against concentration gradient. Potassium concentration of jejuno- and ileostomy effluent is fairly constant at about 15 mmol/l. Main therapeutic problem is water and mineral loss. In jejunostomy patients hyponatremia is a major concern. Urinary sodium concentration of less than 5 mmol/l is a sign of sodium deficiency. This group of patients should have daily urinary output of more than 800 ml, and urinary sodium concentration of more than 20 mmol/l. Another important problem is malnutrition. Weight changes, albumin and trasferin are important follow-up parameters. Often neglected problem is large stomal effluent volume, that can incapacitate patient for the usual life. All these problems can be prevented by the adequate nutritional support. Oral' fluids should have minimal sodium concentration of 90 mmol/l. Intake of sodium poor fluids should be restricted. If plasma or urinary sodium are low intravenous sodium supplementation is warranted. Magnesium and zinc should be monitored and supplemented. Addition of vitamin D can improve their absorption. Vitamins B12 and K must be given parenteral, because their resorption is severely impaired. Patient should eat usual food rich in

  12. Investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy

    Institute of Scientific and Technical Information of China (English)

    Shiro Yokohama; Masaru Aoshima; Yukiomi Nakade; Junya Shindo; Junichi Maruyama; Masashi Yoneda

    2009-01-01

    AIM: To investigate and predict enteral nutrition problems after percutaneous endoscopic gastrostomy (PEG).METHODS: We retrospectively analyzed data for 252 out of 285 patients who underwent PEG at our hospital from 1999 to 2008. Enteral nutrition problems after PEG were defined as: (1) patients who required ≥ 1 mo after surgery to switch to complete enteral nutrition, or who required additional parenteral alimentation continuously; or (2) patients who abandoned switching to enteral nutrition using the gastrostoma and employed other nutritional methods.We attempted to identify the predictors of problem cases by using a logistic regression analysis that examined the patients' backgrounds and the specific causes that led to their problems.RESULTS: Mean age of the patients was 75 years, and in general, their body weight was low and their overall condition was markedly poor. Blood testing revealed that patients tended to be anemic and malnourished. A total of 44 patients (17.5%) were diagnosed as having enteral nutrition problems after PEG. Major causes of the problems included pneumonia, acute enterocolitis (often Clostridium difficile-related), paralytic ileus and biliary tract infection. A multivariate analysis identified the following independent predictors for problem cases: (1) enteral nutrition before gastrectomy (a risk reduction factor); (2) presence of esophageal hiatal hernia; (3) past history of paralytic ileus; and (4) presence of chronic renal dysfunction.CONCLUSION: Enteral nutrition problems after PEG occurred at a comparatively high rate. Patient background analysis elucidated four predictive factors for the problem cases.

  13. Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

    Institute of Scientific and Technical Information of China (English)

    LIN Fa-liang; CHI Nan; LI Wei; XIE Lin; WANG Xue-xin

    2015-01-01

    Objective:To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI), and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN), delayed enteral nutrition (DEN), and parenteral nutrition (PN), respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow comascale (GCS) scores of 3 groups were higher than treatment before (P Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

  14. [Usefulness of postoperative support by enteral nutrition of patients with epidermoid carcinoma of the larynx].

    Science.gov (United States)

    de Luis, D A; Cabezas, G; Aller, R; Izaola, O

    2000-01-01

    At the present time, artificial nutrition has made great strides and enteral nutrition has become the first choice delivery method. The purpose of our paper is to analyze the usefulness of this type of nutrition in the post-operative care of patients with larynx tumours. A total of 38 patients were studied, with an average age of 63.2 +/- 10.2 years. On average, in the post-operative period until oral nutrition was restored enteral nutrition lasted for 10.6 +/- 4.9 days. A biochemical and anthropometric assessment of the nutritional condition was effected at the time of admission and 7-10 days into the nutritional treatment. During the post-operative period, no anthropometric changes were detected; the analytical variation, however, showed an improvement on the first review of pre-albumen (12.5 +/- 5.1 mg/dl versus 18.7 +/- 7.9 mg/dl; p enteral nutrition was 4,723 +/- 1,600 pesetas per day. Enteral nutrition is effective in the post-operative care of patients with tumour of the larynx, improving their nutritional biochemistry parameters and allowing easy transition to oral nutrition, with presentation of few side effects and all for low cost.

  15. Enteral nutrition practices in the intensive care unit: Understanding of nursing practices and perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2012-01-01

    Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding

  16. Enteritis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001149.htm Enteritis To use the sharing features on this page, please enable JavaScript. Enteritis is inflammation of the small intestine. Causes Enteritis ...

  17. A Meta-Analysis of Enteral Nutrition and Total Parenteral Nutrition in Patients with Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Heming Quan

    2011-01-01

    Full Text Available Objective. To analyze the effect of total parenteral nutrition (TPN and enteral nutrition (EN in patients with acute pancreatitis. Methods. Randomized controlled trials of TPN and EN in patients with acute pancreatitis were searched in NCBI and CBM databases and The Cochrane Controlled Trials Register. Six studies were enrolled into the analysis, and the details about the trial designs, characters of the subjects, results of the studies were reviewed by two independent authors and analyzed by STATA 11.0 software. Results. Compared with TPN, EN was associated with a significantly lower incidence of pancreatic infection complications (RR=0.556, 95% CI 0.436∼0.709, P=.000, MOF (RR=0.395, 95% CI 0.272∼0.573, P=.003, surgical interventions (RR=0.556, 95% CI 0.436∼0.709, P=.000, and mortality (RR=0.426, 95% CI 0.238∼0.764, P=.167. There was no statistic significance in non-pancreatitis-related complications (RR=0.853, 95% CI 0.490∼1.483, P=.017. However, EN had a significantly higher incidence of non-infection-related complications (RR=2.697, 95% CI 1.947∼3.735, P=.994. Conclusion. EN could be the preferred nutrition feeding method in patients with acute pancreatitis.

  18. Impact of enteral nutrition on postoperative immune function and nutritional status.

    Science.gov (United States)

    Wang, F; Hou, M X; Wu, X L; Bao, L D; Dong, P D

    2015-06-10

    We studied the effects of enteral nutrition (EN) support initiated 1 week before surgery on postoperative nutritional status, immune function, and inflammatory response in gastric cancer patients. A total of 200 gastric cancer patients were randomly divided into two groups: EN starting 1 week before surgery (study group) and EN starting early after surgery (control group). The two groups received EN support, following different therapeutic schedules, until the 9th day after operation. In the patients, body weight, skinfold thickness, upper-arm circumference, white blood cell count, albumin, prealbumin, C-reactive protein, peripheral immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets, interleukin-6, and tumor necrosis factor-α were measured 10 days before and after surgery and on the first day after surgery. There was no statistically significant difference in the results of recovery time of passage of gas by anus, abdominal distension, stomachache, blood glucose, hepatic and renal functions, and electrolytes between the two groups of patients (P > 0. 05). Adverse reactions occurred to both groups at 1 and 2 days after operation. Such conditions was improved after the intravenous drip rate was adjusted. The albumin and prealbumin levels of the patients in both groups decreased at 1 day after operation (P gastric cancer patients can improve their postoperative nutritional status and immune function, can reduce inflammatory response, and is more conducive to the recovery of patients.

  19. [Fiber in enteral nutrition: systematic review of the literature].

    Science.gov (United States)

    del Olmo, D; López del Val, T; Martínez de Icaya, P; de Juana, P; Alcázar, V; Koning, A; Vázquez, C

    2004-01-01

    It has been suggested that adding fibre to enteral nutrition (EN) formulas may achieve a normalization of the gastrointestinal tract's functions by reducing the incidence of diarrhoea and constipation. However, this supposition is based on the demonstrated effect of fibre in natural feeding. There have so far been no firm recommendations on the use, amount or type of fibre that is most advisable in EN. To establish the scientific evidence existing on the benefits gained by adding fibre to EN formulas compared with the use of fibre-free formulas. Bibliographical search on PubMed, on the register of Randomized Prospective Trials (RPT) of the Cochrane Library and manual search. RPT comparing fibre-free formulas with isocaloric ad isonitrogen formulas containing fibre in total EN. Four independent reviewers revised the references selected. The data were analyzed using the RevMan 4.1 programme from the Cochrane Library. Of 286 references, 25 fulfilled the inclusion criteria. The data were grouped by population and outcome variable. The addition of fermentable fibre to the EN formulas tends to reduce the incidence of diarrhoea in critically-ill and post-surgery patients (OR = 0.66; 95% CI 0.46-0.95; p = 0.19). The use of formulas with insoluble fibre seems to increase the frequency of depositions and reduce the need for laxatives in immobilized patients receiving long-term EN but the data are insufficient. In people with normal gastrointestinal functions, the frequency of depositions is similar when using formulas with and without fibre (DPM = -0.97; 95% CI -0.12-[-0.02]; p < 0.0001). There is currently insufficient evidence to recommend the systematic use of formulas containing fibre in total EN. However, in critically-ill and post-surgery patients, the use of formulas with fermentable fibre tends to reduce the incidence of diarrhoea. Although information is still lacking. The formulas with insoluble fibre seem to diminish constipation in chronic EN, whereas in other

  20. Nutrición enteral domiciliaria en la Comunidad de Madrid Home enteral nutrition in Madrid

    Directory of Open Access Journals (Sweden)

    A. Castaño Escudero

    2004-03-01

    Full Text Available Objetivo: El consumo de productos de nutrición enteral domiciliaria financiados por el Sistema Nacional de Salud ha experimentado un notable incremento. El objetivo del trabajo es conocer su evolución durante los últimos cuatro años (1998-2001, las diferencias de precio de facturación de un mismo producto y la ocupación de mercado de los distintos preparados. Ámbito: Analizando las recetas de la Seguridad Social que fueron dispensadas por farmacias de Madrid, se ha realizado un estudio atendiendo a tipo de producto, número de envases, importe y empresas fabricantes. Al ser productos sujetos a la Ley de Defensa de la Competencia, los datos de importe se han tomado individualmente de cada receta. Resultados: Son importantes los aumentos entre noviembre de 1998 y mayo de 2000 del consumo de envases (66,6% e importe (supera el 100%. El consumo se reparte de manera desigual entre tres empresas. El precio medio aumenta un 25,9%, disminuyendo la utilización de productos estándar a favor de productos modificados más específicos. La diferencia de precio de facturación del mismo producto, dependiendo de la farmacia que lo dispense, llega a un 120%. Conclusiones: El consumo en envases observa un crecimiento tendencial mantenido hasta el año 2000, ralentizándose en el 2001, no así en importe que mantiene su tendencia ascendente. Se incrementan los preparados envasados para administración con sistemas de infusión continua.Objective: The comsumption of products of home enteral nutrition financed by the national system of health, has experimented a remarkable increment. The purpose of this present paper is to evaluate the changes during the last four years (1998-2001, the differences between the costs in which a product is checked and the market occupation of each product. Scope: Analysing the official social security forms which were dispensed by pharmacies of Madrid, a study was realized attending to type of product, number of units, cost

  1. Prescribing practice and evaluation of appropriateness of enteral nutrition in a university teaching hospital

    Directory of Open Access Journals (Sweden)

    Zhu XP

    2013-02-01

    Full Text Available Xiu-Ping Zhu,1 Ling-Ling Zhu,2 Quan Zhou11Department of Pharmacy, 2Cadre Department, Division of Nursing, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of ChinaBackground: A retrospective utilization study was performed to evaluate utilization patterns for enteral nutrition in a university teaching hospital.Methods: Enteral nutrition was divided into three types according to the nitrogen source, ie, total protein type [Nutrison Fibre®, Fresubin Energy Fibre®, Fresubin®, Supportan® (a special immunonutrition for cancer patients or patients with increased demands for omega-3 fatty acids, Fresubin Diabetes® (a diabetes-specific formula, Ensure®]; short peptide type (Peptison®; and amino acid type (Vivonex®. A pharmacoeconomic analysis was done based on defined daily dose methodology.Results: Among hospitalized patients taking enteral nutrition, 34.8% received enteral nutrition alone, 30% concomitantly received parenteral nutrition, and 35.2% received enteral nutrition after parenteral nutrition. Combined use of the different formulas was observed in almost all hospitalized patients receiving enteral nutrition. In total, 61.5% of patients received triple therapy with Nutrison Fibre, Fresubin Diabetes, and Supportan. Number of defined daily doses (total dose consumed/defined daily dose, also called DDDs of formulas in descending order were as follows: Nutrison Fibre, Fresubin Energy Fibre, Fresubin Diabetes > Supportan > Peptison, Ensure > Vivonex, Fresubin. The ratio of the cumulative DDDs for the three types of enteral nutrition was 35:2.8:1 (total protein type to short peptide type to amino acid type. Off-label use of Fresubin Diabetes was also observed, with most of this formula being prescribed for patients with stress hyperglycemia. Only 2.1% of cancer patients received Supportan. There were 35 cases of near misses in dispensing look-alike or sound-alike enteral

  2. Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

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    Juan A. Sanchez

    2013-02-01

    Full Text Available Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations.

  3. [Prognostic morbidity and mortality factors in hospital enteral nutrition: prospective study].

    Science.gov (United States)

    Moreno Pérez, O; Meoro Avilés, A; Martínez, A; Boix, E; Aznar, S; Martín, Ma D; Picó, A M

    2005-01-01

    To determine the prognostic factors that may best for see the outcome of an enteral nutritional intervention and to assess the assistance quality of a nutrition unit. Patients that required enteral nutrition during hospital admission at a third level center. Observational prospective study in which 160 patients were included by means of consecutive sampling, for a 6-months follow-up period. Underlying pathology, disability degree, nutritional assessment, type of enteral nutrition, complications, nursing care, and clinical course of patients were determined. severe caloric and protein hyponutrition was diagnosed in 48.4 and 52.9% of patients; stress degree was moderate in 52.2% and severe in 36.5%. In 88.2% of patients variation of protein parameters was unchanged or improved, with a 0.26 g/dL increase in albumin levels and 2.4 m/dL in prealbumin (p enteral nutritional intervention in the hospitalized patient (p enteral nutritional support at the hospital setting, to advance in patients care and promote the development of nutritional therapy.

  4. [Quality, Innovation and Technological Development in Enteral Nutrition in the XXI Century].

    Science.gov (United States)

    Wanden-Berghe, Carmina

    2015-05-07

    This work synthesis the quality evolution as well as innovation and technological advances that have been proven in healthcare area and specifically in enteral nutrition field. Clarifying the most relevant landmarks and the best representative characteristics of these advances.

  5. Avaliação do estado nutricional precedente ao uso de nutrição enteral Assessing nutritional status before introducing enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vânia Aparecida Leandro-Merhi

    2009-09-01

    Full Text Available CONTEXTO: O adequado diagnóstico do estado nutricional é de vital importância para a prescrição da terapia nutricional enteral no ambiente hospitalar. OBJETIVO: Avaliar indicadores do estado nutricional em pacientes ingressantes na terapia nutricional enteral em uma unidade hospitalar. MÉTODOS: Estudo transversal com 100 pacientes adultos, sendo analisado o estado nutricional de ingresso à terapia nutricional enteral, por meio do índice de massa corporal obtido do peso e estatura estimados a partir de fórmulas de predição, e de indicadores laboratoriais do estado metabólico e nutricional. RESULTADOS: Do total, 29% dos pacientes foram classificados como desnutridos pelo índice de massa corporal, enquanto 80% dos mesmos apresentaram albumina abaixo do valor de referência (CONTEXT: A proper diagnosis of the nutritional status is of the utmost importance for prescribing enteral nutrition therapy in the hospital environment. OBJECTIVE: To assess nutritional status indicators of patients about to receive enteral nutrition therapy in a hospital unit. METHODS: This cross-sectional study examined the nutritional status of 100 adult patients before they were introduced to enteral nutrition therapy by calculating their body mass index . Their height and weight were estimated by prediction formulas and laboratory indicators of nutritional and metabolic statuses. RESULTS: Almost one-third (29% of the patients were classified as malnourished according to their body mass index, while 80% of them had low albumin values (<3.2 g/dL. When patients were grouped according to body mass index, the distribution of the reasons for hospitalization did not differ between the groups. Cardiovascular and pulmonary diseases prevailed as the main reasons for hospitalization. When patients were grouped according to body mass index and diagnosis upon admission, the rates of low albumin concentration, i.e., concentration below the reference value, did not differ

  6. The Effectiveness of Enteral Nutrition Support in the Growth of Children Patients with Cancer

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    Can Acipayam

    2014-12-01

    Full Text Available Aim: The purpose of this study was to assess, through anthropometric and biochemical parameters, the positive effect on growth of enteral nutrition support in children with cancer receiving chemotherapy. Material and Method: Forty-three consecutive patients newly diagnosed with pediatric malignant disease and receiving intensive chemotherapy were included. Twenty-six patients received an enteral nutrition formula. Seventeen control patients did not receive enteral nutrition formula. Anthropometric parameters (weight, height, body mass index, triceps, subscapular and suprailiac skinfold thickness, serum albumin, prealbumin and transferrin levels and lipid profiles were measured at time of diagnosis and the 3rd month. Results: At the end of 3 months we determined a marked increase in subscapular and suprailiac skin fold thicknesses in the enteral nutrition group compared to at time of diagnosis (p=0.01 and p=0.014, respectively. Prealbumin and albumin values increased considerably after 3 months of enteral nutrition formula support (p=0.005 and p=0.006, respectively. Weight percentile increment was determined (69.2% of patients in the enteral nutrition group compared to at time of diagnosis. At 3 months, albumin and suprailiac skinfold thicknesses values were higher in the enteral nutrition group as compared to controls (p=0.012 and p=0.017, respectively. There were no significant changes in anthropometric and biochemical parameters in the control group at the end of treatment compared to at time of diagnosis. Discussion: This study demonstrates an improvement in anthropometric and biochemical parameters in children with cancer receiving an enteral nutrition formula.

  7. Patient needs and research priorities in the enteral nutrition market - a quantitative prioritization analysis.

    Science.gov (United States)

    Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P

    2014-10-01

    A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they

  8. Development of automated postoperative enteral nutrition: restricting feeding site inflow to match peristaltic outflow

    OpenAIRE

    Moss, Gerald

    2015-01-01

    Background Surgical stress accelerates postoperative metabolism, while simultaneously compromising gut activity. The dysfunction may be worsened by early feeding. These patients are not expected to fully meet their optimum metabolic requirements using current nutritional regimens. For optimum postoperative enteral nutrition, we must automatically match the patients’ feeding site inflows to their impaired peristaltic outflows. An essential adjunct is virtually complete exclusion of swallowed a...

  9. Guidelines for parenteral and enteral nutrition support in geriatric patients in China.

    Science.gov (United States)

    Wei, Junmin; Chen, Wei; Zhu, Mingwei; Cao, Weixin; Wang, Xinying; Shi, Hanping; Dong, Birong; Sun, Jianqin; Chen, Huaihong; Zhou, Yeping; Zhou, Suming; Xu, Jingyong

    2015-01-01

    The mortality and morbidity of geriatric patients is much higher than for younger patients, especially when critically ill. This may be attributed to a lower reserve capacity in most organs and systems, reduced ability to deal with physical stress and the presence of acute or chronic co-mobidities. Parenteral and enteral nutrition support can improve the clinical condition of the elderly patient and result in better outcomes, such as lower mortality, reduced hospital stay and reduced medical costs. There is a need to standardize nutrition screening and assessment, and the implementation of appropriate evidence based nutritional support of geriatric patients in China. The Chinese Medical Association's Group of Geriatric Nutrition Support has developed guidelines by researching the present situation in Chinese hospitals and by referring to the guidelines from both American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN).

  10. Early enteral nutrition therapy and mortality in a pediatric intensive care unit

    OpenAIRE

    2013-01-01

    Objective: To assess the impact of early introduction of enteral nutrition therapy in reducing morbidity and mortality in pediatric intensive care unit.Methods: Search in the literature of the last 10 years, in English and the target population of individuals aged 1 month to 18 years admitted to pediatric intensive care units in the databases PubMed, Lilacs and Embase using the keywords: Critical Care, Nutritional Support and Nutrition Disorders or Malnutrition.Results: Despite advances in th...

  11. Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

    Science.gov (United States)

    Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

    2017-08-01

    The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of

  12. Enteral nutrition in the prevention and treatment of pressure ulcers in adult critical care patients.

    Science.gov (United States)

    Cox, Jill; Rasmussen, Louisa

    2014-12-01

    Prevention and healing of pressure ulcers in critically ill patients can be especially challenging because of the patients' burden of illness and degree of physiological compromise. Providing adequate nutrition may help halt the development or worsening of pressure ulcers. Optimization of nutrition can be considered an essential ingredient in prevention and healing of pressure ulcers. Understanding malnutrition in critical care patients, the effect of nutrition on wound healing, and the application of evidence-based nutritional guidelines are important aspects for patients at high risk for pressure ulcers. Appropriate screenings for nutritional status and risk for pressure ulcers, early collaboration with a registered dietician, and administration of appropriate feeding formulations and micronutrient and macronutrient supplementation to promote wound healing are practical solutions to improve the nutritional status of critical care patients. Use of nutritional management and enteral feeding protocols may provide vital elements to augment nutrition and ultimately result in improved clinical outcomes.

  13. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R. [Strahlentherapeutische Klinik und Poliklinik, Rostock Univ. (Germany)]|[Strahlentherapeutische Klinik und Poliklinik, Erlangen Univ. (Germany)

    1998-11-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [Deutsch] Hintergrund: Der Ernaehrungsstatus von Tumorpatienten ist haeufig bereits vor jeder antitumoroesen Therapie reduziert und kann sich durch die notwendige Radio(chemo)therapie weiter verschlechtern. Methode: Im Rahmen dieses Uebersichtsartikels werden die Moeglichkeiten und Risiken der enteralen und parenteralen Ernaehrung waehrend einer Radiotherapie besprochen. Die Indikationen der enteralen Ernaehrung werden anhand von eigenen Ergebnissen begruendet. Ergebnisse: Die Langzeiternaehrung wird am besten ueber einen enteralen Zugang durchgefuehrt. In einer prospektiven, nichtrandomisierten Studie konnten wir zeigen, dass eine enterale Ernaehrung mittels perkutaner endoskopisch kontrollierter Gastrostomie (PEG) nicht nur die anthropometrischen und biochemischen Parameter waehrend einer Radio(chemo)therapie verbessert, sondern auch die Lebensqualitaet. Eine weitere Moeglichkeit besteht in der

  14. Importance of nutritional status in recovery from acute cholecystitis: benefit from enteral nutrition supplementation including medium chain triglycerides.

    Science.gov (United States)

    Nomura, Yukinobu; Inui, Kazuo; Yoshino, Junji; Wakabayashi, Takao; Okushima, Kazumu; Kobayashi, Takashi; Miyoshi, Hironao; Nakamura, Yuta

    2007-09-01

    This study was undertaken to clarify the importance of nutritional status in patients with acute cholecystitis, and also evaluate whether they benefited from enteral nutrition supplementation, including medium-chain triglycerides (MCT), during the convalescent stage. Patients with acute cholecystitis admitted to our hospital between April 1994 and March 2002 were classified into a poor nutrition group (n=40; total serum proteinnutrition group (n=71; >5.0 g/dl). Patients with poor nutrition were significantly more elderly than those with fair nutrition, and had significantly higher serum C-reactive protein (CRP) concentrations. The two groups did not differ significantly with respect to other laboratory data, gender distribution, or medical treatment. We supplemented ordinary meals with enteral nutrition including MCT in 16 patients during the convalescent stage (MCT group). We compared their length of hospital stay and days required to recovery to pre-admission functional status for activities of daily living (ADL) with the same intervals in 16 patients without supplementation (non-MCT group) selected to match for age, gender, and fair or poor nutritional status from among 111 patients. Hospitalizations were significantly longer in the poor nutrition group (43.0+/-2.2 days) than in the fair nutrition group (27.0+/-8.2 days). Significantly more days were required to recover ADL status in the poor nutrition group (12.0+/-7.2 days) than in the fair group (9.4+/-5.2 days). Hospitalizations were significantly shorter in the MCT group (20.1+/-15 days) than in the non-MCT group (35.4+/-12.8 days). Significantly fewer days were required to recover ADL status in the MCT group (10.9+/-7 days) than in the non-MCT group (13.1+/-6.8 days). Administration of enteral nutrition including MCT during convalescence from acute cholecystitis thus appears to promote functional recovery shorten hospital stay.

  15. Evaluation of enteral formulas for nutrition, health, and quality of life among stroke patients.

    Science.gov (United States)

    Kang, Yunkyeong; Lee, Ho-Sun; Paik, Nam-Jong; Kim, Woo-Sub; Yang, Mihi

    2010-10-01

    Enteral nutritional support has been used via tube feeding for dysphagic stroke patients. We performed long and short term trials to evaluate the effects of commercial enteral nutritional supports on nutrition and health in stroke patients (mRS = 3~5) and quality of life in their caregivers. For a long term study, we recruited chronic (≥ 1 yrs) stroke patients (n = 6) and administered them 6 cans/day (1,200 kcal) of the commercial enteral formula N for 6 months according to IRB-approved protocol. We collected peripheral blood at 0, 2, 4 and 6 months. For a short term study, we recruited acute (≤ 3 months) stroke patients (n = 12) and randomly administered them two different commercial enteral formulas, N or J, for 2 weeks. We collected their blood at 0, 4, 7 and 14 day of the administration. Blood samples were analyzed to quantify 19 health and nutritional biomarkers and an oxidative stress biomarker, malondialdehyde (MDA). In order to evaluate quality of life, we also obtained the sense of competence questionnaire (SCQ) from all caregivers at 'before' and 'after trials'. As results, the enteral formula, N, improved hemoglobin and hematocrit levels in the long term trial and maintained most of biomarkers within normal ranges. The SCQ levels of caregivers were improved in the long term treatment (P nutritional status of the patients. In addition, MDA levels were decreased in the acute patients following formula consumption (0.05 nutrition outcomes were not different, even though there is a big difference in price of the two products. Thus, we evaluate the formula N has equal nutritional efficacy compared to the formula J. In addition, long term use of enteral formula N can be useful to health and nutrition of stroke patients, and the quality of life for their caregivers.

  16. Complications relating to enteral and parenteral nutrition in trauma ...

    African Journals Online (AJOL)

    2014-11-01

    Nov 1, 2014 ... referred to as nutritional therapy.4,5 Critically ill trauma patients endure a catabolic ... patients.13 At least 50-65% of the patient's caloric goal has to be ... The patients were placed on a standardised intravenous insulin infusion ...

  17. Parenteral and enteral nutrition for pediatric oncology in low- and middle-income countries

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    K Viani

    2015-01-01

    Full Text Available Although nutritional therapy is essential for the treatment of childhood cancer, it remains a challenge, especially within the developing world, where there are many barriers to optimizing treatment. The oral route is the first approach to nutritional support, however challenging this might be in children with cancer. Oral supplements are indicated in moderate evaluated nutritional risk patients and its use should consider the family's social conditions and access to industrialized oral supplements. If unavailable, homemade oral supplements can be used respecting regional accessibility, local foods, and culture. Nonetheless, many patients cannot sustain nutritional status on oral feeding alone and need to be supported by enteral tube feeding. Enteral feeding may be modified to accommodate the financial constraints of institution in low- and middle-income countries (LMICs. In some oncologic situations, however, enteral nutrition is not possible and parenteral nutrition is indicated, although only if the need for nutritional support is anticipated to be longer than 5–7 days. Nutritional support in pediatric oncology remains a challenge, especially in LMICs, however, it can be undertaken by getting the best out of the available resources.

  18. Impact of early enteral nutrition on short term prognosis after acute stroke.

    Science.gov (United States)

    Zheng, Tianheng; Zhu, Xinpu; Liang, Huazheng; Huang, Haixia; Yang, Jiandao; Wang, Shaoshi

    2015-09-01

    We hypothesized that early enteral nutritional support would improve the short term prognosis of acute stroke patients with dysphagia, demonstrated by lower malnutrition rates, lower complication rates, and lower National Institutes of Health Stroke Scale (NIHSS) scores at 90 days post stroke. Nutrition support is an essential element in the care of stroke patients and many studies have investigated the effect of specific nutritional elements on stroke patients. However, few studies have looked at the impact of complete enteral nutrition on Chinese patients with acute stroke. To investigate this, we conducted a randomized controlled trial of 146 patients with acute stroke and dysphagia, among whom 75 were supported with nasogastric nutrition and 71 received family managed nutrition after randomization. Nutritional status, nosocomial infection and mortality rates were recorded on day 21 of hospitalization. Neurological deficits were evaluated by the NIHSS activities of daily living Barthel index (ADLBI) and the modified Rankin scale (mRS) and compared between the two groups. We found that the nasogastric nutrition group had a better nutritional status and reduced nosocomial infection and mortality rates after 21 days compared with patients in the family managed nutrition group. In addition, the nasogastric nutrition group showed a lower score on the NIHSS than the control group. However, the differences in the scores of the ADLBI and the 90 day mRS between the groups were not significant. Taken together, the present study shows that early enteral nutrition support improves the short term prognosis of acute stroke patients with dysphagia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Review of American Society for Parenteral and Enteral Nutrition (ASPEN) Clinical Guidelines for Nutrition Support in Cancer Patients: nutrition screening and assessment.

    Science.gov (United States)

    Huhmann, Maureen B; August, David A

    2008-01-01

    It is clear that cancer patients develop complex nutrition issues. Nutrition support may or may not be indicated in these patients depending on individual patient characteristics. This review article, the first in a series of articles to examine the A.S.P.E.N. Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients Cancer Guidelines, evaluates the evidence related to the use of nutrition screening and nutrition assessment in cancer patients. This first article will provide background concerning nutrition issues in cancer patients as well as discuss the role of nutrition screening and nutrition assessment in the care of cancer patients. The goal of this review is to enrich the discussion contained in the Clinical Guidelines, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequent published studies. Future articles will explore the guidelines related to nutrition support in oncology patients receiving anticancer therapies.

  20. Application of spiral nasointestinal tube in enteral nutrition support for patients with extensive burn

    Institute of Scientific and Technical Information of China (English)

    Lai-Ping Wang; Hong-Fei Jia; Yan-Li Cao

    2016-01-01

    Objective:To observe the effect of spiral nasointestinal tube on enteral nutrition support in patients with extensive burn.Methods: A total of 60 patients with extensive burn who were admitted in our hospital from January, 2014 to June, 2015 were included in the study and divided into the observation group and the control group with 30 cases in each group according to different catheter indwelling methods. The patients in the observation group were given spiral nasointestinal tube for enteral nutrition support, while the patients in the control group were given routine gastric tube for enteral nutrition support. The nutrition status and the occurrence rate of complications before catheter indwelling, 3, 6, and 10 d after catheter indwelling in the two groups were recorded.Results:The levels of ALB, HB, PA, and Scr 6, 10 d after catheter indwelling in the observation group were significantly higher than those in the control group (P<0.05). The occurrence rate of complications during the treatment period in the observation group was significantly lower than that in the control group (P<0.05). Conclusions:The spiral nasointestinal tube can provide the patients with extensive burn a better effective enteral nutrition support and improve the nutrition support, with a lower occurrence rate of complications, which is beneficial for the patients’ rehabilitation.

  1. Enteral nutrition: past and future Nutrición enteral: pasado y futuro

    OpenAIRE

    Bengmark, S.; J. J. Ortiz de Urbina

    2004-01-01

    Perioperative nutrition has during the last century been transformed from a tool to provide calorie and nitrogen support to a tool to boost the immune system and increase resistance to complications. Despite all progress in medicine and surgery has perioperative morbidity, rate of infections, thrombosis and development of serosal adhesions remained the same as long as can be judged or at least during the last eighty years. Most prone to develop complications are persons above the age of 65 an...

  2. Evaluation of the role of enteral nutrition in managing patients with diabetes: a systematic review.

    Science.gov (United States)

    Ojo, Omorogieva; Brooke, Joanne

    2014-11-18

    The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor dietary regimes and genetic susceptibility. The development of diabetes often leads to complications such as stroke, which may require enteral nutritional support. The provision of enteral feeds comes with its complications including hyperglycaemia which if not managed can have profound consequences for the patients in terms of clinical outcomes. Therefore, it is essential to develop strategies for managing patients with diabetes on enteral feed with respect to the type and composition of the feed. This is a systematic review of published peer reviewed articles. EBSCOhost Research, PubMed and SwetsWise databases were searched. Reference lists of identified articles were reviewed. Randomised controlled trials comparing enteral nutrition diabetes specific formulas with standard formulas were included. The studies which compared diabetes specific formulas (DSF) with standard formulas showed that DSF was more effective in controlling glucose profiles including postprandial glucose, HbA1c and insulinemic response. The use of DSF appears to be effective in managing patients with diabetes on enteral feed compared with standard feed.

  3. Evaluation of the Role of Enteral Nutrition in Managing Patients with Diabetes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2014-11-01

    Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor dietary regimes and genetic susceptibility. The development of diabetes often leads to complications such as stroke, which may require enteral nutritional support. The provision of enteral feeds comes with its complications including hyperglycaemia which if not managed can have profound consequences for the patients in terms of clinical outcomes. Therefore, it is essential to develop strategies for managing patients with diabetes on enteral feed with respect to the type and composition of the feed. This is a systematic review of published peer reviewed articles. EBSCOhost Research, PubMed and SwetsWise databases were searched. Reference lists of identified articles were reviewed. Randomised controlled trials comparing enteral nutrition diabetes specific formulas with standard formulas were included. The studies which compared diabetes specific formulas (DSF with standard formulas showed that DSF was more effective in controlling glucose profiles including postprandial glucose, HbA1c and insulinemic response. The use of DSF appears to be effective in managing patients with diabetes on enteral feed compared with standard feed.

  4. [The year 2002 national registry on home-based enteral nutrition].

    Science.gov (United States)

    Planas, M; Lecha, M; García Luna, P P; Chamorro, J; Zamarrón, I; Parés, R M; Bonada, A; Cardona, D; Jiménez, M; Irles, J A; Boris, M A; Rodríguez, A; Calañas, A J; Camarero, E; Martí, E; Pérez de la Cruz, A; Mancha, A; Gómez Enterría, P; de Luis, D; Muñoz, A; Bayo, P; Luengo, L M

    2005-01-01

    To communicate the information available by the NADYA-SENPE Working Group from patients on Home Enteral Nutrition (HEN) in our country during the year 2002. The data were collected through a closed questionnaire included in the web site of the Working Group (www.nadya-senpe.com) available only by the authorized users. Variable included were: epidemiological information, the indication to prescribe this treatment, the access path, the specific nutritional formula used, the treatment duration, the complications and hospital readmission related to the nutritional treatment, the follow-up and the quality of life. We register 3967 patients that belong to twenty-one hospitals. Mean age from those adults 69.2 +/- 19.2 years, and from those younger than 14, 5.6 +/- 4.1 years. Neurological and neoplasic diseases were the diagnostics more frequents (39.2% and 34.6%, respectively). Oral nutrition was the preferential rout used for the enteral nutrition (53.6%) followed by naso-enteral tube (30.6%), and only in 15.8% we used ostomy tubes. Polymeric was the enteral formula mainly utilized (81.5%). The mean time on HEN was 5.8 +/- 4.4 months; the 35.7% of patients stayed in the treatment for less than 3 months, 22.4% between 3 and 6 months, and 41.6% more than 6 months. Patients were followed mainly by Nutritional Support Unit from the reference hospital (75.3%). While the reference hospital supplies the material (65.7%), reference hospital pharmacy (43%) and public pharmacies (37.3%) provides the enteral formula. Complications related to enteral nutrition included change of enteral tube (29.7%), mechanical complications (22.9%), gastrointestinal complications (22.9%), and the metabolic one (9.2%). These complications were followed by 0.02 hospitalizations/patient. At the end of the year, 49.3% of patients were in the HEN programme, and in 41.5% HEN was finish due to accept oral conventional alimentation (47.3%) or by deceased of patients. While 31.8% of the patients were

  5. Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Fa-liang LIN

    2015-12-01

    Full Text Available Abstract Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI, and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN, delayed enteral nutrition (DEN, and parenteral nutrition (PN, respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS scores of 3 groups were higher than treatment before (P<0.01, and with statistical differences among groups (P<0.05, or P<0.01. The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01. The level of serum albumin was lower in PN group than in DEN group (P<0.05. There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098. Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

  6. Clinical use of enteral immune nutrition in patients with acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Zhi-cheng ZHANG

    2015-06-01

    Full Text Available Objective To investigate the use of enteral immune nutrition preparation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD, regard its efficacy in improving nutritional status, and its influence on immunity and the status of acute inflammatory reaction of the patients. Methods Sixty-two AECOPD patients requiring mechanical ventilation in ICU of our hospital were randomly divided into two groups: immune nutrition group [study group, n=32, receiving Ruineng (a product of Huarui Pharmaceutical Ltd., which contained essential fatty acids, Omega-3 fatty acids, and energy 1.3 kcal/ml] and conventional nutrition group (control group, n=30, receiving the hospital self-made homogenized diet with 1.2 kal/ml. Patients in the two groups took enteral nutrition of equal calorie, and it was given by nasointestinal tube. On the day of admission and the 14th and 18th after admission, venous blood was obtained for the determination of serum albumin, prealbumin, transferrin, C reactive protein (CRP, tumor necrosis factor-α (TNF-α, and interleukin-6 (IL-6. At the same time upper arm muscle circumference (MAMC was measured at the bed side. The 14-day off-respirator rate and mechanical ventilation time within 28 days were compared between the two groups. Results The 14-day off-respirator rate was higher in study group than in control group (P0.05. Conclusions Compared with homogenized diet, immune enteral nutrition could better improve the nutritional status and immune function, lower the acute inflammatory response level, increase the success rate of early off-respirator in AECOPD patients, therefore, enteral immune nutrition preparation is a better nutrition support solution for AECOPD. DOI: 10.11855/j.issn.0577-7402.2015.05.17

  7. Students entering internship show readiness in the nutrition care process.

    Science.gov (United States)

    Baker, S D; Cotugna, N

    2013-10-01

    The British Dietetic Association and the International Confederation of Dietetic Associations are developing an international model for dietetics practice as an aid in providing evidence-based practice. In the USA, undergraduate programmes are mandated by the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) to incorporate the nutrition care process (NCP) into the curriculum so that students can use the process during their dietetic internship and later practice. The present study aimed to assess interns' readiness in the NCP prior to beginning a dietetic internship. Before starting the internship, the 40 interns in the 2009-2010 class of a university-based internship were sent an e-mail requesting they complete an online survey. Questions inquired about their NCP background with respect to: academic preparation, work or volunteer experiences, knowledge and confidence in ability to apply the NCP. Survey results were analysed with SPSS statistical software (SPSS Inc., Chicago, IL, USA). The 39 interns completing the survey indicated they had prior exposure to the NCP. All but one reported that their academic coursework covered the NCP. Approximately half of the interns worked or volunteered in settings that used the NCP. Overall, students correctly answered most of the questions assessing their basic knowledge in the NCP. Thirty-seven of the 39 interns had some confidence or felt confident in their ability to apply the NCP during internship rotations. This distance internship attracts students from all over the USA, and so the findings of the present study shed light on current undergraduate preparation in the NCP. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  8. Refeeding syndrome with enteral nutrition in children: a case report, literature review and clinical guidelines.

    Science.gov (United States)

    Afzal, N A; Addai, S; Fagbemi, A; Murch, S; Thomson, M; Heuschkel, R

    2002-12-01

    Refeeding syndrome is a potentially fatal complication of the nutritional management of severely malnourished patients. The syndrome almost always develops during the early stages of refeeding. It can be associated with a severe derangement in electrolyte and fluid balance, and result in significant morbidity and mortality. It is most often reported in adults receiving total parenteral nutrition (TPN), although refeeding with enteral feeds can also precipitate this syndrome. We report what we believe to be the first case of refeeding syndrome in an adolescent with newly diagnosed Crohn's disease. This developed within a few days of starting exclusive polymeric enteral nutrition. A systematic literature review revealed 27 children who developed refeeding syndrome after oral/enteral feeding. Of these, nine died as a direct result of complications of this syndrome. We discuss the implications of this syndrome on clinical practice and propose evidence-based guidelines for its management.

  9. Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

    DEFF Research Database (Denmark)

    Aunsholt, Lise; Qvist, Niels; Sangild, Per Torp

    2017-01-01

    be well tolerated in patients with short bowel syndrome. METHODS: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient......BACKGROUND: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would......, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow's milk allergy. CONCLUSION: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly...

  10. Modulation of intestinal inflammation by minimal enteral nutrition with amniotic fluid in preterm pigs

    DEFF Research Database (Denmark)

    Østergaard, Mette V; Bering, Stine Brandt; Jensen, Michael L

    2014-01-01

    Background: Necrotizing enterocolitis (NEC) is a severe inflammatory disorder, associated with the difficult transition from parenteral to enteral feeding after preterm birth. We hypothesized that minimal enteral nutrition (MEN) with amniotic fluid (AF), prior to enteral formula feeding, would...... improve resistance to NEC in preterm pigs. Methods: Experiment 1: IEC-6 cells were incubated with porcine (pAF) and human AF (hAF) to test AF-stimulated enterocyte proliferation and migration in vitro. Experiment 2: Cesarean-delivered, preterm pigs were fed parenteral nutrition and MEN with pAF, h...... fed AF as MEN, but NEC incidences were similar (NEC-pAF) or increased (NEC-hAF) compared with controls. Conclusions: Intake of pAF or hAF improved body growth and modulated intestinal inflammatory cytokines during a period of parenteral nutrition, but did not protect against later formula-induced NEC...

  11. Enteral nutrition volume is not correlated with lower respiratory tract infection in patients on mechanical ventilation.

    Science.gov (United States)

    Colomar, A; Guardiola, B; Llompart-Pou, J A; Ayestarán, I; Rodríguez-Pilar, J; Ferreruela, M; Raurich, J M

    To evaluate the effect of enteral nutrition volume, gastrointestinal function and the type of acid suppressive drug upon the incidence of lower respiratory tract infections in critically ill patients on mechanical ventilation (MV). A retrospective secondary analysis was carried out. The Intensive Care Unit of a University Hospital. Patients≥18-years-old expected to need MV for more than four days, and receiving enteral nutrition by nasogastric tube within 24h of starting MV. We correlated enteral nutrition volume administered during the first 10 days, gastrointestinal function and the type of acid suppressive therapy with the episodes of lower respiratory tract infection up until day 28. Cox proportional hazards ratios in univariate and adjusted multivariate models were used. Statistical significance was considered for p<0.05. Lower respiratory tract infection episodes. Sixty-six out of 185 patients (35.7%) had infection; 27 patients had ventilator-associated pneumonia; and 39 presented ventilator-associated tracheobronchitis. Uninfected and infected groups were similar in terms of enteral nutrition volume (54±12 and 54±9mL/h; p=0.94) and caloric intake (19.4±4.9 and 19.6±5.2kcal/kg/d; p=0.81). The Cox proportional hazards model showed neurological indication of MV to be the only independent variable related to infection (p=0.001). Enteral nutrition volume, the type of acid suppressive therapy, and the use of prokinetic agents were not significantly correlated to infection. Enteral nutrition volume and caloric intake, gastrointestinal dysfunction and the type of acid suppressive therapy used were not associated to lower respiratory tract infection in patients on MV. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. [When enteral nutrition is not possible in intensive care patients: whether to wait or use parenteral nutrition?

    NARCIS (Netherlands)

    Habes, Q.L.M.; Pickkers, P.

    2016-01-01

    - Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral

  13. Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer.

    Science.gov (United States)

    Li, B; Liu, H Y; Guo, S H; Sun, P; Gong, F M; Jia, B Q

    2015-06-29

    The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

  14. Chronic anorexia nervosa: enteral nutrition via percutaneous endoscopic gastrostomy and liaison psychiatry.

    Science.gov (United States)

    Malfi, G; Agnello, E; Da Pont, M C; Palmo, A; Zullo, G; Monero, A; Macario, P F; Sterpone, S; Munno, D

    2006-12-01

    Anorexia nervosa is a complex mental disorder characterized by altered eating behaviour often resulting in life-threatening weight loss (1 month) enteral feeding at home, a percutaneous endoscopic gastrostomy was performed and a home nutrition support regimen that met her energy-protein intake requirements was prescribed. During the follow-up period, an overall improvement in nutritional status, general condition, mood and cognitive functioning was observed. Patient compliance with refeeding is notoriously problematic; however, enteral feeding interventions may be feasible in the long-term treatment of selected anorexia nervosa patients when closely followed-up by a multidisciplinary medical team.

  15. Development of a tool for quality control audits in hospital enteral nutrition

    OpenAIRE

    Guilherme Duprat Ceniccola; Wilma Maria Coelho Araújo; Rita Akutsu

    2014-01-01

    Background and aims: Malnutrition is very prevalent in hospitals, causing physical capacity deterioration, increasing complications and raising mortality. This scenario overloads public health costs enormously. Enteral nutrition (EN) is the first option to fight against malnutrition. Nutrition support teams (NST) work combating such conditions, promoting humanization, but also analyzing the cost benefit of EN therapy. Brazil is one of the first Latin American countries to develop EN laws. Qua...

  16. Parenteral nutrition versus enteral nutrition in severe acute pancreatitis Nutrição parenteral versus enteral em pacientes com pancreatite aguda grave

    Directory of Open Access Journals (Sweden)

    Josiel Paiva Vieira

    2010-10-01

    Full Text Available PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16 and an enteral group (n=15, who met severity criteria for abdominal tomography (Balthazar classes C, D, and E. The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10. Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006. There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.OBJETIVO: Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. MÉTODOS: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16, no período de 1995 a 1998 e grupo enteral (n=15, no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E. Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. RESULTADOS

  17. Enteral Nutrition by Endoscopic Means; II. Complications and Management.

    Science.gov (United States)

    Hoepffner, N; Schröder, O; Stein, J

    2004-12-01

    Despite the benefits and the widespread use of enteral and tube feeding (ETF) some patients experience complications, which can be divided in three categories: mechanical, e. g., tube blockage or removal; gastrointestinal, e. g., vomiting, diarrhea; and metabolic, e. g., re-feeding syndrome, hyperglycemia. The type and frequency of complications related to tube feeding varies considerably in accordance with the access to the intestinal tract (e. g., nasoenteric vs. percutaneous gastric vs. small bowel), the composition of the formula diet used, and the severity of the underlying disease. For example, tube-related complications have been reported to occur in 0-20 % and gastrointestinal complications in 8-65 % of patients during early postoperative feeding via a needle catheter jejunostomy (NCJ) using comparable techniques. The complication rate can be reduced by careful observance of guidelines on tube feeding including those related to food composition, administration rate, portion size, food temperature, and supervision of the patient. Gastrointestinal side effects (including diarrhea) are without doubt the most frequent.

  18. Nutrición enteral con dieta inmunomoduladora perioperatoria Enteral nutrition with peri-surgery immunomodulating diet

    Directory of Open Access Journals (Sweden)

    O. Abdel-lah Fernández

    2005-12-01

    ía postoperatorio respecto del 5º día. Las diferencias son en la mayoría de los casos estadísticamente significativas. Resultaron ser partícipes en la ecuación de predicción de la morbimortalidad las variables, colesterol, enfermedades asociadas, PCR, IgM y sexo varón. Conclusiones: Las variables analizadas, excepto el sexo, parecen ser indicadores adecuados para el estudio de la respuesta a la agresión quirúrgica y así mismo a la nutrición enteral. La nutrición perioperatoria inmunomoduladora creemos que recupera las cifras de parámetros nutricionales postoperatorios.La nutrición enteral por yeyunostomía es bien tolerada y con morbilidad baja y poco severa.Objective: To assess the nutritional peri-surgical status of patients suffering from esophageal or gastric cancer, treated with esophagectomy and total gastrectomy, respectively, and to analyze the impact of an enteral immunomodulating diet on postsurgical complications. Setting: Patients admitted to the Surgery Department of Hospital Clínico Universitario of Salamanca. Patients and methods: Patients submitted to esophagectomy and/or total gastrectomy to whom early enteral nutrition (EN is provided with an immunomodulating diet. Interventions: All patients were prescribed an immunomodulating diet of 1000 Kcal/day p.o. plus a normal grinded diet that they started on the 5th presurgical day and pursued during the immediate postsurgical period (within the first 24 hours with EN through a jejunostomy catheter, in a progressive way until reaching 25 kcal/kg/day at days 4-5. EN was kept in place for at least the first 10 days after surgery and laboratory checkups were done before surgery and at days 5 and 10 after surgery. We also performed a prediction equation, with morbidity as the dependent variable and the remaining as independent variables. Results: Sixty-eight patients were studied of whom 36 (35 men and 1 women suffered from esophageal cancer and 32 (21 men and 11 women from gastric cancer. Mean age of

  19. [Clinical application of enteral immune nutrition for chronic obstructive pulmonary disease patients].

    Science.gov (United States)

    Zhang, Guoyu; Zou, Jianfeng

    2015-05-19

    To explore the application of enteral immune nutrition preparation for chronic obstructive pulmonary disease (COPD) patients and examine the improving effects on nutritional status, immune status and acute inflammatory reaction. A total of 60 cases of hospitalized COPD patients on mechanical ventilation in intensive care unit (ICU) were randomly divided into immune nutrition group (containing essential fatty acids, omega-3 fatty acids, energy 1.3 kcal/ml) (study, n = 30) and standard nutrition group (self-made homogenized diet 1.2 kal/ml) (control, n = 30). Two groups received an equal calorie of enteral nutrition via a nasointestinal tube. On the day of admission and every 2 weeks, venous blood samples were drawn for measuring the serum levels of albumin (ALB), prealbumin (PA), C-reactive protein (CRP) and interleukin-6 (IL-6). And the values of upper arm muscle circumference (MAMC) were recorded simultaneously bedside. The levels of mechanical ventilation and weaning rate were compared between two groups at Day 14. The weaning rate within 14 days in study group was higher than that in control group (73.3% vs 43.3%, P 0.05]. The study group was lower than control group at Day 28 [(108.5 ± 59.6) vs (165.7 ± 76.3) ng/L, P nutrition may improve the nutritional status of COPD patients, lower the levels of acute inflammatory reactions and boost the success rate of early weaning.

  20. [Amyotrophyc lateral sclerosis; gastrointestinal complications in home enteral nutrition].

    Science.gov (United States)

    Ramírez Puerta, R; Yuste Ossorio, E; Narbona Galdó, S; Pérez Izquierdo, N; Peñas Maldonado, L

    2013-11-01

    Objetivos: Analizar las complicaciones relacionadas con el soporte nutricional enteral en los pacientes con esclerosis lateral amiotrófica que forman parte de nuestro programa de ventilación mecánica domiciliaria, haciendo especial hincapié en las gastrointestinales. Método: Estudio retrospectivo de tipo descriptivo de enfermos que se incluyeron en nuestro Programa de Ventilación Mecánica Domiciliaria (PVMD) dirigido por médicos intensivistas, mediante la revisión sistemática de historias clínicas (procedentes de una base de datos de Microsoft Access), durante los años 2004-2011. Resultados: Entre los años 2004-2011 se siguieron 73 pacientes con diagnostico de Esclerosis lateral amiotrófica: 34 de ellos (46,6%) rechazaron el aporte nutricional a través de gastrostomía o de sonda nasogástrica, mientras que 39 (53,4%) aceptaron su colocación. De los 39 pacientes en los que se inició la NED: 20 eran mujeres mujeres (51,3%). La edad media de los pacienes fue de 60,6 + 13,4 años (IC 95% 56,4-64,8). Los diagnósticos al ingreso en el PVMD fueron: ELA, 21 casos (53,8%), y ELA con afectación bulbar, 18 (43,1%). Se alimentaron a través de GEP 34 pacientes (87,2%), con gastrostomía quirúrgica 3 (7,7%) y mediante sonda nasogástrica 3 (7,7%). La gastrostomía percutánea endoscópica se realizó tras la inclusión de los pacientes en el programa, con una media días de 222,7 + 356,6 (IC 95% 110,8-334,7). En pacientes con ELA la media fue de 271,4 + 449,5 días (IC 95% 130,3-412,1), con ELA y afectación bulbar de 126,4 + 131,3 días (IC 95% 90-172,6). El recambio de sonda fue de 7,3 + 4,8 meses (IC 95% 4-10,6). La nutrición enteral tuvo una duración media de 578,6 + 872,9 días (IC 95% 304,7-852,6). Se hallaron complicaciones en 35 pacientes (89,7%), y solamente en 4, no se encontró ninguna (10,3%). Ver tabla 2. El estreñimiento se manifestó, después del inicio de la NE, en 30 pacientes (76,9%); sin embargo, ya existía previamente en 18 de ellos

  1. Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs

    DEFF Research Database (Denmark)

    Stoll, Barbara; Puiman, Patrycja Jolanta; Cui, Liwei

    2012-01-01

    We previously showed that parenteral nutrition (PN) compared with formula feeding results in hepatic insulin resistance and steatosis in neonatal pigs. The current aim was to test whether the route of feeding (intravenous [IV] vs enteral) rather than other feeding modalities (diet, pattern) had...

  2. Effectiveness of Enteral Nutritional Therapy in the Healing Process of Pressure Ulcers: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Gisely Blanc

    2015-02-01

    Full Text Available OBJECTIVE To evaluate the effectiveness of enteral nutritional therapy (ENT in the healing process of pressure ulcers (PU in adults and the elderly. METHOD A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. RESULTS We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. CONCLUSION Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found.

  3. Interactions between drugs and drug-nutrient in enteral nutrition: a review based on evidences

    Directory of Open Access Journals (Sweden)

    Renata Ferreira Silva

    Full Text Available Introduction: Enteral nutrition (EN provides calories, macronutrients and micronutrients in adequate quantity and quality to meet the patient's needs. Some drugs when crushed and diluted may have their properties altered, including the reduction of bioavailability causing the reduction of the serum concentration of the drug; tube obstruction; drug-drug interaction or drug-nutrient interaction. Methods: The study was conducted through review of submitted articles in the databases of the Virtual Health Library (VHL: MEDLINE (National Library of Medicine, USA, Lilacs (Latin American and Caribbean Literature on Health Sciences PUBMED - NCBI (National Center for Biotechnology Information and COCHRANE. Results: For this survey, 42 articles were identified during database searching. After applying the inclusion and exclusion criteria, 08 articles were selected, obtained from the MEDLINE and Lilacs. Discussion: Some interactions were found such as the aluminium hydroxide and lactulose with the enteral nutrition, which may result in a precipitation and reduction of drug bioavailability. Mineral oil will alter the absorption of fat-soluble vitamins and reduces the tube light. Others results were found as phenytoin, warfarin, captopril and furosemide with enteral nutrition may reduce the maximum serum concentration. Conclusion: Drug interactions are more common in day-to-day activities than health professionals may suppose. Knowledge on the matter may also assist in reducing cases of obstruction of tubes, through which enteral nutrition and medications are administered. Thus, the multidisciplinary team, acting together, may have more beneficial effects to the patient.

  4. Enteral obeticholic acid promotes intestinal growth in total parenteral nutrition fed neonatal pigs

    Science.gov (United States)

    Intestinal atrophy is an adverse outcome associated with prolonged total parenteral nutrition (PN) partly due to disruption of normal enterohepatic circulation of bile acids. Previously we showed that enteral treatment with chenodeoxycholic acid (CDCA), a dual agonist for the nuclear receptor, farne...

  5. Supplementing monosodium glutamate to partial enteral nutrition slows gastric emptying in preterm pigs

    Science.gov (United States)

    Emerging evidence suggests that free glutamate may play a functional role in modulating gastroduodenal motor function. We hypothesized that supplementing monosodium glutamate (MSG) to partial enteral nutrition stimulates gastric emptying in preterm pigs. Ten-day-old preterm, parenterally fed pigs re...

  6. Food, Mechanic and Septic Complications in Patients Enterally Nutritioned in Home Conditions

    Directory of Open Access Journals (Sweden)

    Kalita Monika

    2015-02-01

    Full Text Available Home enteral nutrition (HEN for short allows practically normal living for patients who cannot be fed orally but at the same time do not have to stay in hospitals, which is often found to decrease their mental condition, increase of probability of complications and costs of medical treatment.

  7. Efficacy of enteral nutritional support after hospital discharge in major gastrointestinal surgery patients: a systematic review

    Science.gov (United States)

    Vidal Casariego, Alfonso; Calleja Fernández, Alicia; Villar Taibo, Rocío; Urioste Fondo, Ana; Pintor de la Maza, Begoña; Hernández Moreno, Ana; Cano Rodríguez, Isidoro; Ballesteros Pomar, María D

    2017-06-05

    Nutritional support for malnourished patients undergoing gastrointestinal surgery reduces the complication rate and shortens the length of stay. The efficacy of nutritional support after hospital discharge was analyzed in this systematic review. The search strategy (nutrition OR "enteral nutrition" OR "nutritional supplements" OR "oral nutritional supplements" OR "sip feed" OR "sip feeding" OR "dietary counseling") AND ("patient discharge" OR discharge OR postdischarge) AND (surgery OR operation OR "surgical procedure") was followed in Medline, CENTRAL, and Trip databases. Inclusion criteria comprised: type of study (randomized controlled trial), language (English, Spanish), and subjects (patients undergoing gastrointestinal surgery). The risk of bias was assessed by using the Cochrane methodology. Five studies which were published in six different articles and recruited 446 patients were included. A high risk of bias was detected for most of them. Nutritional support improved energy intake and protein intake when high-protein oral supplements were provided. The intervention was associated with better weight prognosis, but the data about body composition were inconsistent. In most of the trials, nutritional intervention did not enhance functional capacity or quality of life. None of the studies analyzed the effects on complications after discharge. Nutritional support provided at discharge may increase dietary intake and improve body weight, but the low quality of studies can weaken the validity of results.

  8. Home enteral nutrition in Spain; NADYA registry 2011-2012.

    Science.gov (United States)

    Wanden-Berghe, Carmina; Matía Martín, P; Luengo Pérez, L M; Cuerda Compes, C; Burgos Peláez, R; Alvarez Hernández, J; Calleja Fernández, A; Pérez de la Cruz, A; Gómez Candela, C; Leyes García, P; Laborda González, L; Martínez Olmos, M A; Campos Martín, C; Suárez Llanos, J P; Penacho Lázaro, M A; Gonzalo Marín, M; Salas Salvadó, J; Irles Rocamora, J A; Cánovas Gaillemin, B; Carrero Caballero, M C; Moreno Villares, J M; Garde Orbaiz, C; Miserachs Aranda, N; Del Olmo García, M D; Apezetxea Celaya, A; Mauri, S

    2014-06-01

    Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED) del grupo NADYASENPE de los años 2011 y 12. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero de 2011 al 31 de diciembre de 2012. Resultados: Hubo 3021 pacientes en el registro durante el periodo, procedentes de 29 hospitales, lo que da una prevalencia de 65,39 casos por millón de habitantes. 97.95% fueron adultos, 51,4% varones. La edad media fue 67,64 ± 19,1 años y la mediana 72 años para los adultos y 7 meses para los niños. La duración media de la NED fue 351 días y para el 97,5% fue el primer episodio con NED. La mayoría de pacientes tenían NED por una enfermedad neurológica (57,8%). La vía de acceso fue sonda nasogástrica para el 43,5% y gastrostomía para el 33,5%. La mayoría de pacientes tuvieron un nivel de actividad física limitado y, respecto a la autonomía, 54,8% necesitaba ayuda total. La fórmula de nutrición se suministró desde las oficinas de farmacia para el 73,8% y los fungibles, cuando fueron necesarios, desde los hospitales para el 53,8%. La NED se suspendió en 1.031 pacientes (34,1%) durante el periodo de estudio, 56,6% debido a fallecimiento y 22,2% debido a recuperación de la vía oral. Conclusiones: Los datos del registro NADYA-SENPE deben ser interpretados con precaución ya que se trata de un registro voluntario. A pesar del cambio de metodología del registro en 2010, las tendencias en NED se han mantenido, salvo la importancia cuantitativa de la vía oral.

  9. [Are Doctors familiar with enteral nutrition at home? Opinion poll in the province of Tarragona].

    Science.gov (United States)

    Bonada, A; Gómez-Gener, A; Boj, M; Salvador, P; Salas-Salvadó, J

    2003-01-01

    At our hospital, there is an At-Home Enteral Nutrition programme (NED in its Spanish acronym) with participation of the Clinical Nutrition Unit and the Pharmacy Service. The products and all necessary material are dispensed directly to the patient's home and nutritional follow-up is carried out. As a lack of information on various aspects of NED was detected among prescribing doctors, we decided to carry out a survey to assess the level of awareness and the opinion of doctors in the province of Tarragona with regard to NED. They were asked if they knew the indications and characteristics of the different enteral nutrition preparations, as well as their opinion on who should do the follow-up of the patients and on how dispensation should be organized. With the results obtained, we conclude that doctors rarely prescribe NED and are not familiar with the indications nor with enteral nutrition preparations (77.5% and 89%, respectively), although they are interested in the subject. They feel that dispensation should be done directly at the patient's home (43%) and that follow-up should be through a specialized team (57.6%).

  10. Hallmarks in the history of enteral and parenteral nutrition: from antiquity to the 20th century.

    Science.gov (United States)

    Vassilyadi, Frank; Panteliadou, Alkistis-Kira; Panteliadis, Christos

    2013-04-01

    Parenteral nutrition (PN) and enteral nutrition (EN) have a very long history, emerging in the ancient world and developing throughout the common epoch. This history dates back as far as 3500 bc to the ancient Egyptians, Indians, and Chinese. Their medical practices were the first reports of enteral feeding therapy, provided via rectum with enemas of wine, milk, whey, wheat, and barley. Hippocrates and Plato, in ancient Greece, were the first personalities to emphasize the importance of diet on health. In the following centuries, Erasistratus and Herophilus described the first notion of the circulatory system, and Oribasius and Celsus described the role of nutrition and disease. There is a great historical gap between the times of Galen (2nd century), who elaborated on the circulatory system; Ibn Zuhr (12th century), who constructed the first model of PN; and Capivacceus (16th century), who placed the first tube for EN. The 17th-19th centuries showed major developments in modern nutrition elements. Steps toward artificial nutrition began in 1628 with the detailed description of blood circulation by William Harvey; however, most of the advances in enteral and parenteral feeding techniques, solutions, and formulas took place in the 20th century. Over the last decade of the 20th century, research focused on metabolic control, multitude formulas, timing and the combination of EN and PN for intensive care patients.

  11. Current status of pediatric home enteral nutrition in Spain: the importance of the NEPAD register.

    Science.gov (United States)

    Gómez-López, L; Martínez-Costa, C; Pedrón-Giner, C; Calderón-Garrido, C; Navas López, V M; Martínez Zazo, A; Moreno Villares, J M

    2010-01-01

    Home enteral nutrition (HEN) is a type of enteral nutrition (EN) which is becoming progressively more widespread in pediatrics due to the benefits it affords to patients, their families and to reducing hospital costs. However, the true extent of its use is unknown in Spain as the data-base set up for this purpose is still underused (Registro de Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria -NEPAD-). More thorough registration of patients in the NEPAD online register will provide information about the characteristics of HEN in Spain: prevalence, diagnosis, the population sector being administered HEN, complications and developments. Likewise, forecast and planning of the necessary resources could be made while those in use could be analysed.

  12. [Evaluation of the cost of home enteral nutrition in relation to different access routes].

    Science.gov (United States)

    Castillo Rabaneda, R M; Gómez Candela, C; de Cos Blanco, A I; González Fernández, B; Iglesias Rosado, C

    1998-01-01

    When home enteral nutrition is needed, there is still, despite the undisputed increase in the quality of life that can be achieved with a Percutaneous Endoscopic Gastrostomy (PEG), a reservation in its use because this technique and its maintenance is considered to be very costly. We aim to assess the true cost of home enteral nutrition using the oral route, a nasogastric tube, and PEG. The data of 65 patients who required home enteral nutrition during 1996, were analyzed retrospectively. The access route was a nasogastric tube in 20 cases, 18 patients had PEG, and 27 candidates used an oral route. The average age was 56 years. 50% were men and 50% were women. The most common diagnoses that led to the indication were oropharyngeal-maxillofacial neoplasms and neurological disorders. In all cases the material and formula used was assessed, as were the associated complications and the cost of the at home enteral nutrition. The average duration of the treatment was 175 +/- 128 days, and this was similar in all three groups. The average formula/day cost was slightly higher in the patients using the oral access route. The average total day cost and the average material/day cost was slightly higher in patients with a PEG. Patients with a PEG presented fewer complications than those with a nasogastric tube. The cost derived from possible complications must be higher in the nasogastric tube group, especially considering the repeated tube changes due to obstruction or loss. The cost of home enteral nutrition is slightly lower if one uses a nasogastric tube. The greater incidence of complications that were mild but required a tube change, in this case a nasogastric tube, suggests higher indirect costs. The oral route is associated with the need for special formulae that are more expensive.

  13. Postpyloric enteral nutrition in the critically ill child with shock: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Bustinza Amaya

    2008-01-01

    Full Text Available Abstract Background Tolerance to enteral nutrition in the critically ill child with shock has not been studied. The purpose of the study was to analyze the characteristics of enteral nutrition and its tolerance in the critically ill child with shock and to compare this with non-shocked patients. Methods A prospective, observational study was performed including critically ill children with shock who received postpyloric enteral nutrition (PEN. The type of nutrition used, its duration, tolerance, and gastrointestinal complications were assessed. The 65 children with shock who received PEN were compared with 461 non-shocked critically ill children who received PEN. Results Sixty-five critically ill children with shock, aged between 21 days and 22 years, received PEN. 75.4% of patients with shock received PEN exclusively. The mean duration of the PEN was 25.2 days and the maximum calorie intake was 79.4 kcal/kg/day. Twenty patients with shock (30.7% presented gastrointestinal complications, 10 (15.4% abdominal distension and/or excessive gastric residue, 13 (20% diarrhoea, 1 necrotising enterocolitis, and 1 duodenal perforation due to the postpyloric tube. The frequency of gastrointestinal complications was significantly higher than in the other 461 critically ill children (9.1%. PEN was suspended due to gastrointestinal complications in 6 patients with shock (9.2%. There were 18 deaths among the patients with shock and PEN (27.7%. In only one patient was the death related to complications of the nutrition. Conclusion Although most critically ill children with shock can tolerate postpyloric enteral nutrition, the incidence of gastrointestinal complications is higher in this group of patients than in other critically ill children.

  14. Influence of postoperative enteral nutrition on cellular immunity. A random double-blinded placebo controlled clinical trial

    DEFF Research Database (Denmark)

    Beier-Holgersen, R; Brandstrup, B

    2012-01-01

    The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive "water".......The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive "water"....

  15. Enteral nutrition therapy for critically ill adult patients; critical review and algorithm creation.

    Science.gov (United States)

    Araújo-Junqueira, L; De-Souza, Daurea A

    2012-01-01

    Undernutrition directly affects critically ill patient's clinical outcome and mortality rates. Interdisciplinar algorithm creation aiming to optimize the enteral nutrition therapy for critically ill adult patients. Pubmed, SciELO, Scholar Google, Web of Science, Scopus, with research of these key words: protocols, enteral nutrition, nutritional support, critical care, undernutrition, fasting. Intensive Care Unit, Hospital de Clínicas, Federal University of Uberlándia, MG, Brazil. Were established in the algorithm a following sequential steps: After a clinical-surgical diagnosis, including the assessment of hemodynamic stability, were requested passage of a feeding tube in post-pyloric position and a drainage tube in gastric position. After hemodynamic stability it should be done the nutritional status diagnosis, calculated nutritional requirements, as well as chosen formulation of enteral feeding. Unless contraindicated, aiming to increase tolerance was started infusion with small volumes (15 ml/h) of a semi-elemental diet, normocaloric, hypolipidic (also hyperproteic, with addition of glutamine). To ensure infusion of the diet, as well as the progressive increase of infusion rates, the patient was monitored for moderate or severe intestinal intolerance. The schedule and infusion rates were respected and diet was not routinely suspended for procedures and diagnostic tests, unless indicated by the medical team. For nutrition therapy success it is essential routine monitoring and extensive interaction between the professionals involved. Nutritional conducts should be reevaluated and improved, seeking complete and specialized care to the critically ill patients. Adherence to new practices is challenging, though instruments such as protocols and algorithms help making information more accessible and comprehensible.

  16. Nutritional status and adequacy of enteral nutrition in pediatric cancer patients at a reference center in northeastern Brazil.

    Science.gov (United States)

    Maciel Barbosa, J; Pedrosa, F; Coelho Cabral, P

    2012-01-01

    Individualized nutritional support is important to pediatric cancer patients and should be integrated to the overall treatment of these patients. Analyze the nutritional status of cancer patients submitted to enteral nutrition (EN) and assess the adequacy of this form of nutrition. A case series study was carried out at the Pediatric Oncology Unit of the Institute of Integrative Medicine Professor Fernando Figueira (IMIP, Brazil, Recife-PE) between January and December 2009. Clinical and anthropometric data were obtained from medical charts and nutritional follow-up charts. Z scores for height for age, weight for age and body mass index for age indicators (H/A, W/A and BMI/A, respectively) were calculated using the AnthroPlus program. Caloric and protein requirements were calculated based on the recommendations of the Brazilian National Council of Oncologic Nutrition. At the beginning of EN, 32.4% of the sample had short stature and 23.9% were underweight based on the BMI/A indicator. The assessment of EN adequacy demonstrated that 49.3% reached the caloric requirements and 76.1% reached the protein requirements, with maximal intakes of 65.6 Kcal/Kg/day and 1.95 g of protein/kg/day. Malnourished patients had greater mean Z scores for W/A and BMI/A at the end of EN, whereas no significant changes were found among patients with adequate nutritional status and significant reductions in these indicators were found among those with overweight or obesity. The patients either maintained or achieved a significant improvement in nutritional status, which demonstrates the importance of nutritional support and follow up during hospitalization.

  17. [Percutaneous endoscopic gastrostomy and gastrojejunostomy. Experience and its role in domiciliary enteral nutrition].

    Science.gov (United States)

    Pereira, J L; Velloso, A; Parejo, J; Serrano, P; Fraile, J; Garrido, M; Pizarro, A; Romero, H; García-Luna, P P

    1998-01-01

    Percutaneous Endoscopic Gastrostomy (PEG) and its variation Percutaneous Endoscopic Gastrojejunostomy (PEGJ), has become the method of choice to achieve an enteral access route in patients who require long term enteral nutrition, especially in the area of the At Home Enteral Nutrition (AHEN). We present our experience on the first PEG's and PEGJ's carried out in our hospital. We studied 48 patients (14 women and 34 men) in whom a PEG/Percutaneous Endoscopic Gastrojejunostomy (PEGJ) was indicated, as they required enteral nutrition for prolonged periods of time (> 4 weeks) and/or they presented obstructive dysphagia, neuromotor dysphagia, or incorrigible vomiting in the two cases in whom PEGJ was carried out. 34 patients underwent the Ponsky-Gauderer technique, 6 patients underwent the Sacks-Vine technique, and 2 patients underwent a PEGJ. 24 hours after the PEGJ enteral nutrition (EN) was begun in a progressive manner. During the hospitalization period there was a daily follow up of the patient. In those cases in which At Home Enteral Nutrition was programmed, the patients/families were trained in the techniques and the care of the PEG and the EN, and the control was carried out through the Nutrition out patient department. PEG was successfully carried out in 42 patients (88%). 35 patients had previously been given EN through a naso-gastric tube (NGT), while in 7 cases the PEG was the first enteral access route. The average duration of the PEG was 212 days, and 27 patients (64%) needed the PEG for more than 3 months. The mean caloric supply was 1921 +/- 200 kcal/day. The mode of administration was by means of an intermittent infusion by gravity in 31 cases, and by continuous infusion using a volumetric pump in 11 patients. Two patients with pregnancy induced hyperemesis underwent a PEGJ in the 3rd and the 4th month of pregnancy, with the pregnancy being successfully brought to term and ending in vaginal deliveries. Carrying out a PEG permitted release from hospital

  18. [Critical analysis of the evolution of commercial preparations for enteral nutrition during 1988-1996].

    Science.gov (United States)

    Hillman, N; del Olmo, D; Koning, A; Martínez de Icaya, P; de Juana, P; Vázquez, C

    1999-01-01

    Enteral nutrition is a form of nutritional support that is continually growing and expanding, and within this area especially the enteral preparations or formulae. The object of the present is to analyze the evolution of the commercially available nutritionally complete enteral preparations between 1988 and 1997, illustrating the variations that have occurred both from the quantitative and form the qualitative points of view. A progressive increase is seen in the absolute number of available enteral formulae, with the increase in both polymeric formulae with dietary fiber, and that of formulae designed for specific diseases being significant (p < 0.05). The standard polymeric formulae and the oligomeric formulae decrease, but not in a significant manner. There is a special discussion or the characteristic and the usefulness of the polymeric formulae with dietary fiber ad the formulae designed especially for specific diseases. The clinical efficacy of most of these special formulae is controversial, with there not being sufficient objective clinical evidence at present that justifies their routine use.

  19. Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients

    Directory of Open Access Journals (Sweden)

    Portanova Michel

    2010-08-01

    Full Text Available Abstract Background Esophagojejunal fistula is a serious complication after total gastrectomy in gastric cancer patients. This study describes the successful conservative management in 3 gastric cancer patients with esophagojejunal fistula after total gastrectomy using total enteral nutrition. Methods Between January 2004 to December 2008, 588 consecutive patients with a proven diagnosis of gastric cancer were taken to the operation room to try a curative treatment. Of these, 173 underwent total gastrectomy, 9 of them had esophagojejunal fistula (5.2%. In three selected patients a trans-anastomotic naso-enteral feeding tube was placed under fluoroscopic vision when the fistula was clinically detected and a complete polymeric enteral formula was used. Results The complete closing of the esophagojejunal fistula was obtained in day 8, 14 and 25 respectively. Conclusion In some selected cases it is possible to make a successful enteral nutrition using a feeding tube distal to the leak area inserted with the help of fluoroscopic vision. The specialized management of a gastric surgery unit and nutritional therapy unit are highlighted.

  20. [Safety and efficacy of enteral nutritional suspension (TPF-FOS) JEVITY in acute stroke].

    Science.gov (United States)

    Peng, Bin; Su, Ying-ying; Cui, Li-ying; Wang, Shao-shi; Guan, Yang-tai; Zhou, Dong; Zhao, He-qing

    2011-10-11

    To evaluate the safety and efficacy of enteral nutritional suspension (TPF-FOS) JEVITY in acute stroke patients. A multicenter, prospective, post-marketing observational study was conducted. A total of 103 acute stroke patients with dysphagia received a 10-day regimen of enteral nutritional suspension (TPF-FOS) JEVITY via nasal gastric tube feeding. The parameters of serum prealbumin, serum albumin and percentage of abnormal blood glucose were evaluated and compared. The incidence of adverse events was recorded. The data were analyzed by paired t-test. At the end of the study in comparison with the baselines, the serum prealbumin increased significantly (213 mg/L ± 56 mg/L vs 219 mg/L ± 66 mg/L) and serum albumin decreased markedly (38 g/L ± 5 g/L vs 36 g/L ± 5 g/L) but stayed stable during tube feeding. No significant changes were found in percentage of abnormal blood glucose (40.78% vs 38.76%), body mass index (23.1 kg/m(2) ± 3.0 kg/m(2) vs 22.8 kg/m(2) ± 2.9 kg/m(2)) and C-reactive protein (13 mg vs 14 mg). Only 18 adverse events were related with the study product. And most of them were gastrointestinal reactions. Enteral nutritional suspension (TPF-FOS) JEVITY may increase the level of serum prealbumin in acute stroke patients and improve the patient nutritional status. With a low incidence of adverse events, it is a preferred option for enteral nutrition formulas in stroke.

  1. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

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    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  2. Levodopa Withdrawal Presenting as Fever in a Critically Ill Patient Receiving Concomitant Enteral Nutrition.

    Science.gov (United States)

    Whitman, Craig B; Ablordeppey, Enyo; Taylor, Beth

    2016-12-01

    Nutritional protein may decrease levodopa absorption and has resulted in withdrawal and neuroleptic malignant-like syndromes in critically ill patients. A 72-year-old male was admitted with shortness of breath. His medical history included Parkinson's disease for over 30 years for which he took carbidopa/levodopa 5 times daily. The patient's home medications were continued. On day 2, he was intubated and transferred to the intensive care unit (ICU). He was extubated the next day and reintubated on day 4. Enteral nutrition was initiated at 85 mL/h overnight. The patient's carbidopa/levodopa was administered to limit coadministration with nutrition. Throughout his ICU stay, the patient did not demonstrate changes in mental status. Despite resolution of his pneumonia, he developed fever after administration of one dose overlapping with nutrition, with defervescence throughout the rest of the day. On hospital day 10, that dose was empirically increased. After this dosing change, the patient failed to develop fever during the rest of his hospital stay. On day 16, the patient was discharged to a long-term care facility without any other complications. Our case highlights the interaction between levodopa and enteral nutrition and the potential of fever as the sole sign of withdrawal.

  3. Utilización clínica de la Nutrición Enteral Clinical use of Enteral Nutrition

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    J. Álvarez Hernández

    2006-05-01

    Full Text Available La Nutrición Enteral es una de las disciplinas más desarrolladas en la medicina moderna. Los avances tecnológicos, el mejor conocimiento de la fisiopatología de la desnutrición, y su participación en la evolución de diferentes entidades clínicas han hecho posible mejorar el cuidado nutricional de nuestros pacientes. La utilización de la NE se ha extendido como una práctica de primera elección en pacientes desnutridos o en riesgo de desnutrición que tienen un intestino minimamente funcionante y no son capaces de cubrir con la alimentación natural o suplementación, el total de sus requerimientos calórico-proteicos. Términos como "alimento-medicamento" o "nutrición órgano o sistema-específica o nutrición patología-específica" han revolucionado el campo de la NE en los últimos 20 años con la eclosión de fórmulas específicamente definidas .La NE ha demostrado ser coste-efectiva en los pacientes desnutridos cuando se establece la indicación con precocidad. La Nutrición Artificial Domiciliaria y Ambulatoria es una técnica regulada administrativamente muy extendida en nuestro país que permite reducir el coste de algunos procesos. En ocasiones la utilización o la retirada de la NE puede constituir una situación de conflicto ético que debe ser evitado desde el respeto, el acompañamiento y la información compartida entre el equipo sanitario, los pacientes y sus sustitutos.Enteral Nutrition is among the most developed disciplines in modern Medicine. Technological advances, a better knowledge of malnutrition physiopathology and its involvement in the evolution of several clinical entities have made it possible to improve the nutritional attention paid to our patients. The use of EN has expanded as a first choice practice in patients with undernutrition or at risk of undernutrition that have a minimally functional intestine and are unable to cover their total calorie and protein requirements with natural or supplemented

  4. Australasian Society for Parenteral and Enteral Nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition

    National Research Council Canada - National Science Library

    Osland, Emma J; Ali, Azmat; Nguyen, Truc; Davis, Melvyn; Gillanders, Lyn

    2016-01-01

    Background and Objectives: This work represents the second part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in adult patients receiving parenteral nutrition...

  5. Nutritional status of refugee children entering DeKalb County, Georgia.

    Science.gov (United States)

    Shah, Ankoor Y; Suchdev, Parminder S; Mitchell, Tarissa; Shetty, Sharmila; Warner, Catherine; Oladele, Alawode; Reines, Susan

    2014-10-01

    This study determines the nutritional status among refugee children entering one of the largest resettlement counties in the United States and identifies differences between incoming populations. Medical records of all newly arriving pediatric refugees (0-18 years) entering DeKalb County, Georgia between October 2010 and July 2011 were reviewed. Refugee children were grouped as African, Bhutanese, or Burmese (resettling from either Thailand or Malaysia) for comparative analysis. Approximately one in five refugees were anemic or malnourished, while a quarter had stool parasites, and nearly half had dental caries. African refugees had the highest anemia but the lowest underweight prevalence (p Malaysia, Burmese children from Thailand had a higher prevalence of anemia, underweight, and stool parasites (p refugees, as well as ensure proper nutritional support and follow-up care.

  6. Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients

    OpenAIRE

    Portanova Michel

    2010-01-01

    Abstract Background Esophagojejunal fistula is a serious complication after total gastrectomy in gastric cancer patients. This study describes the successful conservative management in 3 gastric cancer patients with esophagojejunal fistula after total gastrectomy using total enteral nutrition. Methods Between January 2004 to December 2008, 588 consecutive patients with a proven diagnosis of gastric cancer were taken to the operation room to try a curative treatment. Of these, 173 underwent to...

  7. Early enteral and parenteral nutrition on immune functions of neurocritically ill patients.

    Science.gov (United States)

    Qi, S Y; Wang, W T; Chen, C Y; Chu, Z D; Liu, X J; Liu, X J

    2016-01-01

    This study was designed to investigate the influence of early enteral and parenteral nutrition on immune functions of neurocritically ill patients. Patients who were admitted to the neurological intensive care unit (ICU) of The Second Affiliated Hospital of Zhengzhou University between May 2014 and January 2016 were selected. They had been hospitalized for more than one week and received enteral nutrition (EN) via nasogastric tube, with a gross energy of 25 kcal/(Kg • d). Patients were divided into EN group, EN + early PN (EPN) group and EN + supplemental PN (SPN) group according to the time of PN support. Differences in patients’ general information and changes in serum protein and immune indexes were compared between the three groups. On admission, patients’ Glasgow coma scale (GCS), age, immune functions and protein indexes had no obvious differences between the three groups. After nutritional support, serum protein level reduced in the EN group while prealbumin (PALB) and retinol binding protein (RBP) increased in the EN + EPN group and EN + SPN group after one week of admission to hospital, and the differences were statistically significant (p less than 0.05). Total protein (TP), albumin (ALB), PALB and transferrin (TRF) increased significantly in the EN + EPN group and EN + SPN group compared with the EN group (p total lymphocyte count (TLC), and the difference had a statistical significance (p less than 0.05). These results demonstrate that neurocritically ill patients achieving the target energy can avoid malnutrition and immunodeficiency; serum protein decrease can cause malnutrition after one week of EN support; and enteral and parenteral nutrition can improve nutritional and immune indicators of neurocritically ill patients in the acute phase. In addition, EPN is more likely to improve malnutrition and immune functions of critical patients than SPN.

  8. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vasileios Alivizatos

    2015-04-01

    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  9. Postoperative nutritional effects of early enteral feeding compared with total parental nutrition in pancreaticoduodectomy patients: a prosepective, randomized study.

    Science.gov (United States)

    Park, Joon Seong; Chung, Hye-Kyung; Hwang, Ho Kyoung; Kim, Jae Keun; Yoon, Dong Sup

    2012-03-01

    The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.

  10. Tolerance and efficacy of nasogastric enteral nutrition for severe acute pancreatitis: a metaanalysis

    Directory of Open Access Journals (Sweden)

    Shu-fen FENG

    2013-02-01

    Full Text Available Objective  To evaluate the tolerance and efficacy of nasogastric enteral nutrition (NGEN in the treatment of severe acute pancreatitis (SAP. Methods  PUBMED, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2011 (up to October and Chinese Journals Full-text Database (CNKI, Database for Chinese Technical Periodicals (VIP and Wanfang Digital Journal Full-text Database from 1978 to 2011 (up to October were retrieved to collect clinical randomized controlled trials of NGEN to compare with nasojejunal enteral nutrition (NJEN in the treatment of SAP. Two reviewers independently screened the literature for eligibility and evaluated the quality with confirmation of cross-check. Different opinions would be decided by the third party. Statistical analysis was performed by meta-analysis using Review Manager 4.2. Results  Three randomized controlled trails including 159 patients with SAP met the inclusion criteria, involving 82 patients in NGEN group and 77 in NJEN group. There was no significant difference between NGEN and NJEN group in the risk of mortality of SAP (RR=0.69, 95%CI: 0.37-1.29, P=0.25, conversion to surgery (RR=2.09, 95% CI: 0.55-7.92, P=0.28, diarrhea subsequent to enteral nutrition (RR=1.43, 95% CI: 0.59-3.45, P=0.43, rate of tube displacement (RR=0.42, 95%CI: 0.08-2.17, P=0.30 and pain related with enteral nutrition (RR=0.94, 95%CI: 0.32-2.70, P=0.90. While compared with NJEN, the risk of infectious complications was lower than NGEN (RR=0.64, 95%CI: 0.42-0.99, P=0.04. Conclusion  In enteral nutrition support of SAP, NGEN is comparable to NJEN in efficacy and tolerance, but the former has the lower rate of infectious complications and easier to operate, and there is a tendency of NEGN to replace the latter.

  11. Nutrient intake and contribution of home enteral nutrition to meeting nutritional requirements after oesophagectomy and total gastrectomy.

    Science.gov (United States)

    Baker, M L; Halliday, V; Robinson, P; Smith, K; Bowrey, D J

    2017-06-28

    This study evaluated nutrition after oesophago-gastric resection and the influence of home jejunostomy feeding in the six months after surgery. Data on nutritional intake and physiologic measures were collected as part of a randomised trial with measurements taken before and up to six months after surgery. A total of 41 participants (32 oesophagectomy, 9 total gastrectomy) received home jejunostomy feeding (n=18) or usual care without feeding (n=23). At hospital discharge, oral intakes were adequate for energy and protein in 9% and 6%, respectively. By three and six months, these values had increased to 61% and 55%, 94% and 77% respectively. Six participants (26%) who received usual care required rescue feeding. Six weeks after hospital discharge, energy intakes were met in those who received jejunal feeding because of the contribution of enteral nutrition. Jejunal feeding did not affect oral intake, being similar in both groups (fed: 77% estimated need, usual care: 79%). At three months, inadequate micronutrient intakes were seen in over one third. Compared to baseline values, six weeks after surgery, weight loss exceeding 5% was seen in 5/18 (28%) who received feeding, 14/17 (82%) who received usual care and 5/6 (83%) of those who required rescue feeding, P=0.002. Weight loss averaged 4.1% (fed), 10.4% (usual care) and 9.2% (rescue fed), P=0.004. These trends persisted out to six months. Supplementary jejunostomy feeding made an important contribution to meeting nutrition after oesophago-gastric resection. Importantly, oral nutritional intake was not compromised dispelling the assertion that jejunal feeding deincentivises patients from eating.European Journal of Clinical Nutrition advance online publication, 28 June 2017; doi:10.1038/ejcn.2017.88.

  12. Enteral nutrition in critical patients; should the administration be continuous or intermittent?

    Science.gov (United States)

    Tavares de Araujo, Viviane Maeve; Gomes, Paulo César; Caporossi, Cervantes

    2014-03-01

    Enteral nutrition therapy (ENT) is an essential part in the management of critically ill patients, having a significant impact on these patients' clinical results. It can be administered on a continuous or intermittent basis using an infusion pump. There is a discussion on which of these techniques has the best performance, involving a number of factors such as nausea, diarrhea, and particularly the relationship between diet volume and the ratio of programed calories to calories effectively supplied to the critical patients. To compare the forms of continuous or intermittent infusion of enteral nutrition, using as primary outcome the level of estimated caloric needs daily supplied. Observational prospective randomized clinical study carried out in an intensive care unit on 41 patients divided into two groups, of intermittent (ENT during 18 hours with a 6-hour nocturnal pause), or continuous (ENT during 24 hours continuously) administration. The secondary outcome variables measured in this study were bowel evacuation, distension, emesis, with the primary outcome variable being the relationship between infusion volume and the estimated-to-supplied ratio of caloric needs. The rejection index of the null hypothesis was established at 5% for all the tests. Most of the patients received more than 60% infusion of enteral diet over the 5 days of study (p = 1.0), with no difference regarding the provision of caloric needs. No statistically significant difference between groups was found in the variables vomiting, abdominal distension or diarrhea. The administration modalities of continuous or intermittent enteral nutrition are similar in which regards the comparison of the variables included in this study. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. Enteral nutrition in critical patients: should the administration be continuous or intermittent?

    Directory of Open Access Journals (Sweden)

    Viviane Maeve Tavares de Araujo

    2014-03-01

    Full Text Available Enteral nutrition therapy (ENT is an essential part in the management of critically ill patients, having a significant impact on these patients´ clinical results. It can be administered on a continuous or intermittent basis using an infusion pump. There is a discussion on which of these techniques has the best performance, involving a number of factors such as nausea, diarrhea, and particularly the relationship between diet volume and the ratio of programed calories to calories effectively supplied to the critical patients. Objectives: To compare the forms of continuous or intermittent infusion of enteral nutrition, using as primary outcome the level of estimated caloric needs daily supplied. Methods: Observational prospective randomized clinical study carried out in an intensive care unit on 41 patients divided into two groups, of intermittent (ENT during 18 hours with a 6-hour nocturnal pause, or continuous (ENT during 24 hours continuously administration. The secondary outcome variables measured in this study were bowel evacuation, distension, emesis, with the primary outcome variable being the relationship between infusion volume and the estimated-to-supplied ratio of caloric needs. The rejection index of the null hypothesis was established at 5% for all the tests. Results: Most of the patients received more than 60% infusion of enteral diet over the 5 days of study (p = 1.0, with no difference regarding the provision of caloric needs. No statistically significant difference between groups was found in the variables vomiting, abdominal distension or diarrhea. Conclusion: The administration modalities of continuous or intermittent enteral nutrition are similar in which regards the comparison of the variables included in this study.

  14. The influence of Enteral Nutrition in postoperative patients with poor liver function

    Institute of Scientific and Technical Information of China (English)

    Qing-Gang Hu; Qi-Chang Zheng

    2003-01-01

    AIM: To investigate the safety, rationality and the practicality of enteral nutritional (EN) support in the postoperative patients with damaged liver function and the protective effect of EN on the gut barrier.METHODS: 135 patients with liver function of Child B or C grade were randomly allocated to enteral nutrition group (EN, 65 cases), total parenteral nutrition group (TPN, 40cases) and control group (CON, 30 cases). Nutritional parameters, hepatic and kidney function indexes were measured at the day before operation, 5th and 10th day after the operation respectively. Comparison was made to evaluate the efficacy of different nutritional support. Urinary concentrations of lactulose(L) and mannitol(M) were measured by pulsed electrochemical detection(HPLC-PED)and the L/M ratio calculated to evaluate their effectiveness on protection of gut barrier.RESULTS: No significant damages in hepatic and kidney function were observed in both EN and TPN groups between pre- and postoperatively. EN group was the earliest one reaching the positive nitrogen balance after operation and with the lowest loss of body weight and there was no change in L/M ratio after the operation (0.026±0.004) at the day 1before operation, 0.030±0.004 at the day 5 postoperative and 0.027±0.005 at the day 10 postoperative), but the change in TPN group was significant at the day 5postoperative (0.027±0.003 vs 0.038±0.009,P<0.01).CONCLUSION: EN is a rational and effective method in patients with hepatic dysfunction after operation and has significant protection effect on the gut barrier.

  15. Effect of parenteral and enteral nutrition combined with octreotide on pancreatic exocrine secretion of patients with pancreatic fistula

    Institute of Scientific and Technical Information of China (English)

    Huan-Long Qin; Zhen-Dong Su; Yang Zou; You-Ben Fan

    2004-01-01

    AIM: To evaluate the effect of parenteral and enteral nutrition combined with octreotide on pancreatic exocrine secretion of the patients with pancreatic fistula.METHODS: Pancreatic juice, drained directly from the pancreatic fistula, was collected, and the volume, protein,amylase, HCO3-, K+, Na+ and Cl- were determined on d 1, 4and 7 before and after 7-d treatment with octreotide,respectively.RESULTS: No differences in exocrine pancreatic secretion were observed during the enteral and parenteral nutrition period (t = 2.03, P>0.05); there were significant decreases in pancreatic juice secretion volume, protein, amylase,HCO3-, K+, Na+ and Cl- after parenteral and enteral nutrition combined with octreotide compared with octreotide pretreatment (t = 4.14, P<0.05).CONCLUSION: There is no stimulatory effect on the pancreatic secretion by intrajejunal nutrition and parenteral nutrition. Octreotide is effective on the reduction of pancreatic fistula output.

  16. Effect of glutamine with auxiliary enteral and parenteral nutrition on feeding intolerance of low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Cai; Chun-Hong Chen; Yan-Fang Li

    2016-01-01

    Objective:To analyze the clinical effects of glutamine assisted enteral nutrition and parenteral nutrition on improving the feeding intolerance of low birth weight infants.Methods: A total of 40 cases of low birth weight infants (LBW) in our hospital from May 2013 to June 2015 were selected, which were divided equally into the observation group and the control group according to the different nutritional intervention methods. Patients in the control group received routine enteral nutrition and parenteral nutrition while children of observed group received glutamine assisted enteral and parenteral nutrition. Differences of children’s growth and development indicators, nutritional status and levels of calcium and phosphorus, gastrin and motilin levels, mucosal barrier and immune function were compared between two groups. Results:After receiving nutritional intervention, children in the observation group had higher levels of serum leptin, GH, IGF-I and adiponectin than the control group patients, while Cor values were lower. The observation group patients who received nutritional intervention had higher TSF, AMC, TP, ALB, calcium and phosphorus levels than the control group, while the ALP values were lower; children of observation group who received nutrition intervention had higher GAS and MOT levels than the control group; children of observation group after intervention had higher peripheral blood CD3+T, CD4+T and CD4+/CD8+ levels than the control group children, while D-lactic acid and blood ammonia levels were lower.Conclusion:Glutamine assisted enteral nutrition and parenteral nutrition could improve the feeding intolerance of low birth weight infants, and it improved the nutritional status as well as growth and development of children as a whole, and thus had positive clinical significance.

  17. Enteral feeding induces diet-dependent mucosal dysfunction, bacterial proliferation, and necrotizing enterocolitis in preterm pigs on parenteral nutrition

    DEFF Research Database (Denmark)

    Bjørnvad, Charlotte R.; Thymann, Thomas; Deutz, Nicolaas E.

    2008-01-01

    Preterm neonates have an immature gut and metabolism and may benefit from total parenteral nutrition (TPN) before enteral food is introduced. Conversely,delayed enteral feeding may inhibit gut maturation and sensitize to necrotizing enterocolitis (NEC). Intestinal mass and NEC lesions were first...

  18. [Nutrients and energy intake assessment in the critically ill patient on enteral nutritional therapy].

    Science.gov (United States)

    Abilés, J; Lobo, G; Pérez de la Cruz, A; Rodríguez, M; Aguayo, E; Cobo, M A; Moreno-Torres, R; Aranda, A; Llopis, J; Sánchez, C; Planells, E

    2005-01-01

    The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de las Nieves Hospital were studied from January to December of 2003, aged more than 18 years, and on enteral nutrition. A total of 90 patients (52 men and 38 women) were studied, 81% of which were older than 50 years, and 57% had hospital stays longer than 8 days, with a 21% mortality rate. Intake was assessed from time of admission and throughout the whole hospitalization period. Energetic requirements were calculated according to the modified Long's formula and micronutrients intakes were compared to existing general recommendations for the Spanish, European and American populations, and to vitaminic requirements in critically ill patients. Percentages of mean energy and nutrients intakes in relation to theoretical calculated requirements for both genders are presented in figure 1. Mean energy intake was 1,326 cal in men and 917 cal in women. With regards to micronutrients intake, the values found for proteins, falts, and carbohydrates were lower than 50% of the requirements for both genders. The percentage of adequacy as referred to requirements for vitamins and minerals intake is shown in figure 2. Reference recommendations used correspond to sufficient intakes to cover the healthy individual requirements, therefore, the values obtained in our study show and adequacy greater than 75%, with the exception of particular elements such as vitamin A and magnesium

  19. Acute respiratory failure due to refeeding syndrome and hypophosphatemia induced by hypocaloric enteral nutrition.

    Science.gov (United States)

    Patel, Utpal; Sriram, Krishnan

    2009-03-01

    We report a case of acute respiratory failure due to refeeding syndrome caused by hypocaloric enteral tube feeds. A 60-y-old obese man, with a diagnosis of esophageal carcinoma with local metastases, underwent feeding jejunostomy tube insertion. Enteral tube feeding was initiated at small volumes providing 4.4 kcal x kg(-1) x d(-1) and gradually increased over 48 h to 29 kcal x kg(-1) x d(-1) (based on adjusted body weight). The patient then developed acute respiratory distress requiring intubation and ventilatory support. Serum phosphorus (P) level was extremely low at 4 d to adequately correct the electrolyte derangements. Successful liberation from mechanical ventilation was then possible. In chronically malnourished patients undergoing nutritional support, even hypocaloric feeding should be considered a risk factor for developing refeeding syndrome leading to severe and acute electrolyte fluid-balance and metabolic abnormalities.

  20. Nursing intervention bundle for enteral nutrition in intensive care: a collective construction

    Directory of Open Access Journals (Sweden)

    Aline Daiane Colaço

    2014-10-01

    Full Text Available Objective The collective construction of a nursing intervention bundle for patients in critical care in the hospital receiving enteral nutrition therapy, supported by evidence-based practice. Method A qualitative convergent-care study with 24 nursing professionals in an intensive care unit of a public hospital in Santa Catarina. Data collection was performed from May to August 2013, with semi-structured interviews and discussion groups. Results Four interventions emerged that constituted the bundle: bedside pH monitoring to confirm the position of the tube; stabilization of the tube; enteric position of the tube; and maintaining the head of the bed elevated at 30° to 45°.
 Conclusion The interventions chosen neither required additional professional workload nor extra charges to the institution, which are identified as improving the adoption of the bundle by nursing professionals at the ICU.

  1. [Loco-regional chemotherapy at the outpatient clinic for gastric cancer patients with home enteral nutrition].

    Science.gov (United States)

    Maruyama, Michio; Nagahama, Takeshi; Sugano, Norihide; Satoh, Eigo; Maruyama, Shouji; Tanami, Hideo; Chiba, Tetsuma; Murakata, Ayano; Mitsuhashi, Yosuke; Uehira, Daisuke; Akazawa, Naoya; Suzuki, Keiichirou

    2011-11-01

    In over the 10 years from 2000-2010, 21 gastric cancer patients received loco-regional chemotherapy with home enteral nutrition (HEN) at an outpatient clinic because of insufficient oral intake. These loco-regional chemotherapy regimens consisted of 5 intra-aortic chemotherapies, 4 hepato-arterial infusions and 12 intra-peritoneal chemotherapies. Five out of 8 cases that had measurable lesions showed PR, and 3 cases revealed PD. The patients received HEN with peptide central formula, 400-1,200 kcal/day in night time. The average duration of HEN was 12.9 months. The post-operative nutritional management was needed for continuation and securing of outpatient chemotherapy. The author reported an experience of the outpatient loco-regional chemotherapy with HEN for the gastric cancer patients who could not eat a sufficient volume of food.

  2. Consensus statement of the academy of nutrition and dietetics/american society for parenteral and enteral nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition)

    Science.gov (United States)

    The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommend that a standardized set of diagnostic characteristics be used to identify and document adult malnutrition in routine clinical practice. An etiologically based diagno...

  3. Effects of preoperative and postoperative enteral nutrition on postoperative nutritional status and immune function of gastric cancer patients.

    Science.gov (United States)

    Ding, Dayong; Feng, Ye; Song, Bin; Gao, Shuohui; Zhao, Jisheng

    2015-03-01

    Effects of preoperative one week enteral nutrition (EN) support on the postoperative nutritional status, immune function and inflammatory response of gastric cancer patients were investigated. 106 cases of gastric cancer patients were randomly divided into preoperative one week EN group (trial group) and early postoperative EN group (control group), which were continuously treated with EN support until the postoperative 9th day according to different treatment protocols. All the patients were checked for their body weight, skinfold thickness, upper arm circumference, white blood cell count (WBC), albumin (ALB), prealbumin (PA), C-reactive protein (CRP), humoral immunity (IgA, IgG), T cell subsets (CD4, CD8 and CD4/CD8), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), etc. on the preoperative and the postoperative 1st and 10th day, respectively. PA and IgG levels of the experimental group were higher than those of the control group on the postoperative 10th day, whereas IL-6 level of the experimental group was lower than that of the control group. EN support for preoperative gastric cancer patients will improve the postoperative nutritional status and immune function, alleviate inflammatory response, and facilitate the recovery of patients.

  4. The Role of Enteral Nutrition in Patients with Inflammatory Bowel Disease: Current Aspects

    Directory of Open Access Journals (Sweden)

    John K. Triantafillidis

    2015-01-01

    Full Text Available Enteral nutrition (EN is considered to be of great importance in patients with inflammatory bowel disease (IBD and nutritional problems. This comprehensive review is aiming to provide the reader with an update on the role of EN in IBD patients. EN can reduce Crohn’s disease (CD activity and maintain remission in both adults and children. Nutritional support using liquid formulas should be considered for CD patients and in serious cases of ulcerative colitis (UC, especially for those who may require prolonged cycles of corticosteroids. Given that the ultimate goal in the treatment of CD is mucosal healing, this advantage of EN over corticosteroid treatment is valuable in therapeutic decision-making. EN is indicated in active CD, in cases of steroid intolerance, in patient’s refusal of steroids, in combination with steroids in undernourished individuals, and in patients with an inflammatory stenosis of the small intestine. No differences between the efficiency of elemental diets and nonelemental formulas have been noticed. EN must be the first choice compared to TPN. EN has a restricted value in the treatment of patients with large bowel CD. In conclusion, it seems important not to underestimate the role of nutrition as supportive care in patients with IBD.

  5. Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition.

    Science.gov (United States)

    Vermeulen, Mechteld A R; van Stijn, Mireille F M; Visser, Marlieke; Lemmens, Stéphanie M P; Houdijk, Alexander P J; van Leeuwen, Paul A M; Oudemans-van Straaten, Heleen M

    2016-02-01

    Nutrition studies in the intensive care unit (ICU) have shown that adequate enteral nutrition (EN) support has clinical benefits. However, the course of amino acid concentrations in plasma has never been investigated in patients admitted with shock receiving EN. We hypothesized that plasma concentrations, when deficit, increase during EN and that persistent deficiency is associated with poor outcome. In 33 septic or cardiogenic shock patients receiving EN, plasma amino acid concentrations were measured during 5 days. Changes in amino acid concentrations, correlations with clinical outcome variables, and regression analyses were studied. On ICU admission, several plasma concentrations were deficient. Plasma concentrations of almost all amino acids increased. In contrast, taurine decreased by >50%, from 47.6 µmol/L on admission to 20.0 µmol/L at day 1, and remained low at day 5. Taurine (admission) correlated with time on mechanical ventilation (R = -0.42, P = .015). Taurine decrease within 24 hours correlated with Acute Physiology and Chronic Health Evaluation II predicted mortality (R = 0.43, P = .017) and Sequential Organ Failure Assessment score (R = 0.36, P = .05). Regression analyses confirmed correlations. Several amino acids were deficient in plasma on ICU admission but increased during EN. Taurine concentrations declined and were associated with longer periods of mechanical ventilation and ICU support. Fast taurine decline correlated with severity of organ failure. These findings support the role of taurine during ischemia, reperfusion, and inflammation. Taurine may be an essential candidate to enrich nutrition support for critically ill patients, although more research is required. © 2015 American Society for Parenteral and Enteral Nutrition.

  6. Delivery of enteral nutrition after the introduction of practice guidelines and participation of dietitians in pediatric critical care clinical teams.

    Science.gov (United States)

    Gentles, Emma; Mara, Jackie; Diamantidi, Krystalia; Alfheeaid, Hani A; Spenceley, Neil; Davidson, Mark; Gerasimidis, Konstantinos

    2014-12-01

    Provision of optimal nutrition is often difficult to achieve in the critically ill child, but can improve with better nutritional support practices. This study evaluated the joint impact of the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds on enteral nutrition (EN) intake and practices in children in intensive care. Nutritional intake and EN practices were audited before (period A) and after (period B) the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds in a pediatric intensive care unit. Information was collected on a daily basis and nutritional intake was compared with predefined targets and the United Kingdom dietary reference values. There were 65 patients and 477 nutritional support days in period A and 65 patients and 410 nutritional support days in period B. Basal metabolic rate (BMR) energy requirements were achieved in a larger proportion of nutritional support days in period B (BMR achieved [% nutritional support days]; period A: 27% vs period B: 48.9%; Pnutritional intake in some patients in critical care, but can have limited benefit for children admitted for corrective heart surgery.

  7. Fistuloclysis improves liver function and nutritional status in patients with high-output upper enteric fistula.

    Science.gov (United States)

    Wu, Yin; Ren, Jianan; Wang, Gefei; Zhou, Bo; Ding, Chao; Gu, Guosheng; Chen, Jun; Liu, Song; Li, Jieshou

    2014-01-01

    Background. We aimed to determine the efficacy of fistuloclysis in patients with high-output upper enteric fistula (EF). Methods. Patients were assigned into the fistuloclysis group (n = 35, receiving fistuloclysis plus total enteral nutrition (TEN)) and the control group (n = 60, receiving TEN). Laboratory variables were measured during the four-week treatment. Results. At baseline, variables were similar between the two groups. Delta value was defined as the changes from baseline to day 28. Compared with the control group, the fistuloclysis group showed greater improvements in liver function (Delta total bilirubin (TB): 20.3 ± 9.7 in the fistuloclysis group versus 15.6 ± 6.3 in the control group, P = 0.040; Delta direct bilirubin (DB): 12.5 ± 3.4 versus 10.0 ± 3.6, P = 0.011; Delta alkaline phosphatase (ALP): 98.4 ± 33.5 versus 57.6 ± 20.9, P fistuloclysis subgroups, biliary fistula patients had the maximum number of variables with the greatest improvements. Conclusions. Fistuloclysis improved hepatic and nutritional parameters in patients with high-output upper EF, particularly in biliary fistula patients.

  8. [Enteral nutrition in neurological patients: is there enough vitamin D content in commonly used formulas?].

    Science.gov (United States)

    Botella Romero, F; Alfaro Martínez, J J; Luna López, V; Galicia Martín, I

    2012-01-01

    Vitamin D deficiency produces inadequate bone mineralization, proximal muscle weakness, abnormal gait and increased risk of falls and fractures. Moreover, in epidemiological studies, has been associated with increased risk of cancer, autoimmune diseases, type 1 and 2 diabetes, rheumatoid arthritis, multiple sclerosis, infectious diseases, cardiovascular diseases and depression. When synthesis through the skin by sun exposure is not possible and the patient can not eat by mouth, as in the advanced stages of various neurological diseases, the supply of vitamin D has to be done by enteral nutrition. The aim of this study is to review the role of vitamin D in a common group of neurological conditions that often require artificial nutrition and analyze whether the vitamin D of different enteral nutrition formulas is adequate to meet the needs of this group of patients. Numerous studies have shown the association between vitamin D deficiency and increased incidence of dementia, stroke and other neurodegenerative diseases. Interventions aimed to increase levels of vit. D and its effects on functional (falls, pain, quality of life) and cardiovascular goals (cardiovascular death, stroke, myocardial infarction, cardiovascular risk factors) have obtained as highlight data a clear reduction of falls and fractures, while the evidence for the other parameters studied is still limited and inconsistent. The content of calcium and vitamin D of enteral formulas is legislated in our country. The total amount of vitamin D for a daily intake of 1,500-2,000 kcal ranges between 300 and 1,600 IU/d (mean ± SD: 32.9 ± 8.5 mg/100 kcal) in the complete formulas for enteral nutrition most commonly used. 50% of the diets studied, for an intake of 2,000 kcal/d, and 90% for an intake of 1,500 kcal/d, provide less than 600 IU/d of vitamin D. Some revised recently guidelines published recommendations of daily intake of vitamin D. The document published by the U.S. Institute of Medicine

  9. Nutritive utilization of protein and digestive utilization of fat in two commercial diets designed for clinical enteral nutrition.

    Science.gov (United States)

    Alférez, M J; Campos, M S; Barrionuevo, M; López-Aliaga, I

    1990-01-01

    The digestive and metabolic utilization of protein (50% lactoalbumin + 50% casein) and fat (43.0% butter, 29.5% olive oil, 14.7% soy oil, 9.8% MCT and 3.0% lecithin) provided by two commercial diets used in clinical enteral nutrition (normoproteic, 16.1% protein and 20.8% fat, and hyperproteic, 23.1% protein and 14.9% fat), was studied in adult rats (mean body weight 180 g). The diet containing the greater amount of protein improved the digestive utilization of nitrogen, and although nitrogen retention was optimal, it failed to rise further when the dietary protein supply was increased. The digestive utilization of fat in both diets was excellent.

  10. Nutritional and technological evaluation of an enzymatically methionine-enriched soy protein for infant enteral formulas.

    Science.gov (United States)

    de Regil, Luz María; de la Barca, Ana María Calderón

    2004-03-01

    Enzymatically modified soy proteins have the amino acid profile and functional properties required for dietary support. The objective of this study was to evaluate the nutritional and technological properties of an enzymatically modified soy protein ultrafiltered fraction with bound methionine (F(1-10)E) to be used as a protein ingredient for infant enteral formulas. F(1-10)E was chemically characterized and biologically evaluated. Thirty-six weaning Wistar rats were fed during 3 weeks with a 4% casein-containing diet. Rats were divided into three groups and recovered for 3 weeks with 18% protein-containing diets based on: (1) F(1-10)E, (2) casein or (3) soy isolate+methionine. Nutritional indicators were weight gain, protein efficiency ratio, plasma proteins, apparent digestibility and protein in the carcass. Additionally, F(1-10)E was added as a protein ingredient of an enteral formula, and its sensory and rheological properties were compared with a hydrolyzed-whey protein commercial formula. F(1-10)E contained 68% protein and 5% sulphur amino acids, with 60% of peptides 0.05) in weight gain (108 g and 118 g, respectively), protein efficiency ratio (2.7), apparent digestibility (93% and 95%), plasma proteins (5.7 mg/100 ml) and carcass protein (61%), and better than soy isolate-based+methionine diet (Pformula and our formula was similar during a 24-h period. Sensory acceptability was 8 for our formula and 3.5 for the commercial one, on a scale of 1-10 (Pprotein source in infant enteral formulas.

  11. Endoscopically placed nasogastrojejunal feeding tubes: a safe route for enteral nutrition in patients with hepatic encephalopathy.

    Science.gov (United States)

    Lee, Steven S; Mathiasen, Ronald A; Lipkin, Craig A; Colquhoun, Steven D; Margulies, Daniel R

    2002-02-01

    Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ("push" and "pull") were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.

  12. Antioxidant enriched enteral nutrition and oxidative stress after major gastrointestinal tract surgery

    Institute of Scientific and Technical Information of China (English)

    Mireille FM van Stijn; Gerdien C Ligthart-Melis; Petra G Boelens; Peter G Scheffer; Tom Teerlink; Jos WR Twisk; Alexander PJ Houdijk; Paul AM van Leeuwen

    2008-01-01

    AIM: To investigate the effects of an enteral supplement containing antioxidants on circulating levels of antioxidants and indicators of oxidative stress after major gastrointestinal surgery.METHODS: Twenty-one patients undergoing major upper gastrointestinal tract surgery were randomised in a single centre, open label study on the effect of postoperative enteral nutrition supplemented with antioxidants. The effect on circulating levels of antioxidants and indicators of oxidative stress, such as F2-isoprostane, was studied.RESULTS: The antioxidant enteral supplement showed no adverse effects and was well tolerated. After surgery a decrease in the circulating levels of antioxidant parameters was observed. Only selenium and glutamine levels were restored to pre-operative values one week after surgery. F2-isoprostane increased in the first three postoperative days only in the antioxidant supplemented group. Lipopolysaccharide binding protein (LBP) levels decreased faster in the antioxidant group after surgery.CONCLUSION: Despite lower antioxidant levelsthere was no increase in the circulating markers of oxidative stress on the first day after major abdominal surgery. The rise in F2-isoprostane in patients receiving the antioxidant supplement may be related to the conversion of antioxidants to oxidants which raises questions on antioxidant supplementation. Module AOX restored the postoperative decrease in selenium levels.The rapid decrease in LBP levels in the antioxidant group suggests a possible protective effect on gut wall integrity. Further studies are needed on the role of oxidative stress on outcome and the use of antioxidants in patients undergoing major abdominal surgery.

  13. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition).

    Science.gov (United States)

    White, Jane V; Guenter, Peggi; Jensen, Gordon; Malone, Ainsley; Schofield, Marsha

    2012-05-01

    The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommend that a standardized set of diagnostic characteristics be used to identify and document adult malnutrition in routine clinical practice. An etiologically based diagnostic nomenclature that incorporates a current understanding of the role of the inflammatory response on malnutrition's incidence, progression, and resolution is proposed. Universal use of a single set of diagnostic characteristics will facilitate malnutrition's recognition, contribute to more valid estimates of its prevalence and incidence, guide interventions, and influence expected outcomes. This standardized approach will also help to more accurately predict the human and financial burdens and costs associated with malnutrition's prevention and treatment, and further ensure the provision of high quality, cost effective nutritional care. Copyright © 2012 American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. The Effects of Early Post-Operative Soluble Dietary Fiber Enteral Nutrition for Colon Cancer

    Directory of Open Access Journals (Sweden)

    Rui Xu

    2016-09-01

    Full Text Available We examined colon cancer patients who received soluble dietary fiber enteral nutrition (SDFEN to evaluate the feasibility and potential benefit of early SDFEN compared to EN. Sixty patients who were confirmed as having colon cancer with histologically and accepted radical resection of colon cancer were randomized into an SDFEN group and an EN group. The postoperative complications, length of hospital stay (LOH, days for first fecal passage, and the difference in nutritional status, immune function and inflammatory reaction between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test and the chi square test. Statistical significance was defined as p < 0.05. After the nutrition support, differences in the levels of albumin, prealbumin and transferrin in each group were not statistically significant (p > 0.05; the levels of CD4+, IgA and IgM in the SDFEN group were higher than that of the EN group at seven days (p < 0.05; the levels of TNF-α and IL-6 in the SDFEN group were lower than that of the EN group at seven days (p < 0.05; and patients in the SDFEN group had a significantly shorter first flatus time than the EN group (p < 0.05. Early post-operative SDFEN used in colon cancer patients was feasible and beneficial in immune function and reducing inflammatory reaction, gastrointestinal function and speeding up the recovery.

  15. Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Wu-Ping Wang

    2013-12-01

    Full Text Available Background: Olive oil-based lipid emulsion (LE and medium chain triglyceride/long chain triglyceride (MCT/LCT emulsion are both LEs with low ω-6 polyunsaturated fat acids (PUFAs content. However, which one of these LEs is associated with a lower infection risk in patients receiving parenteral nutrition (PN remains unclear. The aim of the study was to compare the effects of the two LEs in PN in esophageal cancer patients undergoing surgery. Methods: Patients with resectable esophageal carcinoma were recruited and allocated randomly to two groups. The test group was given enteral nutrition (EN with PN containing olive oil-based LE after tumor resection for ≥7 days, and the patients in the control group were supported by EN with MCT/LCT emulsion-based PN after surgery for the same time period. Immunological markers and inflammatory indicators were tested and perioperative clinical outcomes were determined. The trial was registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-13003562. 94 Patients were recruited, and grouped (olive oil-based LE, n = 46 and MCT/LCT, n = 48, matched for sex, age, body mass index, histological type, TNM stage, and nutrition risk screening (NRS 2002 score. Results: There were no differences in perioperative fever (>38 °C, infectious complications, length of hospital stay (>14 days, length of critical care stay (>2 days, time for oral food intake, and in-hospital mortality between the two groups. The test group showed a higher increase in IgG level compared with the MCT/LCT group (p = 0.028. There was no difference in other immunological markers and inflammatory indicators between the two groups. Conclusion: PN containing olive oil-based or MCT/LCT LEs had similar effects on perioperative outcome, cell-mediated immune function and inflammatory response in esophageal cancer patients who had undergone surgery and were receiving EN.

  16. A systematic review of the cost and economic outcomes of home enteral nutrition.

    Science.gov (United States)

    Wong, A; Goh, G; Banks, M D; Bauer, J D

    2017-06-21

    Studies are lacking in the health economic implications of home enteral nutrition (HEN) in home-residing and long-term care/institutionalized patients. The aims of this review were to determine the total costs, the cost-effectiveness and other economic outcomes for HEN. A systematic search of randomized trials and observational studies available from January 2000 to April 2016 was performed using standard literature and electronic databases. Inclusion criteria were adults receiving HEN with economic outcomes in the long-term care or home settings. There was no restriction to the control groups used in the studies. A total of 10 studies met the inclusion criteria. The majority of the studies were not specifically designed for economic evaluation. Cost per QALY was lower in residents residing in home compared to long-term care facilities, and HEN appeared to be cost-effective for those with pressure ulcers. Higher costs were incurred for patients with dementia on HEN. Lower hospitalization costs and infection rates were reported for patients who switched to commercial feeds from blenderized food. The availability of nutritional support teams may decrease overall costs but these studies were of poor study quality. The lack of good quality economic evaluation studies affected the ability to conclude the overall cost-effectiveness of HEN. There is a trend for cost-saving and improved clinical outcomes in some populations. HEN is unlikely beneficial for patients with dementia. The availability of a nutrition support team may lead to cost savings and improved clinical outcomes for HEN. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  17. [Nutritional study in geriatric patients (older than 65 years of age) with ambulatory enteral nutrition: correlation between underlying disease, nutritional support, and drug treatment].

    Science.gov (United States)

    Martínez Vázquez, M J; Piñeiro Corrales, G; Martínez Olmos, M

    2002-01-01

    To identify the current status of out-patient enteral nutrition among elderly patients in Galicia: indications, access routes, forms of administration, types of diet, complications, disability status. Assessment of nutritional status and concomitant pharmacological treatment. Prospective, observational, multi-centric study lasting for one month. Data capture by means of a questionnaire regarding: age, sex, diagnosed pathology leading to nutritional analysis, disability status, current nutritional status, type of diet, months under treatment with NEA (out-patient enteral nutrition in its Spanish acronym), form of administration, complications, concomitant medication. The statistical methodology included a descriptive analysis and a study of the correlations between the different variables. For the comparison of both groups, Student's t test or Mann-Whitney's U test was used for quantitative variables and chi-squared, Yate's correction or Fisher's exact test was used for qualitative variables. 469 patients were studied, corresponding to 13 publicly-funded centres. Age: 81.15 years (95% CI 80.8-82.3), women (70.6%). neurological disorders (46.1%), cerebrovascular accidents (27.5%), neoplasia (12.4%) and others (14.1%). 45.2% presented a bedbound disability status and 53.5% presented communication difficulties. Standard diet was the most common (39.4%). DURATION OF THE NUTRITION: > 1 year in 36.7% of cases, between 6 months and 1 year for 21.3%, between 3 and 6 months for 10.9% and < 3 months in 13.7% of cases. Nasogastric tube was the route for administration in 55.2%. Patients with nutrition treatment lasting over 1 year presented a significantly lower rate of malnutrition (p < 0.0001). Neurological patients and those with communication difficulties had a lower prevalence of malnutrition (p < 0.0001), as did those with a greater degree of disability (p < 0.01). Undernourished patients presented a greater prevalence of bedsores (49.1% versus 25.8%, p < 0.0001). The

  18. Enteral Nutrition Related Complications Relevant to Alteration of Formulas in Two Critically Ill Pediatric Patients

    Science.gov (United States)

    Akuzawa, Nobuhiro; Takeuchi, Aya Murata; Tsukagoshi, Jun; Kaneko, Ryoko; Naito, Hiroshi; Mizuno, Takahisa; Sunaga, Yasuo; Tashiro, Masahiko

    2013-01-01

    The early institution of enteral nutrition is associated with beneficial outcomes and intestinal growth in pediatric patients. However, the number, frequency, and types of unfavorable events occurring with particular formulas are undefined. We experienced unexpected complications in two cases following a change in formula. One case diagnosed with myotubular myopathy experienced highly-increased gastric residuals and watery diarrhea leading to decreased calorie intake and weight loss. The second case with campomelic dysplasia suffered liver dysfunction and fever. In both cases, symptoms developed soon after of the change in formula and improved after resumption of the previous formula. Both cases had undergone tracheostomy and artificial ventilation, and had a history of feeding the same formula for an extended period of time. In chronic care patients such as ours, a change in formula may cause unexpected adverse events; therefore, caution is warranted.

  19. Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates

    DEFF Research Database (Denmark)

    Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre

    2011-01-01

    -six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs...... bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing...... no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few...

  20. Nutritional Issues in the Short Bowel Syndrome - Total Parenteral Nutrition, Enteral Nutrition and the Role of Transplantation.

    Science.gov (United States)

    O'Keefe, Stephen J D

    2015-01-01

    In this review, I focus on the extreme of the short bowel syndrome where the loss of intestine is so great that patients cannot survive without intravenous feeding. This condition is termed short bowel intestinal failure. The review outlines the principles behind diagnosis, assessing prognosis and management. The advent of intravenous feeding (parenteral nutrition) in the 1970s enabled patients with massive (>90%) bowel resection to survive for the first time and to be rehabilitated back into normal life. To achieve this, central venous catheters were inserted preferably into the superior vena cava and intravenous infusions were given overnight so that the catheter could be sealed by day in order to maximize ambulation and social integration. However, quality of life has suffered by the association of serious complications related to permanent catheterization - mostly in the form of septicemias, thrombosis, metabolic intolerance and liver failure - from the unphysiological route of nutrient delivery. This has led to intense research into restoring gut function. In addition to dietary modifications and therapeutic suppression of motility, novel approaches have been aimed at enhancing the natural adaptation process, first with recombinant growth hormone and more recently with gut-specific glucagon-like peptide-2 analogues, e.g. teduglutide. These approaches have met with some success, reducing the intravenous caloric needs by approximately 500 kcal/day. In controlled clinical trials, teduglutide has been shown to permit >20% reductions in intravenous requirements in over 60% of patients after 6 months of treatment. Some patients have been weaned, but more have been able to drop infusion days. The only approach that predictably can get patients with massive intestinal loss completely off parenteral nutrition is small bowel transplantation, which, if successful (1-year survival for graft and host >90%) is accompanied by dramatic improvements in quality of life.

  1. Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula.

    Science.gov (United States)

    Sanz-Paris, Alejandro; Boj-Carceller, Diana; Lardies-Sanchez, Beatriz; Perez-Fernandez, Leticia; Cruz-Jentoft, Alfonso J

    2016-03-09

    Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p nutritional parameters were improved at one year (albumin: +10.6%, p nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

  2. [Comparison of two types of surgical gastrostomies, open and laparoscopic in home enteral nutrition].

    Science.gov (United States)

    Tous Romero, M C; Alarcón del Agua, I; Parejo Campos, J; Oliva Rodríguez, R; Serrano Aguayo, P; Hisnard Cadet Dussort, J M; Pereira Cunill, J L; Morales-Conde, S; García-Luna, P P

    2012-01-01

    Exposing the complications of surgical gastrostomies used as way of home enteral nutritional support (HEN) and detecting the differences between the two techniques used in our environment: Open Surgery vs Laparoscopic Surgery. Retrospective descriptive observational study of the surgical gastrostomies performed between 1994 and 2009 followed up by our unit. Have been analyzed the complications detected in our practice during the follow-up of patients with HEN performed via open laparotomy vs. laparoscopic tecniques, assessing: leaks of gastric fluid to the exterior, abdominal wall irritation, presence of exudate, presence of exudate with positive culture that required antibiotical treatment, burning or loss of substance of the periostomic zone, breach of balloon, decubitus ulcer caused by the tube and formation of granuloma. Between 1994 and 2009, 57 surgical gastrostomies were performed: 47 using the conventional laparotomic (open) tecnique and 10 laparoscopies. The average age of the patients was 57.51 ± 17.29 years old. The most common cause for the performance of surgical gastrostomy was esophageal cancer (38.6%) followed by neurologic alterations (26.3%) and head and neck tumors (26.3%). 97.9% of the patients who underwent to surgical gastrostomy presented at least one complication, meaning that only 2.1% were free of complications; meanwhile, 50% of the patients were laparoscopic gastrostomy was performed had none of these complications. The most common complications were the presence of leaks of gastric fluid and abdominal wall irritation that appeared on 89.4% and 83% respectively of the laparotomic gastrostomies versus the presence of only 30% of both complications in laparoscopic gastrostomies being the difference statistically significant (p enteral nutritional support related to surgical gastrostomies.

  3. Application of dietary fiber in clinical enteral nutrition: A meta-analysis of randomized controlled trials

    Institute of Scientific and Technical Information of China (English)

    Gang Yang; Xiao-Ting Wu; Yong Zhou; Ying-Li Wang

    2005-01-01

    AIM: To evaluate the effects of dietary fiber (DF) as a part of enteral nutrition (EN) formula on diarrhea, infection, and length of hospital stay.METHODS: Following electronic databases were searched for randomized controlled trials about DF: Chinese Biomedicine Database (CBM), MEDLINE, EMBASE and Cochrane Controlled Trials Register. RevMan 4.1 was used for statistical analysis.RESULTS: Seven randomized controlled trials with 400pat-ients were included. The supplement of DF in EN was compared with standard enteral formula in five trials.Combined analysis did not show a significant reduction in occurrence of diarrhea, but there were valuable results for non-critically iii patients. Combined analysis of two trials observing the infection also did not show any valid evidence that DF could decrease the infection rate, though the length of hospital stay was reduced significantly.CONCLUSION: Based on the current eligible randomized controlled trials, there is no evidence that the value of DF in the diarrhea can be proved. Though length of hospital stay was shortened by the use of DF, there is no available evidence in preventing infection by DF. Further studies are needed for evaluating the value of DF in EN.

  4. [Complications of enteral nutrition at home. Results of a multicentre trial].

    Science.gov (United States)

    Gómez Candela, C; Cos Blanco, A; García Luna, P P; Pérez de la Cruz, A; Luengo Pérez, L M; Iglesias Rosado, C; Vázquez, C; Koning, A; Planas, M; Camarero, E; Wanden-Berghe, C; Chamorro, J; Pereira, J L; Mellado, C; Morera, M

    2003-01-01

    In spite of the increasing number of home enteral nutrition (HEN) patients, only few articles had reported the frequency of complications related to this treatment. Our multicentric study analyzes the HEN complications in relation to access device and time of treatment. 92 HEN patients from 8 hospitals were randomly selected. Patients were distributed in relation to the time of treatment and access device (nasogastric tube and percutaneous or surgical gastrostomies). After an educational program, they were filled in an initial questionnaire and repeated it the days 15 and 30. They received a mean of 1650 Kcal of enteral solution. A total of 2760 HEN prospective days were analyzed. In prospective study 42% of patients had some complication (112 episodes). The most frequent were gastrointestinal (55%) and mechanical (29%); 0.16 complications of patient-year were registered. The most common complications were: extraction (15%), constipation (13%), vomiting (12%) and diarrhoea (10%). The gastrostomy group had more gastrointestinal complications. In retrospective evaluation, percutaneous gastrostomy group had the lowest ratio of complications and nasogastric tube group required more tube replacements (4 vs 2) and had 1.96 episodes/patient (percutaneous group 1.85 and surgical gastrostomy 3.1 episodes/patient). HEN is safe with low incidence of complications. An adequate educational program is very important and we expect, in the future, to establish an proper National Home Care System.

  5. Economic analysis of costs with enteral and parenteral nutritional therapy according to disease and outcome.

    Science.gov (United States)

    Hyeda, Adriano; Costa, Élide Sbardellotto Mariano da

    2017-01-01

    To conduct an economic analysis of enteral and parenteral diet costs according to the type of disease and outcome (survivors versus deaths). It is a cross-sectional, observational, retrospective study with a qualitative and quantitative design, based on analysis of hospital accounts from a healthcare insurance provider in the Southern region of Brazil. We analyzed 301 hospital accounts of individuals who used enteral and parenteral diets. The total cost of the diet was 35.4% of hospital account total costs. The enteral modality accounted for 59.8% of total dietary costs. The major costs with diets were observed in hospitalizations related to infections, cancers and cerebro-cardiovascular diseases. The major costs with parenteral diet were with admissions related by cancers (64.52%) and dementia syndromes (46.17%). The highest ratio between total diet costs with the total of hospital account costs was in dementia syndromes (46.32%) and in cancers (41.2%). The individuals who died spent 51.26% of total of hospital account costs, being 32.81% in diet (47.45% of total diet value and 58.81% in parenteral modality). Enteral and parenteral nutritional therapies account for a significant part of the costs with hospitalized individuals, especially in cases of cancers and dementia syndromes. The costs of parenteral diets were higher in the group of patients who died. Realizar uma análise econômica de custos da terapia nutricional enteral e parenteral, conforme o tipo de doença e o desfecho (sobreviventes versus óbitos). Estudo transversal, observacional, retrospectivo, com estratégia qualitativa e quantitativa, a partir da análise de contas hospitalares de uma operadora de saúde da Região Sul do Brasil. Foram analisadas 301 contas hospitalares de usuários que utilizaram dieta enteral e parenteral. O custo total com dieta foi de 35,4% do custo total das contas hospitalares. A modalidade enteral representou 59,8% do custo total em dieta. Os maiores custos com dieta

  6. EFFECTS OF ENTERAL AND PARENTERAL NUTRITION ON GASTROENTERIC HORMONES AND GASTRIC MOTILITY AFTER SUBTOTAL GASTRECTOMY

    Institute of Scientific and Technical Information of China (English)

    Wei-ming Kang; Jian-chun Yu; Qun Zhang; Mei-yun Ke; Jia-ming Qian

    2008-01-01

    Objective To investigate the effects of enteral nutrition (EN) and parenteral nutrition (PN) on gastric motilityand gastroenteric hormones after subtotal gastrectomy.Methods Forty-one patients underwent gastrectomy were randomly divided into EN group ( n = 20) and PN group (n =21 ). From the fast postoperative day to the seventh day, patients received either EN (EN group) or PN (Pnplasma motilin (MTL), and plasma cholecystokinin (CCK) were measured on preoperative day, the fast and seventh postoperative day. Electrogastrography (EGG) was measured on preoperative day and the seventh postoperative day.Results Compared with preoperation, blood GAS, MTL, and CCK levels of 41 patients decreased significantlyon the first day after subtotal gastrectomy (P<0. 001), but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained ( P <0. 001 ). On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group ( P < 0.05 ).There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoper-atively.Conclusions The levels of gastroenteritic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy.

  7. [Home enteral nutrition. Case load of the Clinical Hospital of Barcelona].

    Science.gov (United States)

    Leyes, P; Forga, M T; Montserrat, C; Coronas, R

    2001-01-01

    The use of Enteral Nutrition at Home (ENH) in the Hospital Clínico de Barcelona has grown greatly over the last decade, with a certain trend towards stabilization being observed in the last two years, but still growing at a rate of 9.2% per annum. A transverse analysis of the active patients on our ENH register at a given moment has revealed a total of 315 patients receiving treatment. The retrospective analysis of our series during 1998 gave a figure of 643 new cases. The most frequent indication for ENH was neoplasia (44%), followed by neurological pathology (28%). The administration route most frequently used was oral (66% of cases). In the oral route, oncological diagnoses were dominant (52%), whereas administration by means of a naso-gastric tube was mainly due to neurological disorders (72%). The use of PEG (12.5% of administrations via tube) was distributed between oncological and neurological patients, with a slight predominance of the first. Of those patients completing ENH in the same year, duration was in most cases (67%) less than one month. The decrease of the patient due to the underlying disorder was the main cause of termination, followed by the need for short-term nutritional support following discharge from hospital.

  8. Effects of enteral nutrition with parenteral glutamine supplementation on the immunological function in septic rats.

    Science.gov (United States)

    Fan, Jun; Wu, Lidong; Li, Guoping; Tao, Shaoyu; Sheng, Zhiyong; Meng, Qingyan; Li, Fengxin; Yu, Lijuan; Li, Li

    2015-06-14

    The aim of the present study was to investigate the effects of enteral nutrition (EN) with parenteral glutamine (GLN) supplementation on inflammatory response, lymphatic organ apoptosis, immunological function and survival in septic rats by caecal ligation and puncture (CLP). Male rats were randomly assigned into two experimental groups and two sham CLP control groups (n 10 per group). After CLP or sham CLP model and nutrition programme were completed, the GLN concentrations of plasma and tissues and several indices of immunological function including serum Ig content, circulating lymphocyte number, the CD4:CD8 ratio, the neutrophil phagocytosis index (NPI), the organ index and apoptosis of thymus and spleen, and plasma cytokine levels were determined. Moreover, the survival in septic rats was observed. The results revealed that EN with parenteral GLN supplementation remarkably increased the GLN concentrations of plasma and tissues, serum Ig content, the circulating lymphocyte number, the CD4:CD8 ratio, the indexes of thymus and spleen, NPI and survival compared with the control group (P< 0·05). In contrast, the apoptosis of thymus and spleen and the levels of TNF-α, IL-1β and IL-6 in plasma were obviously decreased compared with the control group (P< 0·05). These results show that EN with parenteral GLN supplementation diminished the release of inflammatory cytokines, attenuated lymphatic organ apoptosis, enhanced the immunological function and improved survival in septic rats.

  9. Low-FODMAP formula improves diarrhea and nutritional status in hospitalized patients receiving enteral nutrition: a randomized, multicenter, double-blind clinical trial

    OpenAIRE

    Yoon, So Ra; Lee, Jong Hwa; Lee, Jae Hyang; Na, Ga Yoon; Lee, Kyun-Hee; Lee, Yoon-Bok; Jung, Gu-Hun; Kim, Oh Yoen

    2015-01-01

    Background Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are poorly absorbed, short-chain carbohydrates that play an important role in inducing functional gut symptoms. A low-FODMAP diet improves abdominal symptoms in patients with inflammatory bowel disease and irritable bowel syndrome. However, there were no study for the effect of FODMAP content on gastrointestinal intolerance and nutritional status in patients receiving enteral nutrition (EN). Methods...

  10. Parenteral nutrition(PN)vs.enteral nutrition(EN)%肠外营养与肠内营养的比较

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Summary Inappropriate emphasis has been given to conflictingcamps in the debate over enteral nutrition versus parenteral nutrition.It is not a question of one or the other,but a question of finding the right balance between parenteral and enteral nutrition using both EN and PN to achieve the daily caloric needs of the patient.Not uncommonly,paitents receive inadequate nutrition support during the ramp-up of enteral feedings over several days under the perception that parenteral nutrition carries a high risk of complications,and therefore should be avoided.Properly administered parenteral nutrition is both safe and effective,especially when used with a “background patter”of enteral nutrition.Just a small amount of enteral nutrition significantly reduces the potential complications from parenteral nutrition associated with lack of gut barrier function and inadequate stimulation of the enteral-hepatic circulation.A small amount of background enteral nutrition paves the way for safe administration of apropriate parenteral nutrition to meet the caloric needs and achieve the necessary macro-and micro-nutrient balance to accelerate the recovery of medical and surgical patients otherwise suffering from nutritional compromise.Ⅰ.PN vs.EN Not either-or,but…BOTHⅡ.Risk Factors for EN*Mechanical*Septic*Obtunded patient*Gastroparesis*Frequently occurs for 1-3 days post op*More common and severe with diabetes*Uneven GI function*Stomach-jejunum-ileum-colon*Improperly placed feeding tube*Naso-gastric*Naso-jejunal*Importance of decompressing the stomach*Acquired lactase deficiency*Diarrhea*Constipation*Mechanical-related to insertion and maintenance of IV line*Septic-related to sterile technique,potential for bacterial contamination*Metabolic-issues of fluid balance and nutrition:electrolytes,fat,carbohydrate,protein,vitamins,trace elementsⅢ.Goals *Maintain appropriate level of nutrition support*Avoid complicationsⅣ.Keys to Success *Nutritional Assessment*Keep it simple

  11. La nutrición enteral precoz en el enfermo grave Early enteral nutrition in the critically-ill patient

    OpenAIRE

    B. García Vila; Grau, T

    2005-01-01

    La nutrición enteral se ha demostrado como un método eficaz y seguro de nutrir a los enfermos graves ingresados en una Unidad de Cuidados Intensivos. Aunque se desconoce cuánto tiempo puede estar un enfermo grave sin nutrición, el catabolismo acelerado y el ayuno pueden ser deletéreos en el enfermo grave y la recomendación más frecuente es la de empezar la nutrición artificial cuando se prevea un período de ayuno superior a los siete días. Las ventajas de la nutrición enteral sobre la nutrici...

  12. A novel protein mixture containing vegetable proteins renders enteral nutrition products non-coagulating after in vitro gastric digestion

    NARCIS (Netherlands)

    Braak, van den C.C.M.; Klebach, M.; Abrahamse, E.; Minor, M.; Knol, J.; Hofman, Z.; Ludwig, T.

    2013-01-01

    Background & aims: Non-coagulation of protein from enteral nutrition (EN) in the stomach is considered to improve gastric emptying and may result in reduced upper gastrointestinal complications such as reflux and aspiration pneumonia. For the development of a new EN protein mixture with reduced

  13. Continuous administration of enteral lipid- and protein-rich nutrition limits inflammation in a human endotoxemia model

    NARCIS (Netherlands)

    Lubbers, T.; Kox, M.; Haan, J.J. de; Greve, J.W.; Pompe, J.C.; Ramakers, B.P.C.; Pickkers, P.; Buurman, W.A.

    2013-01-01

    OBJECTIVE: : An overzealous inflammatory response is an important cause of morbidity and mortality in surgical, trauma, and critically ill patients. Enteral administration of lipid-rich nutrition was previously shown to attenuate inflammation and reduce organ damage via a cholecystokinin-1 receptor-

  14. Limited effects of preterm birth and the first enteral nutrition on cerebellum morphology and gene expression in piglets

    DEFF Research Database (Denmark)

    Bergström, Anders; Kaalund, Sanne S.; Skovgaard, Kerstin

    2016-01-01

    three ages but the proportion of white matter increased postnatally, relative to term pigs. Early initiation of enteral nutrition had limited structural or molecular effects. The Sonic Hedgehog pathway was unaffected by preterm birth. Few differences in expression of the selected genes were found...

  15. Effects of exclusive enteral nutrition on the mucosal healing in adult patients with active Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    郭振

    2014-01-01

    Objective To explore the effects of exclusive enteral nutrition(EEN)on the mucosal healing under endoscopy in adults with active Crohn’s disease(CD).Methods From August 2011 to August 2012,adults with active CD met the inclusion criteria were prospectively enrolled and treated with EEN for four weeks.CD activity index(CDAI)score,C-reactive

  16. Cytokine and Chemokine Expression Associated with Steatohepatitis and Hepatocyte Proliferation in Rats Fed Ethanol Via Total Enteral Nutrition

    Science.gov (United States)

    Sprague-Dawley rats were intragastrically fed low carbohydrate-containing ethanol (EtOH) diets via total enteral nutrition for up to 49 d. Induction of EtOH metabolism and appearance of steatosis preceded development of oxidative stress, inflammation, and cell death. A transitory peak of tumor necro...

  17. Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

    Directory of Open Access Journals (Sweden)

    Risako Yamashita

    2014-12-01

    Full Text Available Spontaneous esophageal perforation is relatively uncommon, but carries a high mortality rate if diagnosis or treatment is delayed. We report the case of a 68-year-old man with spontaneous esophageal perforation who was successfully treated over 96 h after onset by thoracic drainage and jejunostomy for enteral nutrition. He vomited after drinking alcohol, soon followed by epigastralgia. Heart failure was suspected on admission to another hospital. Spontaneous esophageal perforation was diagnosed 48 h after admission. Chest tube drainage was performed, but his general condition deteriorated and he was transferred to our hospital. Emergent surgery was performed and esophageal perforation combined with pyothorax and mediastinitis was identified on the left side of the lower esophagus. The left thoracic cavity was rinsed and thoracic drainage was performed. Feeding jejunostomy was performed for postoperative enteral nutrition. Effective drainage and sufficient nutrition management appear extremely valuable in treating spontaneous esophageal perforation.

  18. Diet-Dependent Effects of Minimal Enteral Nutrition on Intestinal Function and Necrotizing Enterocolitis in Preterm Pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Boye, Mette; Thymann, Thomas

    2011-01-01

    characterized. It was hypothesized that a commonly used MEN feeding volume (16-24 mL/kg/d) prevents NEC and improves intestinal structure, function, and microbiology in preterm pigs. Methods: After preterm birth pigs were stratified into 4 nutrition intervention groups that received the following treatments: (1......Background: A rapid advance in enteral feeding is associated with necrotizing enterocolitis (NEC) in preterm infants. Therefore, minimal enteral nutrition (MEN) combined with parenteral nutrition (PN) is common clinical practice, but the effects on NEC and intestinal function remain poorly......: NEC was absent in the CC group but frequent in the other groups (50%-67%). Compared with other groups, CC pigs showed improved mucosal structures, brush border enzyme activities, and hexose absorption (all P prevent...

  19. Enteral nutrition in the critically ill-an overview%重症病人的肠内营养支持

    Institute of Scientific and Technical Information of China (English)

    DavidBihan,MD

    2001-01-01

    Nutritional support is an essential part of the management of anycritically ill patient,Severe muscle wasting and immune suppression are prominent features of critical illness and are difficult to prevent.The introduction of parenteral nutrition and hyperalimentation in the 1970s was initially thought to be an effective solution to this problem.However,there is little evidence of any improvement in outcome associated iwth the use of conventional parenteral nutrition in this particular group of patients.Moreover,parenteral nutrition solutions are expensive and their administration is associated with a number of avoidable complications(line related sepsis,immune suppressing hyperglycaemia and other metabolic abnormalities).Their use in British and Australian ICU practice has declined such that fewer than 10% of critically ill patients requiring nutritional support are fed in this manner.In contrast enteral nutrition has become more frequently used even in patients in whom it was previously thought to be contra-indicated,for example those with acute pancreatitis,a small bowel anastomosis,inflammatory bowel disease.In the last 25 years,evidence has accrued suggesting that enteral nutrition when compared with TPN is associated with an improvement in outcome-fewer infections and a reduction in mortality.This is certainly the case for three specific groups of patients-those suffering an episode of multiple trauma or a burn injury and those undergoing elective surgery for a gastrointestinal malignancy.Animal and human studies support the introduction of enteral nutrition early on in the course of the critical illness,the notion being that nutrient within the lumen of the gut reduces the likelinood of mucosal atrophy and the subsequent increases in gastrointestinal permeability.Support of the calculated or measured energy requirements is not necessarily the primary purpose of early enteral nutrition.More emphasis is placed on the low doses of nutrients stimulating mucosal

  20. Development of a tool for quality control audits in hospital enteral nutrition

    Directory of Open Access Journals (Sweden)

    Guilherme Duprat Ceniccola

    2014-01-01

    Full Text Available Background and aims: Malnutrition is very prevalent in hospitals, causing physical capacity deterioration, increasing complications and raising mortality. This scenario overloads public health costs enormously. Enteral nutrition (EN is the first option to fight against malnutrition. Nutrition support teams (NST work combating such conditions, promoting humanization, but also analyzing the cost benefit of EN therapy. Brazil is one of the first Latin American countries to develop EN laws. Quality control it is in the core of this legal instrument, playing an essential role in NSTv s task of providing care. Nowadays, tools to access quality control represent a gap in the area. The aim of this study was to develop a quality control tool, according to Brazilian law for EN Therapy regarding multidisciplinary approach, good practices, standard operating procedures, protocol implementation, proper registration and electronic health record. Methods: A content validation method was utilized in this four stages development process: bibliographic research, expert opinion (subjective, semantic evaluation and expert opinion (objective. In the latter stage ten specialists, expressed their opinion, evaluating the tools by four different attributes: utility, simplicity, objective and low cost on a 5-point Likert scale (1-5. Results: We elaborate three independent tools that together, represent the whole evaluation process, named: NST Activities, EN Preparation and EN Administration. Content Validation Index to the four different attributes ranged form 0,9 to 1. Conclusion: This tool had positive approval from experts and is of great value guiding hospital audits, or even serving as checklist to implement a plan on EN therapy.

  1. Early nasogastric enteral nutrition for severe acute pancreatitis: A systematic review

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP).METHODS: We searched Cochrane Central Register of Controlled Trials (Issue 2, 2006), Pub-Medline (1966-2006), and references from relevant articles. We included randomized controlled trials (RCTs) only, which reported the mortality of SAP patients at least. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration's RevMan 4.2.9 software was used for statistical analysis.RESULTS: Three RCTs were included, involving 131 patients. The baselines of each trial were comparable.Meta-analysis showed no significant differences in mortality rate of SAP patients between nasogastric and conventional routes (RR = 0.76, 95% CI = 0.37 and 1.55, P = 0.45), and in other outcomes, including time of hospital stay (weighted mean difference = -5.87,95% CI = -20.58 and 8.84, P = 0.43), complication rate of infection (RR = 1.41, 95% CI = 0.62 and 3.23, P =0.41) or multiple organ deficiency syndrome (RR = 0.97,95% CI = 0.27 and 3.47, P = 0.97), rate of admission to ICU (RR = 1.00, 95% CI = 0.48 and 2.09, P = 0.99) or conversion to surgery (RR = 0.66, 95% CI = 0.12 and 3.69, P = 0.64), as well as recurrence of re-feeding pain and adverse events associated with nutrition.CONCLUSION: Early NGEN is a breakthrough in the management of SAP. Based on current studies, early NGEN appears effective and safe. Since the available evidence is poor in quantity, it is hard to make an accurate evaluation of the role of early NGEN in SAP.Before recommendation to clinical practice, further high qualified, large scale, randomized controlled trials are needed.

  2. [Current situation of domiciliary enteral nutrition in Galicia. A multicenter study].

    Science.gov (United States)

    Pérez Méndez, L F; García-Mayor, R V

    2001-01-01

    To determinate the prevalence of patients with Home Enteral Nutrition (HEN) in Galicia. Transversal study. Patients aged > or = 14 years, treated with HEN in our community since January 1998 to December 1999. Population of reference was 1.789.983. Questionnaire previously designed. During the study period were treated 2,784 patients which represent a prevalence of 10.34 cases/10,000 inhabitants, being 18.8 for La Coruña, 1.3 for Lugo, 0.4 for Ourense and of the 20.85 for Pontevedra. The mean age of the patients was of 56 +/- 2.29 years (range 14-96). The Clinics units that required more frequently HEN were the Medical Units (48.3%), followed of the Surgery Units (20.2%) and the Primary Care Units (19.2%). Neurological abnormalities (43.6%), Neoplasias (30.7%) and Intestinal Inflammatory Disease (10.5%) were patients more frequently required HEN. Regarding to administration route 58.3%, 28.46%, 9.87%, 0.5% and 0.65% used oral, nasogastric tube, PEG, gastrostomy and yeyunostomy respectively. The Index of complications was 0.18 of patient-year, due to gastrointestinal anomalies 0.12 patient-year, mechanical 0.09 patient-year. The index of hospitalizations in relation to the nutritional treatment was 0.026 patient-year. The prevalence of HEN in our community is of 10.34 cases/10,000 inhabitants. This kind of treatment is more frequently in the areas with high-density population. The frequency of complications was low. This data may be useful to compare with date from other areas and countries.

  3. Utilización clínica de la Nutrición Enteral Clinical use of Enteral Nutrition

    OpenAIRE

    J. Álvarez Hernández; N. Peláez Torres; A. Muñoz Jiménez

    2006-01-01

    La Nutrición Enteral es una de las disciplinas más desarrolladas en la medicina moderna. Los avances tecnológicos, el mejor conocimiento de la fisiopatología de la desnutrición, y su participación en la evolución de diferentes entidades clínicas han hecho posible mejorar el cuidado nutricional de nuestros pacientes. La utilización de la NE se ha extendido como una práctica de primera elección en pacientes desnutridos o en riesgo de desnutrición que tienen un intestino minimamente funcionante ...

  4. Parenteral lipids and partial enteral nutrition affect hepatic lipid composition but have limited short term effects on formula-induced necrotizing enterocolitis in preterm piglets

    DEFF Research Database (Denmark)

    Vegge, Andreas; Thymann, Thomas; Lauritzen, Lotte

    2015-01-01

    Rapid transition from total parenteral nutrition (TPN) to enteral feeding is a risk factor for necrotizing enterocolitis (NEC) in preterm infants. We hypothesized that partial enteral nutrition with colostrum, increased proportion of n-3 polyunsaturated fatty acids (PUFA), or exclusion of lipid...

  5. Infliximab Combined with Enteral Nutrition for Managing Crohn's Disease Complicated with Intestinal Fistulas

    Science.gov (United States)

    Wu, Xiao-Li; Tao, Li-Ping; Wu, Jian-Sheng; Chen, Xiang-Rong

    2016-01-01

    Aim. This study was performed to evaluate the additional enteral nutrition (EN) in the efficacy of infliximab (IFX) compared with the conventional therapy in managing Crohn's disease (CD) complicated with intestinal fistulas. Methods. A total of 42 CD with intestinal fistulas were randomly divided into infliximab treatment group (n = 20) and conventional therapy group (n = 22). We evaluated the laboratory indexes, Crohn's disease activity index (CDAI), Crohn's disease simplified endoscopic score (SES-CD), and healing of fistula in the two groups before treatment, at 14 weeks, and at 30 weeks, respectively. Results. In the IFX treatment group, the CDAI score, the SES-CD, erythrocyte sedimentation rate, and C-reactive protein levels were significantly decreased during treatment compared with those before treatment. The body mass index and albumin levels were increased in both groups. Moreover, in the IFX treatment group, fistula healing was found in 8 at the 14th week and 18 at the 30th week, respectively, which was greater than that in the conventional therapy group. Conclusion. Our study suggested that infliximab combined with EN is an effective treatment for CD patients complicated with intestinal fistulas.

  6. Simulated neonatal exposure to DEHP and MEHP from PVC enteral nutrition products.

    Science.gov (United States)

    Takatori, Satoshi; Okamoto, You; Kitagawa, Yoko; Hori, Shinjiro; Izumi, Shun-Ichiro; Makino, Tsunehisa; Nakazawa, Hiroyuki

    2008-03-20

    The leaching of di(2-ethylhexyl)phthalate (DEHP) and mono(2-ethylhexyl)phthalate (MEHP) from medical products made of polyvinyl-chloride (PVC) to enteral nutrition (EN) for neonatal patients was determined in a simulated study. The study simulated a typical case of EN administration to a neonatal patient (body weight, 3 kg) in a neonatal care unit (temperature, 25 degrees C); the medical products used were an irrigator and catheter containing DEHP (9.1-31.8%, w/w) as a plasticizer. The worst-case daily exposures of the neonatal patient to DEHP and MEHP by the administration of EN were estimated to be 148 and 3.72 microg/(kg day), respectively, as assessed from the levels of these compounds leaching from the medical products to the EN. The use of DEHP-free medical products reduced the exposure of DEHP and MEHP to the minimum levels contained in the EN at preparation. A transition to DEHP-free medical products for neonatal patients would be effective in reducing the exposure of neonatal patients to DEHP via EN administration.

  7. The influence of the initial state of nutrition on the lifespan of patients with amyotrophic lateral sclerosis (ALS during home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Janusz Sznajder

    Full Text Available Aim: Amyotrophic lateral sclerosis (ALS is a chronic, neurodegenerative disease, which leads to development of malnutrition. The main purpose of this research was to analyze the impact of malnutrition on the course of the disease and long-term survival. Material and methods: A retrospective analysis has been performed on 48 patients (22 F [45,83%] and 26 M [54,17%], the average age of patients: 66,2 [43-83] in 2008-2014.The analysis of the initial state of nutrition was measured by body mass index (BMI, nutritional status according to NRS 2002, SGA and concentration of albumin in blood serum. Patients were divided into two groups, depending on the state of nutrition: well-nourished and malnourished. The groups were created separately for each of these, which allowed an additional comparative analysis of techniques used for the assessment of nutritional status. Results: Proper state of nutrition was interrelated with longer survival (SGA: 456 vs. 679 days, NRS: 312 vs. 659 vs. 835 days, BMI: respectively, 411, 541, 631 days, results were statistically significant for NRS and BMI. Concentration of albumin was not a prognostic factor, but longer survival was observed when level of albumin was increased during nutritional therapy. Conclusions: The initial nutrition state and positive response to enteral feeding is associated with better survival among patients with ALS. For this reason, nutritional therapy should be introduced as soon as possible.

  8. The influence of the initial state of nutrition on the lifespan of patients with amyotrophic lateral sclerosis (ALS) during home enteral nutrition

    Science.gov (United States)

    Sznajder, Janusz; S Lefarska-Wasilewska, Marta; Kłek, Stanisław

    2016-02-16

    Aim: Amyotrophic lateral sclerosis (ALS) is a chronic, neurodegenerative disease, which leads to development of malnutrition. The main purpose of this research was to analyze the impact of malnutrition on the course of the disease and long-term survival. Material and methods: A retrospective analysis has been performed on 48 patients (22 F [45,83%] and 26 M [54,17%], the average age of patients: 66,2 [43-83]) in 2008-2014.The analysis of the initial state of nutrition was measured by body mass index (BMI), nutritional status according to NRS 2002, SGA and concentration of albumin in blood serum. Patients were divided into two groups, depending on the state of nutrition: well-nourished and malnourished. The groups were created separately for each of these, which allowed an additional comparative analysis of techniques used for the assessment of nutritional status. Results: Proper state of nutrition was interrelated with longer survival (SGA: 456 vs. 679 days, NRS: 312vs. 659vs. 835 days, BMI: respectively, 411, 541, 631 days, results were statistically significant for NRS and BMI). Concentration of albumin was not a prognostic factor, but longer survival was observed when level of albumin was increased during nutritional therapy. Conclusions: The initial nutrition state and positive response to enteral feeding is associated with better survival among patients with ALS. For this reason, nutritional therapy should be introduced as soon as possible.

  9. Toward Enteral Nutrition in the Treatment of Pediatric Crohn Disease in Canada: A Workshop to Identify Barriers and Enablers

    Directory of Open Access Journals (Sweden)

    Johan Van Limbergen

    2015-01-01

    Full Text Available The treatment armamentarium in pediatric Crohn disease (CD is very similar to adult-onset CD with the notable exception of the use of exclusive enteral nutrition (EEN [the administration of a liquid formula diet while excluding normal diet], which is used more frequently by pediatric gastroenterologists to induce remission. In pediatric CD, EEN is now recommended by the pediatric committee of the European Crohn’s and Colitis Organisation and the European Society for Paediatric Gastroenterology Hepatology and Nutrition as a first-choice agent to induce remission, with remission rates in pediatric studies consistently >75%. To chart and address enablers and barriers of use of EEN in Canada, a workshop was held in September 2014 in Toronto (Ontario, inviting pediatric gastroenterologists, nurses and dietitians from most Canadian pediatric IBD centres as well as international faculty from the United States and Europe with particular research and clinical expertise in the dietary management of pediatric CD. Workshop participants ranked the exclusivity of enteral nutrition; the health care resources; and cost implications as the top three barriers to its use. Conversely, key enablers mentioned included: standardization and sharing of protocols for use of enteral nutrition; ensuring sufficient dietetic resources; and reducing the cost of EEN to the family (including advocacy for reimbursement by provincial ministries of health and private insurance companies. Herein, the authors report on the discussions during this workshop and list strategies to enhance the use of EEN as a treatment option in the treatment of pediatric CD in Canada.

  10. Enteral or parenteral nutrition in traumatic brain injury: a prospective randomised trial Nutrición enteral o parenteral en lesión traumática cerebral: un estudio prospectivo y randomizado

    National Research Council Canada - National Science Library

    C. Mª Justo Meirelles; J. E. de Aguilar-Nascimento

    2011-01-01

    ...: We aimed at investigating whether early enteral (EN) or parenteral nutrition (TPN) may differ in protein/ calorie supply, serum glucose modifications, and acute phase response in patients with traumatic brain injury (TBI). Methods...

  11. Evidence-based recommendations and expert consensus on enteral nutrition in the adult patient with diabetes mellitus or hyperglycemia.

    Science.gov (United States)

    Sanz-Paris, Alejandro; Álvarez Hernández, Julia; Ballesteros-Pomar, María D; Botella-Romero, Francisco; León-Sanz, Miguel; Martín-Palmero, Ángela; Martínez Olmos, Miguel Ángel; Olveira, Gabriel

    2017-09-01

    The aim of this study was to develop evidence-based recommendations for glycemic control of patients with diabetes mellitus or stress hyperglycemia who are receiving enteral nutrition (EN). A Delphi survey method using Grading Recommendations Assessment, Development and Evaluation criteria was utilized for evaluation of suitable studies. In patients with diabetes or stress hyperglycemia who were on EN support, the following results were found: CONCLUSIONS: These recommendations and suggestions regarding enteral feeding in patients with diabetes and hyperglycemia have direct clinical applicability. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Maintaining Enteral Nutrition in the Severely Ill using a Newly Developed Nasojejunal Feeding Tube with Gastric Decompression Function.

    Science.gov (United States)

    Toh Yoon, Ezekiel; Nishihara, Kazuki; Murata, Hirohiko

    2016-01-01

    For nutritional support of critically ill patients, the enteral route is preferred over the parenteral route. Although nasojejunal feeding can be superior to gastric feeding when gastrointestinal symptoms occur, it does not necessarily solve the problem of large gastric residual volumes. We report the successful use of a newly developed nasojejunal feeding tube with gastric decompression function in an 84-year-old man with severe pneumonia. After gastric feeding was considered not well tolerated, the use of this tube improved the delivery of nutrition until the patient was stable enough to undergo percutaneous endoscopic gastrostomy.

  13. Early enteral nutrition after surgical treatment of gut perforations: A prospective randomised study

    Directory of Open Access Journals (Sweden)

    Malhotra Amber

    2004-04-01

    Full Text Available BACKGROUND: Withholding enteral feeds after an elective gastrointestinal surgery is based on the hypothesis that this period of "nil by mouth" provides rest to the gut and promotes healing. AIMS: To assess whether early postoperative naso-gastric tube feeding in the form of a balanced diet formula is safe in and beneficial to patients who have undergone surgical intervention for perforation of the gut. SETTING: A surgical unit of a Medical College Hospital. DESIGN AND SUBJECTS: Prospective randomised open control study. METHODS AND MATERIAL: Patients undergoing surgical intervention for peritonitis following perforation of the gut were randomised to the study group receiving feedings of a balanced diet formula through a naso-gastric tube from the second postoperative day, or the control group in which patients were managed with the conventional regimen of intravenous fluid administration. The groups were compared for incidence and duration of complications, biochemical measurements and other characteristics like weight loss/gain. STATISTICAL ANALYSIS: Chi square test and ′T′ test. RESULTS: One hundred patients were enrolled in each group. 88% subjects in the study group achieved positive nitrogen balance on the eighth postoperative day as compared to none in the conventionally managed group. The relative risks (95% confidence interval of morbidity from wound infection, wound dehiscence, pneumonia, leakage of anastomoses and septicaemia were 0.66 (0.407-1.091, 0.44 (0.141-1.396, 0.70 (0.431-1.135, 0.54 (0.224-1.293 and 0.66 (0.374-1.503 respectively. Average loss of weight between the first and tenth day was 3.10 kg in the study group as compared to 5.10 kg in the conventionally managed group (′P′ value < 0.001, 95% Confidence Interval - 2.46 - 1.54. CONCLUSION: Early enteral nutrition is safe and is associated with beneficial effects such as lower weight loss, early achievement of positive nitrogen balance as compared to the conventional

  14. Home enteral nutrition recipients: patient perspectives on training, complications and satisfaction

    LENUS (Irish Health Repository)

    Boland, Karen

    2016-10-01

    The equitable provision of home enteral nutrition (HEN) in the community can have a transformative effect on patient experience and family life for adults and children alike. While optimising quality of life in HEN patients can be challenging, the initiation of HEN positively impacts this measure of healthcare provision.1 Quality of life scores have been shown to improve in the weeks after hospital discharge, and HEN is physically well tolerated. However, it may be associated with psychological distress, and sometimes reluctance among HEN patients to leave their homes.2 Globally, HEN can attenuate cumulative projected patient care costs through a reduction in hospital admission and complications including hospital acquired infections.3 In an era where the cost of disease related malnutrition and associated prolonged hospital stay is being tackled in our healthcare systems, the role of HEN is set to expand. This is a treatment which has clear clinical and social benefits, and may restore some independence to patients and their families. Rather than the indications for HEN being focused on specific diagnoses, the provision of months of quality life at home for patients is adequate justification for its prescription.4 Previously, a review of HEN service provision in 39 cases demonstrated that patients want structured follow-up after hospital discharge, and in particular, would like one point of contact for HEN education and discharge.5 Management structures, funding challenges and the need for further education, particularly within the primary care setting may limit optimal use of HEN. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) aims to develop a national guideline document, drawing on international best practice, forming a template and standards for local policy development in the area of HEN service provision, training and follow-up. The first step in guideline development was to investigate patient experience for adults and children alike. Care

  15. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition).

    Science.gov (United States)

    Becker, Patricia; Carney, Liesje Nieman; Corkins, Mark R; Monczka, Jessica; Smith, Elizabeth; Smith, Susan E; Spear, Bonnie A; White, Jane V

    2015-02-01

    The Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), utilizing an evidence-informed, consensus-derived process, recommend that a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice. The recommended indicators include z scores for weight-for-height/length, body mass index-for-age, or length/height-for-age or mid-upper arm circumference when a single data point is available. When 2 or more data points are available, indicators may also include weight gain velocity (Dietetics.

  16. Trends in home enteral nutrition in Spain: analysis of the NADYA registry 1992-2007 Tendencias en nutrición enteral domiciliaria en España: análisis del registro NADYA 1992-2007

    OpenAIRE

    Cuerda, C.; M. Planas; C. Gómez Candela; L. M. Luengo

    2009-01-01

    Background: There are few data on trends in home enteral nutrition (HEN) practice in different countries. NADYA is the Spanish home artificial nutrition (HAN) group, and is responsible for the Spanish HAN registry. Method: We performed a 16-year retrospective study (1992-2007) of the Spanish HEN registry by retrieving data from the NADYA database and from publications of the working group. People receiving more than 1000 kcal/d with an enteral formula were included regardless of the access ro...

  17. Registro Nacional de la Nutrición Enteral Domiciliaria del año 2003 National registry of home enteral nutrition in 2003

    Directory of Open Access Journals (Sweden)

    M. Planas

    2006-02-01

    órmula se repartió entre la farmacia del hospital de referencia (46,8% y la farmacia no hospitalaria (32,0%. Se presentaron complicaciones relacionadas con el tratamiento nutritivo en 2.437 ocasiones. De ellas, el cambio de sonda, en el 44,5% fue la más frecuente, seguida de las complicaciones gastrointestinales (30,5%, las mecánicas (21,7% y las metabólicas (3,3%. Estas complicaciones significaron 0,02 hospitalizaciones por paciente. Al finalizar el año, observamos que seguían en activo en el programa el 54,7% de los pacientes; mientras que en el 35,2% se había suspendido la NED y se dejaron de seguir por diversos motivos el 10,.1% de los pacientes. Las principales causas de retirada fueron por paso a dieta oral convencional (49,2% y por éxitus en relación a la enfermedad de base (40,9%. En cuanto al grado de incapacidad, el 26,6% estaban confinados en silla o cama y el 19,7% no presentaba ningún grado de incapacidad o sólo una leve incapacidad social CONCLUSIONES: Observamos un mantenimiento en la tasa de registro de NED en España. Las causas principales de empleo de este tratamiento fueron la enfermedad neurológica y la enfermedad neoplásica muy distanciadas del resto de patologías. Persiste el elevado uso de la vía oral y el escaso empleo de las ostomías. De las complicaciones asociadas al tratamiento nutricional el cambio de sonda sigue siendo la complicación más frecuentemente observada.GOAL. To communicate the information available by the NADYA-SENPE Working Group from patients on Home Enteral Nutrition (HEN in our country during the year 2003. MATERIAL AND METHODS: The data were collected through a closed questionnaire included in the web site of the Working Group (www.nadya-senpe.com available only by the authorized users. Variable included were: epidemiological information, the indication to prescribe this treatment, the access path, the specific nutritional formula used, the treatment duration, the complications and hospital readmission related

  18. Weight loss and body composition changes following three sequential cycles of ketogenic enteral nutrition

    Directory of Open Access Journals (Sweden)

    Gianfranco Cappello

    2012-01-01

    Full Text Available Background: Ketogenic enteral nutrition (KEN is a modification of the protein sparing modified fast in which a protein solution is introduced with a continuous infusion through a nasogastric tube over 10-days cycles. The aim of the study was to perform a retrospective analysis of the safety, compliance, weight loss and body composition changes after 3 sequential 10-days cycles of KEN therapy. Materials and Methods: From a large number of patients who underwent KEN therapy in our department over a 5-year period, we selected 188 patients who participated in 3 KEN cycles with 10-13 days of break between them. Before and after the treatment cycles, body composition was analyzed by bioelectric impedance; a final assessment was made 10 days after the end of last cycle. During each rest period all the patients were on a low-carbohydrate, normal caloric diet. Results: Most patients (97% successfully tolerated the nasogastric treatment and lost an average of 14.4 kg of body weight, 10.6 kg of fat mass and 3.4 kg of body cell mass. Adverse effects were recorded as mild gastric hypersecretion (2% and constipation (5%. Patients continued to lose fat during the 10-day follow up period after the end of each KEN Cycle. This effect may be explained by abnormality of water distribution during the rapid weight loss inducing the observed change in fat mass. Conclusion: Ten-days KEN treatment cycles can induce rapid weight loss and reduction of fat mass in obese patients. Furthermore, preservation of lean mass can be achieved by infusing 1.9 g of protein/kg of BCM.

  19. Immune functional impacts of oyster peptide-based enteral nutrition formula (OPENF) on mice: a pilot study

    Institute of Scientific and Technical Information of China (English)

    CAI Bingna; PAN Jianyu; WU Yuantao; WAN Peng; SUN Huili

    2013-01-01

    Oyster peptides were produced from Crassostrea hongkongensis and used as a new protein source for the preparation of an oyster peptide-based enteral nutrition formula (OPENF).Reserpineinduced malabsorption mice and cyclophosphamide-induced immunosuppression mice were used in this study.OPENF powder is light yellow green and has a protein-fat-carbohydrate ratio of 16:9:75 with good solubility in water.A pilot study investigating immune functional impacts of the OPENF on mice show that the OPENF enhanced spleen lymphocyte proliferation and the activity of natural killer (NK) cells in BALB/c mice.Furthermore,OPENF can improve intestinal absorption,increase food utilization ratio,and maintain the normal physiological function of mice.These results suggest that oyster peptides could serve as a new protein source for use in enteral nutrition formula,but more importantly,also indicate that OPENF has an immunostimulating effect in mice.

  20. Immune functional impacts of oyster peptide-based enteral nutrition formula (OPENF) on mice: a pilot study

    Science.gov (United States)

    Cai, Bingna; Pan, Jianyu; Wu, Yuantao; Wan, Peng; Sun, Huili

    2013-07-01

    Oyster peptides were produced from Crassostrea hongkongensis and used as a new protein source for the preparation of an oyster peptide-based enteral nutrition formula (OPENF). Reserpineinduced malabsorption mice and cyclophosphamide-induced immunosuppression mice were used in this study. OPENF powder is light yellow green and has a protein-fat-carbohydrate ratio of 16:9:75 with good solubility in water. A pilot study investigating immune functional impacts of the OPENF on mice show that the OPENF enhanced spleen lymphocyte proliferation and the activity of natural killer (NK) cells in BALB/c mice. Furthermore, OPENF can improve intestinal absorption, increase food utilization ratio, and maintain the normal physiological function of mice. These results suggest that oyster peptides could serve as a new protein source for use in enteral nutrition formula, but more importantly, also indicate that OPENF has an immunostimulating effect in mice.

  1. Registro Nacional de la nutrición enteral domiciliaria del año 2002 The year 2002 national registry on home-based enteral nutrition

    Directory of Open Access Journals (Sweden)

    M. Planas

    2005-08-01

    repartió entre la farmacia del hospital de referencia (43% y la farmacia no hospitalaria (37,3%. Se presentaron complicaciones relacionadas con el tratamiento nutritivo en 3.375 ocasiones. De ellas, el cambio de sonda, en el 38,2% fue la más frecuente, seguida de las complicaciones gastrointestinales (29,7%, las mecánicas (22,9% y las metabólicas (9,2%, Estas complicaciones significaron 0,02 hospitalizaciones por paciente. Al finalizar el año, observamos que seguían en activo en el programa el 49,3% de los pacientes; mientras que en el 41,5% se había suspendido la NED y se dejaron de seguir por diversos motivos el 9,2% de los pacientes. Las principales causas de retirada fueron por paso a dieta oral convencional (47,3% y por éxitus en relación a la enfermedad de base (36,8%. En cuanto al grado de incapacidad, el 31,8% estaban confinados en silla o cama y el 17,8% no presentaba ningún grado de incapacidad o sólo una leve incapacidad social. Conclusiones: Observamos un mantenimiento en la tasa de registro de NED en España (96,5 pacientes/millón de habitantes. La causa principal de empleo de este tratamiento fue la enfermedad neurológica seguida de la enfermedad neopiásica. Esta elevada incidencia de enfermedad neoplásica quizás es la responsable del gran uso de la vía oral en nuestra serie. De las complicaciones asociadas al tratamiento nutricional el cambio de sonda fue la que se presentó en más ocasiones.Goal: To communicate the information available by the NADYA-SENPE Working Group from patients on Home Enteral Nutrition (HEN in our country during the year 2002. Material and methods: The data were collected through a closed questionnaire included in the web site of the Working Group (www.nadya-senpe.com available only by the authorized users. Variable included were: epidemiological information, the indication to prescribe this treatment, the access path, the specific nutritional formula used, the treatment duration, the complications and hospital

  2. Hepatic transcriptomic profiles of preterm piglets nourished by enteral and parenteral nutrition

    Science.gov (United States)

    Parenteral nutrition is a life-saving nutritional support for more than half a million premature and hospitalized infants in the U.S. annually. Lipids in parenteral nutrition provide essential fatty acids and are a major source of energy. Intralipid (IL) is the only approved lipid emulsion in the U....

  3. [Registry of home-based enteral nutrition in Spain for the year 2006 (NADYA-SENPE Group)].

    Science.gov (United States)

    Cuerda, C; Chicharro, M L; Frías, L; García Luna, P P; Cardona, D; Camarero, E; Penacho, M A; Calañas, A; Parés, R M; Martínez Olmos, M A; Zapata, A; Rabassa Soler, A; Gómez Candela, C; Pérez de la Cruz, A; Lecha, M; Luis, D de; Luengo, L M; Wanden-Berghe, C; Laborda, L; Matía, P; Cantón, A; Martí, E; Irles, J A

    2008-01-01

    To communicate the results obtained from the registry of Home-Based Enteral Nutrition (HBEN) of the NADYA-SENPE group for the year 2006. Recompilation of the data from the HBEN registry of the NADYA-SENPE group from January 1st to December 31st of 2006. During the year 2006, 3,921 patients (51% men) from 27 hospital centers were registered. Ninety-seven percent were older than 14 years. The mean age for those or = 14 years, it was 68.5 +/- 18.2 years. The most common underlying disease was neurological pathology (42%), followed by cancer (28%). Enteral nutrition was administered p.o. in 44% of the patients, through nasogastric tube in 40%, gastrostomy in 14%, and jejunostomy in 1%. The average time of nutritional support was 8.8 months. The most common reasons for ending the therapy were patient's death (54%) and switching to oral feeding (32%). Thirty-one percent of the patients presented a limited activity and 40% were confined to bed/coach. Most of the patients required partial (25%) or total (43%) care assistance. The nutritional formula was provided by the hospital in 62% of the cases and from the reference pharmacy in 27%. The fungible material was provided by the hospital in 80% of the cases and by primary care in the remaining patients. Although the number of registered patients is slightly higher than that from the last years, there are no important changes in the patients characteristics, or way of administration and duration of enteral nutrition.

  4. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

    Science.gov (United States)

    Perro, G; Bourdarias, B; Cutillas, M; Higueret, D; Sanchez, R; Iron, A

    1995-10-01

    The efficacy of an oral supplement of vitamins and trace elements during a longterm artificial parenteral and enteral nutrition was investigated for 3 months in patients with extensive burns. Thirty severely burned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 years, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: *vitamins B1, B12, A, E, *folic acid, *copper, zinc, iron, *transferrin, albumin, prealbumin, total proteins, *fibronectin, retinol binding protein (RBP), *calcium, *phosphorus, *triglycerides, *total cholesterol, *C reactive protein (CRP), *erythrocyte folic acid. The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with enteral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vitamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus, RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the average levels of transferrin and iron remaining below normal values until day 50. There was a significant decrease in C-reactive protein levels, however above normal limits. No deficiency in vitamins or trace elements was found. Cyclic variations of serum levels occurred which may be more related to volemic, hydroelectrolytic, endocrine and inflammatory disorders than to nutritional problems.

  5. 肽类肠内营养制剂的益处%Benefits of peptide-based enteral nutrition

    Institute of Scientific and Technical Information of China (English)

    PamelaR.Poberts

    2001-01-01

    Theories of protein digestion have classically asserted thatproteins are completely hydrolyzed to free amino acids within the intestine before absorption occurs.Further,it has been taught that only free amino acids enter the circulation.However,current evidence indicates that hydrolyzed protein fragments(i.e.peptides)also cross the small intestine and reach peripheral tissue via the systemic circulation,Nitrogen sources for enteral nutrition are free amino acids,peptides,or intact proteins.Current experimental evidence indicates that diets which possess the capability of producing luminal peptides are superior to diets lacking this capacity.The parent protein used for enteral nutrition generates specific peptides which may dictate a variety of metabolic responses. Many small peptides derived from the diet possess bioligic activity and may also play a role in regulating physiologic processes.Dietary peptides can have specific actions either locally,on the gastrointestinal tract,or at more distant sites.These peptides may alter cellular metabolism and may act as vasoregulators,growth factors,releasing hormones,,or neurotransmitters.The concept of dietary bioactive peptides offers an explanation for varying effects of diet on physiologic responses.These concepts have spurred research efforts into the possibility of enteral administration of biogenic amines.

  6. Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

    Directory of Open Access Journals (Sweden)

    Alejandro Sanz-Paris

    2016-03-01

    Full Text Available Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p < 0.001, days spent at hospital (64.1%; p < 0.001 and emergency visits (57.7%; p < 0.001. Health-care costs were reduced by 65.6% (p < 0.001 during the intervention. Glycemic control (short- and long-term and the need of pharmacological treatment did not change, while some nutritional parameters were improved at one year (albumin: +10.6%, p < 0.001; hemoglobin: +6.4%, p = 0.026. In conclusion, using HDSF in malnourished older type-2 diabetic patients may allow increasing energy intake while maintaining glucose control and improving nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

  7. Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury: Effects on Immune Function, Nutritional Status and Outcomes(△).

    Science.gov (United States)

    Ming-Chao, Fan; Qiao-Ling, Wang; Wei, Fang; Yun-Xia, Jiang; Lian-di, Li; Peng, Sun; Zhi-Hong, Wang

    2016-11-20

    Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function, complications and clinical outcomes were examined and compared statistically. Results There were 120 patients enrolled in the study, with 40 pationts in each group. In EN+PN group, T lymthocyte subsets CD3+%, CD4+%, ratio of CD3+/CD25+, ratio of CD4+/CD8+, the plasma levels of IgA, IgM, and IgG at 20 days after nutritional treatment were significantly increased compared to the baseline(t=4.32-30.00, Pnutritional status, the serum total protein, albumin, prealbumin and hemoglobin were significantly higher in the EN (t=5.87-11.91; Pnutrition treatment. The serum prealbumin was higher in EN+PN group than that in EN group (t=2.08; Pnutritional status, decrease complications and improve the clinical outcomes in patients with severe traumatic brain injury.

  8. Effect of perioperative immuno-enhanced enteral nutrition on inflammatory response, nutritional status, and outcomes in head and neck cancer patients undergoing major surgery.

    Science.gov (United States)

    Felekis, Dimitrios; Eleftheriadou, Anna; Papadakos, Georgios; Bosinakou, Irini; Ferekidou, Eliza; Kandiloros, Dimitrios; Katsaragakis, Stylianos; Charalabopoulos, Konstantinos; Manolopoulos, Leonidas

    2010-01-01

    Administration of immuno-enhanced nutritional support may decrease postoperative morbidity, mortality, and infectious complications in cancer patients. The aim of this study was to verify that perioperative enteral diet, enriched with the nutrients arginine, ribonucleic acid (RNA), and ω-3 fatty acids improves outcomes of head and neck cancer patients undergoing major surgery. Forty patients with squamous cell carcinoma of the head and neck were studied. Group 1 received no preoperative nutritional support, whereas Group 2 received an oral formula with nutrients arginine, RNA, and ω-3 fatty acids. After surgery, Group 1 received a standard enteral formula, whereas Group 2 received an enriched enteral formula. Albumin (g/dl), prealbumin, fibrinogen, CRP, Il-6, and TNFa were measured 5 days before and 8 days after surgery. No statistically significant difference was observed for all the evaluated markers between postoperative and preoperative levels for both groups. The rate of complications was significantly reduced in the total number of patients receiving immunonutrition and in the particular subgroup of well-nourished patients receiving an immuno-enhanced diet. Perioperative enteral immuno-enhanced feeding in head and neck cancer patients undergoing major surgery may influence the postoperative outcomes by reducing the frequency rate of infections and wound complications.

  9. A qualitative study of the perceived value of membership in The Oley Foundation by home parenteral and enteral nutrition consumers.

    Science.gov (United States)

    Chopy, Katelyn; Winkler, Marion; Schwartz-Barcott, Donna; Melanson, Kathleen; Greene, Geoffrey

    2015-05-01

    Support and educational organizations have been shown to improve quality of life of consumers of home nutrition support. One such organization, The Oley Foundation, offers resources for the home parenteral and enteral nutrition (HPEN) consumer. While research has shown proven benefits to HPEN consumers affiliated with The Oley Foundation, no studies have investigated the perceived value of membership to the consumer or the way in which consumers are introduced to the organization. Qualitative methodology was used to gain a deeper understanding of the perceived value of membership in The Oley Foundation. Audiotaped, in-depth, semistructured telephone interviews were conducted to explore participants' experiences with The Oley Foundation and HPEN. Inductive content analysis was used to analyze data and identify themes associated with membership value. The value of The Oley Foundation lies in programs and resources and the competency, inspiration, normalcy, and advocacy gained from membership, helping individuals adjust to life with HPEN dependency. More than half of participants found the organization through self-initiated Internet searches, but all participants clearly expressed the desire "I wish I knew about it sooner." This study identifies the value of membership in The Oley Foundation and the important role the organization has in the lives of HPEN-dependent consumers. Nutrition support clinicians should introduce the organization to patients when the need for HPEN is established and prior to hospital discharge. © 2014 American Society for Parenteral and Enteral Nutrition.

  10. Early enteral and parenteral nutritional support after hepatectomy in patients with hepatic carcinoma: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Gao LB

    2015-03-01

    Full Text Available Lin-Ben Gao,1* He Tian,2* Xing-Guang Wang,3 Xiao-Fei Yu,4 Yan Guan,2 Ming-Lu Chen,5 Jian Zhang6 1Department of Respiratory Medicine, Haiyang People’s Hospital, Haiyang, 2Department of Oncology, Shandong Province Tumor Hospital, Jinnan, 3Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinnan, 4Department of Emergency, Haiyang People’s Hospital, Haiyang, 5Department of Nuclear Radiology, Shandong Province Tumor Hospital, Jinnan, 6Department of Gastroenterology, Haiyang People’s Hospital, Haiyang, People’s Republic of China *These two authors contributed equally to this work Background: This study sought to conduct a systematic review providing a comparative analysis of enteral nutrition (EN and parenteral nutrition (PN after hepatectomy. Methods: PubMed, Embase, and the China National Knowledge Infrastructure databases were searched for publications describing randomized controlled trials that compared early EN and PN after hepatectomy. The time period for this search was from January 1990 to December 2013. In accordance with the inclusion criteria of this study, two researchers independently screened the retrieved literature, extracted data, and assessed methodological quality. A meta-analysis of the included publications was then performed using RevMan 5.2 software. Results: The meta-analysis results indicated statistically significant differences between the group that received EN and the group that received PN during the early stages after hepatectomy with respect to average total bilirubin and alanine aminotransferase levels after nutrition, prealbumin levels, incidence of diarrhea and abdominal bloating, time to flatus, and average cost of nutrition. To varying degrees, better results were observed in the EN group than in the PN group for these metrics. Conclusion: During the early stages after hepatectomy, EN has obvious advantages relative to PN; thus, EN merits more widespread promotion

  11. PRESENT; PREScription of Enteral Nutrition in pediaTric Crohn's disease in Spain.

    Science.gov (United States)

    Navas-López, Victor Manuel; Martín-de-Carpi, Javier; Segarra, Oscar; García-Burriel, José Ignacio; Díaz-Martín, Juan José; Rodríguez, Alejandro; Medina, Enrique; Juste, Mercedes

    2014-03-01

    Objetivos: La nutrición enteral exclusiva (NEE) es una de las estrategias terapéuticas empleadas para inducir la remisión en niños con enfermedad de Crohn (EC). Pese a que la NEE se recomienda en las guías de práctica clínica y en los documentos de consenso, la frecuencia real de su empleo en España es desconocida. Métodos: Encuesta compuesta por 70-items (PRESENT: PREScription of Enteral Nutrition in pediaTric Crohn’s disease in Spain) que se distribuyó a través de la lista de distribución de Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP). Resultados: Se recibieron los datos de 51 unidades de Gastroenterología Pediátrica del territorio español. De los 287 pacientes recién diagnosticados de EC durante los años 2011-12 en esos centros (139 en 2011 y 148 en 20212), 182 (63%) recibieron NEE (58% en 2011 y 68% en 2012). El 26% de los pacientes que recibieron NEE estaban en recaída. Todos los facultativos que respondieron pensaban que la NEE es efectiva para inducir la remisión clínica en los brotes leves-moderados. El 24,5% no emplean la NEE durante las recaídas. Las formulas enterales empleadas más frecuentemente fueron las específicas para EC (70,6%), la vía oral fue la más utilizada, el 60,8% utilizaron saborizantes y el 9,8% de las unidades permitían un porcentaje variable de calorías en forma de otros alimentos durante el periodo de NEE. El 65% emplearon 5-ASA junto con la NEE, el 69% antibióticos y hasta un 95% inmunomoduladores. La duración de la NEE fue de 8 semanas en el 47,1% de los casos, la transición hacia una dieta normal se realizó de forma secuencial. En relación a las barreras y factores limitantes encontrados por los respondedores para instaurar la NEE destacaban la falta de aceptación por el paciente y/o la familia (71%), falta de tiempo o de personal auxiliar (69%) y la dificultad para convencer al paciente o su familia de la idoneidad del tratamiento (43%). Conclusiones

  12. Parenteral and enteral nutrition for pediatric oncology in low- and middle-income countries

    OpenAIRE

    K Viani

    2015-01-01

    Although nutritional therapy is essential for the treatment of childhood cancer, it remains a challenge, especially within the developing world, where there are many barriers to optimizing treatment. The oral route is the first approach to nutritional support, however challenging this might be in children with cancer. Oral supplements are indicated in moderate evaluated nutritional risk patients and its use should consider the family's social conditions and access to industrialized oral suppl...

  13. Phase Angle and Handgrip Strength Are Sensitive Early Markers of Energy Intake in Hypophagic, Non-Surgical Patients at Nutritional Risk, with Contraindications to Enteral Nutrition

    Directory of Open Access Journals (Sweden)

    Riccardo Caccialanza

    2015-03-01

    Full Text Available The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA and handgrip strength normalized for skeletal muscle mass (HG/SMM are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20, while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10. The mean adjusted difference and 95% CI were +1.4° (0.5–2.3 (p = 0.005 for PhA and +0.23 (0.20–0.43 (p = 0.033 for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23–0.77; p = 0.0023. PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of Ph

  14. Phase angle and handgrip strength are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition.

    Science.gov (United States)

    Caccialanza, Riccardo; Cereda, Emanuele; Klersy, Catherine; Bonardi, Chiara; Cappello, Silvia; Quarleri, Lara; Turri, Annalisa; Montagna, Elisabetta; Iacona, Isabella; Valentino, Francesco; Pedrazzoli, Paolo

    2015-03-11

    The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN) in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA) and handgrip strength normalized for skeletal muscle mass (HG/SMM) are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20), while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10). The mean adjusted difference and 95% CI were +1.4° (0.5-2.3) (p = 0.005) for PhA and +0.23 (0.20-0.43) (p = 0.033) for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23-0.77); p = 0.0023). PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of PhA variations as early

  15. American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: Revised 2014 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition Support.

    Science.gov (United States)

    Brantley, Susan L; Russell, Mary K; Mogensen, Kris M; Wooley, Jennifer A; Bobo, Elizabeth; Chen, Yimin; Malone, Ainsley; Roberts, Susan; Romano, Michelle M; Taylor, Beth

    2014-12-01

    This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice. © 2014 American Society for Parenteral and Enteral Nutrition.

  16. Effects of postoperative immune-enhancing enteral nutrition on the immune system, inflammatory responses, and clinical outcome

    Institute of Scientific and Technical Information of China (English)

    蒋小华; 李宁; 朱维铭; 吴国豪; 全志伟; 黎介寿

    2004-01-01

    Objective This study was conducted to evaluate the effects of postoperative immune enhancing enteral nutrition on the immune system, inflammatory responses, and clinical outcome of patients undergoing major abdominal surgery. Methods This study was designed as a multicenter, prospective,randomized and controlled clinical trial. One hundred twenty-four patients undergoing major abdominal surgery were randomly assigned to receive either an immune enhancing enteral diet or an isocaloric and isonitrogenous control enteral diet for seven days. Enteral feeding was initiated 24 hours after surgery. Host immunity was evaluated by measuring levels of IgG, IgM, IgA, CD4, CD8, and CD4/CD8, and the inflammatory response was determined by assessing IL-1α, IL-2, IL-6, IL-10, and TNF-α levels. Infectious complications were also recorded. Results One hundred twenty patients completed the study and four patients were excluded. On postoperative day 9, among patients receiving an immune enhancing diet,IgG, IgA, CD4 and CD4/CD8 levels were significantly higher and TNF-α and IL-6 concentrations were significantly lower compared to the control group. Moreover, among patients receiving an immune enhancing diet, when comparing preoperation to day 9 postoperation levels, increases in IgA, CD4, and CD4/CD8 levels were significantly higher than in control patients and increases in TNF-α concentrations were significantly lower. No statistically significant differences were found between the two groups with regard to infectious complications.Conclusions Postoperative administration of immune enhancing enteral nutrition in patients undergoing major abdominal surgery can positively modulate postoperative immunosuppressive and inflammatory responses.

  17. Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer.

    Science.gov (United States)

    Yu, Guiping; Chen, Guoqiang; Huang, Bin; Shao, Wenlong; Zeng, Guangqiao

    2013-06-01

    To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme-linked immunosorbent assay (ELISA). After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (Pcancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune function.

  18. Effect of three different doses of arginine enhanced enteral nutrition on nutritional status and outcomes in well nourished postsurgical cancer patients: a randomized single blinded prospective trial.

    Science.gov (United States)

    De Luis, D A; Izaola, O; Terroba, M C; Cuellar, L; Ventosa, M; Martin, T

    2015-01-01

    Patients with head and neck cancer undergoing surgery have a high occurrence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an enhanced enteral formula with three different doses of arginine could improve nutritional variables as well as clinical outcome, depending of arginine dose. A population of 84 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly assigned to three different treatment groups, each one containing at less 28 patients. Group I (28 patients) received an enteral diet supplements with a low physiological dose of arginine (5.7 g per day), group II (28 patients) received an isocaloric, isonitrogenous enteral formula with a medium dose of arginine (12.3 g per day) and group III (28 patients) received an isocaloric, isonitrogenous enteral formula with a high dose of arginine (18.9 g per day). The length of postoperative stay had a trend to be better with high dose of arginine received (31.9 ± 17.2 days in group I vs 27.8 ± 15.2 days in group II vs 24.8 ± 18.3 days in group III: p = 0.034). No differences were detected in postoperative infections complications and diarrhea. Fistula was less frequent in groups II and III than I (10.7% group I vs 3.6% group II vs 3.6% group III: p = 0.033), The length of postoperative stay had a trend to be better with high dose of arginine received (31.9 ± 17.2 days in group I vs 27.8 ± 15.2 days in group II vs 24.8 ± 18.3 days in group III: p = 0.034). Our results suggest that these patients could benefit from a high dose of arginine enhanced enteral formula to decrease length of hospital stay and fistula wound complications.

  19. Enteral obeticholic acid prevents hepatic cholestasis in total parenteral nutrition-fed neonatal pigs

    Science.gov (United States)

    Total parenteral nutrition (TPN) is a vital support for neonatal infants with congenital or acquired gastrointestinal (GI) disorders and requiring small bowel resection. An adverse outcome associated with prolonged TPN use is parenteral nutrition associated cholestasis (PNAC). We previously showed t...

  20. Enteral Nutrient Supply for Preterm Infants : Commentary From the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition

    NARCIS (Netherlands)

    Agostoni, C.; Buonocore, G.; Carnielli, V. P.; De Curtis, M.; Darmaun, D.; Decsi, T.; Domellof, M.; Embleton, N. D.; Fusch, C.; Genzel-Boroviczeny, O.; Goulet, O.; Kalhan, S. C.; Kolacek, S.; Koletzko, B.; Lapillonne, A.; Mihatsch, W.; Moreno, L.; Neu, J.; Poindexter, B.; Puntis, J.; Putet, G.; Rigo, J.; Riskin, A.; Salle, B.; Sauer, P.; Shamir, R.; Szajewska, H.; Thureen, P.; Turck, D.; van Goudoever, J. B.; Ziegler, E. E.

    The number of surviving children born prematurely has increased substantially during the last 2 decades. The major goal of enteral nutrient supply to these infants is to achieve growth similar to foetal growth coupled with satisfactory functional development. The accumulation of knowledge since the

  1. Association between probiotics and enteral nutrition in an experimental acute pancreatitis model in rats

    NARCIS (Netherlands)

    Baal, M.C.P.M. van; Rens, M.J. van; Geven, C.B.; Pol, F.M. van de; Brink, I. van den; Hannink, G.J.; Nagtegaal, I.D.; Peters, W.H.M.; Rijkers, G.T.; Gooszen, H.G.

    2014-01-01

    BACKGROUND/OBJECTIVES: Recently, a randomized controlled trial showed that probiotic prophylaxis was associated with an increased mortality in enterally fed patients with predicted severe pancreatitis. In a rat model for acute pancreatitis, we investigated whether an association between probiotic

  2. Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

    National Research Council Canada - National Science Library

    Rugeles, Saúl-Javier; Rueda, Juan-David; Díaz, Carlos-Eduardo; Rosselli, Diego

    2013-01-01

    Our aim was to evaluate the impact of hyperproteic hypocaloric enteral feeding on clinical outcomes in critically ill patients, particularly on severity of organic failure measured with the Sequential...

  3. Should early enteral nutrition be used in the trauma intensive care ...

    African Journals Online (AJOL)

    catabolism, which, in turn, necessitates increased protein intake to compensate for ... the gut is functional.2,4-8 The concept of early enteral feeding (EEF) refers to the ... of emesis and raised gastric residual volumes between the groups.13.

  4. Relationship between energy expenditure, nutritional status and clinical severity before starting enteral nutrition in critically ill children.

    Science.gov (United States)

    Botrán, Marta; López-Herce, Jesús; Mencía, Santiago; Urbano, Javier; Solana, Maria José; García, Ana; Carrillo, Angel

    2011-03-01

    The objective of the present study was to investigate the relationship between energy expenditure (EE), biochemical and anthropometric nutritional status and severity scales in critically ill children. We performed a prospective observational study in forty-six critically ill children. The following variables were recorded before starting nutrition: age, sex, diagnosis, weight, height, risk of mortality according to the Paediatric Risk Score of Mortality (PRISM), the Revised Paediatric Index of Mortality (PIM2) and the Paediatric Logistic Organ Dysfunction (PELOD) scales, laboratory parameters (albumin, total proteins, prealbumin, transferrin, retinol-binding protein, cholesterol and TAG, and nitrogen balance) and EE measured by indirect calorimetry. The results showed that there was no relationship between EE and clinical severity evaluated using the PRISM, PIM2 and PELOD scales or with the anthropometric nutritional status or biochemical alterations. Finally, it was concluded that neither nutritional status nor clinical severity is related to EE. Therefore, EE must be measured individually in each critically ill child using indirect calorimetry.

  5. Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution: A prospective randomized double-blind study

    Institute of Scientific and Technical Information of China (English)

    Tarkan Karakan; Meltem Ergun; Ibrahim Dogan; Mehmet Cindoruk; Selahattin Unal

    2007-01-01

    AIM: To compare the beneficial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who required stoppage of oral feeding for 48 h, were randomly assigned to nasojejunal EN with or without prebiotics. APACHE Ⅱ score, Balthazar's CT score and CRP were assessed daily during the study period.RESULTS: The median duration of hospital stay was shorter in the study group [10 ± 4 (8-14) d vs 15 ± 6 (7-26) d] (P<0.05). The median value of days in intensive care unit was also similar in both groups [6 ± 2 (5-8) d vs 6 ± 2 (5-7) d]. The median duration of EN was 8 ± 4 (6-12) d vs 10 ± 4 (6-13) d in the study and control groups, respectively (P>0.05). Deaths occurred in 6 patients (20%), 2 in the study group and 4 in the control group. The mean duration of APACHE Ⅱ normalization (APACHE Ⅱ score < 8) was shorter in the study group than in the control group (4 ± 2 d vs 6.5 ± 3 d, P<0.05). The mean duration of CRP normalization was also shorter in the study group than in the control group (7 ± 2 d vs 10 ± 3 d, P<0.05).CONCLUSION: Nasojejunal EN with prebiotic fiber supplementation in severe AP improves hospital stay, duration nutrition therapy, acute phase response and overall complications compared to standard EN therapy.

  6. Endoscopic gastrostomy for enteral nutrition in neurogenic dysphagia: Application of a nasogastric tube or percutaneous endoscopic gastrostomy.

    Science.gov (United States)

    Maitines, Gennaro; Ugenti, Ippazio; Memeo, Riccardo; Clemente, Nicola; Iambrenghi, Onofrio Caputi

    2009-01-01

    Enteral nutrition can be administered via a nasogastric tube or, in selected patients, via a percutaneous endoscopic gastrostomy. In patients with neurogenic dysphagia, the choice of nutritional administration, and above all the timing, are crucial. Our aim was to retrospectively assess the impact of new guidelines for percutaneous endoscopic gastrostomy insertion adopted since January 2002 and compare them with our previous experience. From January 1992 to June 2007, 285 gastrostomies (168 M, 117 F) were positioned in our institute. We analysed 232 patients (139 M, 93 F) in whom a percutaneous endoscopic gastrostomy was applied for neurogenic dysphagia: Group A (from January 1992 to December 2001) consisting of 174 patients; Group B (from January 2002 to June 2007) consisting of 58 patients. The percutaneous endoscopic gastrostomy was positioned in all the cases with neurogenic dysphagia after a period of not less than 3 weeks of nutrition by nasogastric tube. A total of 6 major complications (2.3 %) occurred, almost all in group A. The mortality rate (3 patients, 2%) correlated with the complications in group A. In cases of neurogenic dysphagia we believe that greater methodological rigour in the multidisciplinary decision-making process, and a period of about 6-8 weeks' nutrition by nasogastric tube after the acute neurological damage may be useful to ensure a better prognostic evaluation of the patient and hence of the indications for percutaneous endoscopic gastrostomy.

  7. Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial.

    Science.gov (United States)

    Van Bokhorst-de Van der Schuer, M A; Langendoen, S I; Vondeling, H; Kuik, D J; Quak, J J; Van Leeuwen, P A

    2000-12-01

    This study evaluated the use of perioperative nutritional support on Quality of Life (QOL) in malnourished head and neck cancer patients undergoing surgery. 49 Malnourished (weight loss >10%) head and neck cancer patients who were included in a nutrition intervention trial were randomized to receive either no preoperative and standard postoperative tube-feeding (group I), standard preoperative and postoperative tube-feeding (group II) or arginine-supplemented preoperative and postoperative tube-feeding (group III). Of these patients, 31 completed a full QOL assessment on the first day of preoperative nutritional support, one day before surgery, and 6 months after surgery. Both a disease-specific (EORTC QLQ-C30) and a generic questionnaire (COOP-WONCA) were used. One way analysis of variance (ANOVA) and the Kruskal-Wallis test were applied for testing differences in scores between groups. Between baseline and the day before surgery, both preoperatively fed groups revealed a positive change for the dimensions physical and emotional functioning and dyspnea (with significance in group II, P=0.050,0.031,0.045 respectively). Group III showed a negative change in appetite (P=0.049). Between baseline and 6 months after surgery, there were no differences between group I and both pre-fed groups. There were no differences in favour of group III compared to group II. Enteral nutrition improves QOL of severely malnourished head and neck cancer patients in the period preceding surgery. No benefit of preoperative enteral feeding on QOL could be demonstrated 6 months after surgery. Copyright 2000 Harcourt Publishers Ltd.

  8. Gastric enteral nutrition and parenteral nutrition Nursing Analysis%胃癌术后肠内营养与肠外营养的护理分析

    Institute of Scientific and Technical Information of China (English)

    代开聪

    2016-01-01

    Objective:To investigate the gastric enteral nutrition and parenteral nutrition care. Methods:80 patients with gastric cancer, the use of parenteral nutrition support group care, observation group using enteral nutrition care. Results:Before and after each nursing protein index, postoperative complications, and long-flatus on hospitalization, the observation group than the control group, p<0.05. Conclusion:The postoperative gastric cancer support via enteral nutritional care can effectively enhance patient recovery effect, accelerate postoperative recovery, reduce postoperative complications.%目的:探讨胃癌术后肠内营养与肠外营养的护理。方法:研究我院2014年3月至2015年12月期间随机抽取的胃癌术后患者80例,分为对照组与观察组各40例,其中对照组运用肠外营养支持护理,观察组运用肠内营养支持护理,分析两组患者营养支持护理效果差异。结果:在护理前后各蛋白指数上,观察组改善幅度高于对照组,p<0.05;在术后感染率显著并发症发生率上,观察组低于对照组,p<0.05;在肛门排气与住院时长上,观察组短于对照组,p<0.05。结论:胃癌术后通过肠内营养支持护理可以有效的提升患者恢复效果,加快术后恢复,减少术后并发症。

  9. Fermented liquid feed - Microbial and nutritional aspects and impact on enteric diseases in pigs

    DEFF Research Database (Denmark)

    Canibe, Nuria; Jensen, Bent Borg

    2012-01-01

    The use of liquid feed in pig nutrition has recently gained interest due to several reasons: (1) the political wish of decreasing the use of antibiotics in pig production; (2) the current fluctuations in feed prices what makes liquid feed, with the possibility of using cheap liquid ingredients...... are related to free lysine degradation. The possible contribution of other microorganisms present in the FLF to this degradation is uncertain, though. Liquid fermentation has the potential of improving the nutritional value of feed ingredients. Data show that fermentation can improve digestibility of various...... nutrients, e.g., organic matter, nitrogen, amino acids, fibre, and calcium. The conditions of fermentation and the ingredients used are crucial factors in order to benefit from this, though. Further, there are some strategies that can help improving the microbial and nutritional characteristics of FLF...

  10. Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake Evaluación nutricional a largo plazo de pacientes con grave síndrome de intestino corto controlada con nutrición enteral e ingestión oral

    OpenAIRE

    V. Chaer Borges; M.ª de L. Teixeira da Silva; M.ª C. Gonçalves Dias; M.ª C. González; D. Linetzky Waitzberg

    2011-01-01

    Background: Parenteral nutrition (PN) is used to control the nutritional state after severe intestinal resections. Whenever possible, enteral nutrition (EN) is used to promote intestinal rehabilitation and reduce PN dependency. Our aim is to verify whether EN + oral intake (OI) in severe short bowel syndrome (SBS) surgical adult patients can maintain adequate nutritional status in the long term. Methods: This longitudinal retrospective study included 10 patients followed for 7 post-operative ...

  11. Nutrición enteral domiciliaria (NED: Registro Nacional del año 2000 Enteral nutrition at home: National register for 2000

    Directory of Open Access Journals (Sweden)

    M. Planas

    2003-02-01

    registrados. Persiste el gran peso de las patologías neurológicas y oncológicas en este tratamiento a domicilio. Probablemente, por existir un elevado número de pacientes oncológicos, la administración de la NED por boca es elevada. A destacar que hay pocos pacientes con ostomías. Finalmente, la NED en nuestro país es un tratamiento seguro con bajo número de complicaciones.Goal: Once again, the NADYA-SENPE Working Group analysed the registered data of Home Enteral Nutrition (HEN in our country, during the year 2000. Material and methods: The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com. Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient’s quality of life and progress. All data were processed and analysed by the co-ordinating team. Results: Twenty two hospital participated and 2,986 patients, aged 65.1 ± 19.7 years, were enrolled. Of these patients, 41.2% were diagnosed with neurological diseases and 33.3% with cancer. The mean time on HEN was 6.3 ± 4.4 months. Oral nutrition was the preferential route (50.8%, followed by nasoenteral tube (30.5%, and in 17.4% ostomy tubes were placed. Polymeric was the formula composition mainly used (83.2%. Patients were followed (70.1 % by the hospital reference Nutritional Support Unit. The complications related to nutrition included the gastrointestinal (0.25 complications/ patient, the mechanical one (0.19 complications/patient, and the metabolic (0.007 complications/ patient. Feeding tube need to be replaced 0.3 times/ patient/year. The readmission rate, for nutritional problems, was observed in 0.03 patients. At the end of the year, 54.9% of the patients were in the HEN program, and in 30.3% HEN was finish due to different reasons. In 21,9% of the patients no, o light

  12. Ketogenic enteral nutrition as a treatment for obesity: short term and long term results from 19,000 patients

    Directory of Open Access Journals (Sweden)

    Cappello Gianfranco

    2012-10-01

    Full Text Available Abstract Background Only protein diet has been used successfully to prevent loss of lean body mass first in post-surgical and then in obese patients. We studied overweight and obese patients receiving short treatments of an exclusively protein-based nutritional solution as 24-hour enteral infusion. Methods 19,036 patients (age 44.3 ± 13, M:F = 2:5 with an initial body mass index of 36.5 ± 7.1 underwent 10-day cycles of enteral nutrition through a fine nasogastric tube. The nutritional solution consisted solely of 50–65 g of proteins, plus vitamins and electrolytes. The 24-hour infusion was controlled with a small portable pump. Before and after each 10-day cycle body composition was checked with a Handy 3000 impedance analyzer. At the onset of treatment, average fat mass was 40.9 ± 12.8 kg while body cell mass was 42.7 ± 7.2 kg in males and 27.4 ± 4.6 kg in females. Results After an average of 2.5 cycles the patients lost 10.2 ± 7.0 kg of body weight, 5.8 ± 5.5 kg of fat mass and 2.2 ± 3.3 kg of body cell mass. No significant adverse effects were recorded except asthenia and constipation which were easily controlled with therapy. Long-term results were obtained from 15,444 patients and after an average of 362 ± 296 days we found a mean weight regain of 15.4%. Conclusion Ketogenic Enteral Nutrition treatment of over 19,000 patients induced a rapid 10% weight loss, 57% of which was Fat Mass. No significant adverse effects were found. The treatment is safe, fast, inexpensive and has good one-year results for weight maintenance.

  13. [The functional planning of a enteral nutrition unit for home care at a hospital in Brazil].

    Science.gov (United States)

    Ribeiro Salomon, Ana Lúcia; Carvalho Garbi Novaes, Maria Rita

    2013-11-01

    Introducción: Con el objeto de garantizar la calidad del producto ofrecido a los clientes en sus domicilios, las unidades hospitalarias necesitan adecuar sus áreas físicas para poder desarrollar todas las actividades especializadas que conlleva la nutrición enteral. Objetivo: Proporcionar una planificación funcional y las herramientas para la reorganización del espacio físico de una unidad de nutrición enteral, describiendo el proceso de preparación, la descripción de sus características y funciones laborales. Métodos. Estudio descriptivo, retrospectivo y documental, proporcionando las herramientas para la planificación funcional y de gestión de calidad en una unidad de preparación de la nutrición enteral en un hospital público del Distrito Federal, Brasil. Los datos fueron recolectados en el período comprendido entre los años 2000 y 2010. Resultados. A través de la creación de un programa de nutrición enteral en el Departamento de Salud Pública del Distrito Federal y según lo dispuesto por la legislación nacional, se efectuó un plan de alta complejidad respecto de la nutrición enteral en atención al perfil demográfico y epidemiológico de la población. Este trabajo consiste en una propuesta de implementación de terapia nutricional dentro de un plan de alta complejidad, y de acuerdo a lo prescrito por la legislación del Ministerio de Salud Brasileño. El número de pacientes atendidos por esta modalidad terapéutica se ha ido incrementando, por consiguiente se hace necesario garantizar la calidad del servicio, por medio de la organización de los espacios funcionales. Conclusión. Por medio de la planificación funcional de un Laboratorio de Nutrición Enteral, se puede garantizar la asistencia nutricional especializada y de calidad, a la población hospitalaria o domiciliaria, tomando las precauciones necesarias en la manipulación de las fórmulas enterales.

  14. Nutrición Enteral Domiciliaria (NED: Registro Nacional 2001 Home Enteral Nutrition (HEN in our country, during the year 2001

    Directory of Open Access Journals (Sweden)

    M. Planas

    2004-05-01

    muerte relacionada con la enfermedad de base (43,5%. Un 29,7% de los pacientes estaban confinados en cama o silla, mientras que un 22,9% no presentaba prácticamente ningún grado de incapacidad. Conclusiones: Persiste la vía de administración oral como la más prevalente frente a la sonda y ostomía. Predominio de la patología neurológica. El bajo número de complicaciones e ingresos comportan que la NED sea un tratamiento seguro en nuestro medio.Goal: The NADYA-SENPE Working Group analyzed the registered data of patients on Home Enteral Nutrition (HEN in our country, during year 2001. Material and methods: The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com. Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and read-mission rate in hospital, follow-up of the treatment, patient's quality of life and progress. All data were precessed and analyzed by the coordinating team.Results: Twenty two hospitals participated and 3,458 patients, aged 5.6 ± 4.0 y for those younger than 14 y, and 67.1 ± 19.5 y for those older than 14 y, were enrolled. Of these patients, 43.4% were diagnosed with neurological diseases and 33.5% with cancer. The mean time on HEN was 6.5 ± 4.5 months. Oral nutrition was the preferential route (54.5%, followed by nasoenteral tube (32.3%, and in 13.3% ostomy tubes were placed. Polymeric was the formula composition mainly used(85.9%. Patients were followed (71.1% by the hospital reference Nutritional Support Unit. The complications related to nutrition included mainly the gastrointestinal (0.16 complications/patient, and the mechanical one (0.15 complications/patient. At the end for the year, 48.3% of the patients were in the HEN program, and in 33.3% HEN was finish due to different reasons. In 22.9% of the patients no, o light, discapacity degree was found

  15. Early enteral nutrition therapy in congenital cardiac repair postoperatively: A randomized, controlled pilot study

    Science.gov (United States)

    Sahu, Manoj Kumar; Singal, Anuradha; Menon, Ramesh; Singh, Sarvesh Pal; Mohan, Alka; Manral, Mala; Singh, Divya; Devagouru, V.; Talwar, Sachin; Choudhary, Shiv Kumar

    2016-01-01

    Background and Objectives: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery. Methodology: Fifty infants surgery is feasible and recommended. In addition, enriching the EBM is helpful in achieving the maximum possible calorie intake in the postoperative period. EN therapy might help in providing adequate nutrition, and it decreases ventilation duration, infection rate, LOIS, LOHS, and mortality. PMID:27716696

  16. ILSI Task Force on enteral nutrition; estimated composition and costs of blenderized diets

    Directory of Open Access Journals (Sweden)

    Roseli Borghi

    2013-12-01

    Full Text Available Blenderized tube diets (BTD are used in some parts of Brazil and few studies have analyzed their features in comparison with industrialized preparations. Among 14 randomly collected BTD recipes 9 were poorly described or failed to standardize foodstuffs and portions and, consequently, nutrient and energy composition was difficult to define. Only five BTD allowed theoretical estimation of their nutritional properties. Macronutrient content was highly variable, often conflicting with accepted daily recommendations. According to the literature there are further disadvantages with BTD use including diet high risk of contamination, physical and chemical instability, and high osmolarity and viscosity. Nominal cost of BTD was comparatively low in relation to industrialized formulas; however we did not compute labor and indirect expenses, probably rendering final value more expensive than with the industrialized alternative. It is likely that within such circumstances, hospital and home care malnutrition will not be adequately dealt with and related complications may occur. It is concluded that the continued use of blenderized tube feeding diets requires careful assessment, prioritizing correction of potencial nutritional deficits by means of safe, balanced, chemically complete and effective nutritional prescriptions.

  17. ILSI Task Force on enteral nutrition; estimated composition and costs of blenderized diets.

    Science.gov (United States)

    Borghi, Roseli; Dutra Araujo, Thalita; Airoldi Vieira, Roberta Ianni; Theodoro de Souza, Telma; Waitzberg, Dan Linetzky

    2013-11-01

    Blenderized tube diets (BTD) are used in some parts of Brazil and few studies have analyzed their features in comparison with industrialized preparations. Among 14 randomly collected BTD recipes 9 were poorly described or failed to standardize foodstuffs and portions and, consequently, nutrient and energy composition was difficult to define. Only five BTD allowed theoretical estimation of their nutritional properties. Macronutrient content was highly variable, often conflicting with accepted daily recommendations. According to the literature there are further disadvantages with BTD use including diet high risk of contamination, physical and chemical instability, and high osmolarity and viscosity. Nominal cost of BTD was comparatively low in relation to industrialized formulas; however we did not compute labor and indirect expenses, probably rendering final value more expensive than with the industrialized alternative. It is likely that within such circumstances, hospital and home care malnutrition will not be adequately dealt with and related complications may occur. It is concluded that the continued use of blenderized tube feeding diets requires careful assessment, prioritizing correction of potencial nutritional deficits by means of safe, balanced, chemically complete and effective nutritional prescriptions. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  18. A disease-specific enteral nutrition formula improves nutritional status and functional performance in patients with head and neck and esophageal cancer undergoing chemoradiotherapy: results of a randomized, controlled, multicenter trial.

    Science.gov (United States)

    Fietkau, Rainer; Lewitzki, Victor; Kuhnt, Thomas; Hölscher, Tobias; Hess, Clemens-F; Berger, Bernhard; Wiegel, Thomas; Rödel, Claus; Niewald, Marcus; Hermann, Robert M; Lubgan, Dorota

    2013-09-15

    In patients with head and neck and esophageal tumors, nutritional status may deteriorate during concurrent chemoradiotherapy (CRT). The aim of this study was to investigate the influence of enteral nutrition enriched with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on body composition and nutritional and functional status. In a controlled, randomized, prospective, double-blind, multicenter study, 111 patients with head and neck and esophageal cancer undergoing concurrent CRT received either an enteral standard nutrition (control group) or disease-specific enteral nutrition Supportan®-containing EPA+DHA (experimental group) via percutaneous endoscopic gastrostomy. The primary endpoint was the change of body cell mass (BCM) following CRT at weeks 7 and 14 compared with the baseline value. Secondary endpoints were additional parameters of body composition, anthropometric parameters, and nutritional and functional status. The primary endpoint of the study, improvement in BCM, reached borderline statistical significance. Following CRT, patients with experimental nutrition lost only 0.82 ± 0.64 kg of BCM compared with 2.82 ± 0.77 kg in the control group (P = .055). The objectively measured nutritional parameters, such as body weight and fat-free mass, showed a tendency toward improvement, but the differences were not significant. The subjective parameters, in particular the Kondrup score (P = .0165) and the subjective global assessment score (P = .0065) after follow-up improved significantly in the experimental group, compared with the control group. Both enteral regimens were safe and well tolerated. Enteral nutrition with EPA and DHA may be advantageous in patients with head and neck or esophageal cancer by improving parameters of nutritional and functional status during CRT. © 2013 American Cancer Society.

  19. [The registry of home artificial nutrition and ambulatory of the Spanish Society of Parenteral and Enteral Nutrition; SWOT analysis].

    Science.gov (United States)

    Wanden-Berghe, C; Pérez de la Cruz, A; Lobo Tamer, G; Calleja Fernández, A; Gómez Candela, C; Zugasti Murillo, A; Apezetxea Celaya, A; Torres Corts, A; Moreno Villarés, J M; de Luis, D; Penacho, Ma Á; Laborda, L; Burgos, R; Irles, J A; Cuerda Compes, C; Virgili Casas, Ma N; Martínez Olmos, M A; García Luna, P P

    2012-01-01

    To evidence by means of a SWOT-R analysis performed by an expert consensus the most worrying characteristics of the register on Home-based and Outpatient Artificial Nutrition. SWOT-R analysis with expert consensus. We requested the participation of the active members of the NADYA group within the last 5 years with the premise of structuring the SWOT-R based on the characteristics of the NADYA registry from its beginning. 18 experts from hospitals all over Spain have participated. The internal analysis seems to be positive, presenting the registry as having important resources. The external analysis did not show a great number of threats, there are very potent factors, "the voluntariness" of the registry and the "dependence on external financing". The opportunities identified are important. The recommendations are aimed at stabilizing the system by decreasing the threats as one of the main focus of the strategies to develop as well as promoting the items identified as opportunities and strengths. The analysis shows that the NADYA register shows a big potentiality for improvement. The proposed recommendations should be structured in order to stay on the track of development and quality improvement that has characterized the NADYA register from the beginning.

  20. [THE CASE OF ENTERAL NUTRITIONAL SUPPORT TUBE IN COLOMBIA: INSTITUTIONAL COORDINATION PROBLEMS].

    Science.gov (United States)

    Pinzón-Espitia, Olga Lucia; Chicaiza-Becerra, Liliana; Garcia-Molina, Mario; González-Rodríguez, Javier Leonardo

    2015-07-01

    Introducción: el presente artículo estudia el caso de la prescripción del soporte nutricional enteral por sonda en Colombia, analizada desde el marco del Sistema de Seguridad Social en Salud, y lo explica como resultado de un problema de coordinación institucional. Para ello se identifican el papel y los incentivos de los distintos agentes y se muestra cómo la interacción de los mismos desincentiva el uso de la nutrición enteral, en casos en los que esta es necesaria, con su correspondiente efecto clínico para el paciente y el aumento de costes para el sistema. Métodos: análisis de los efectos que puede tener en la práctica clínica el problema de la coordinación institucional de los entes reguladores del país. Analiza su origen y los incentivos e intereses de los distintos agentes involucrados, previa síntesis de la revisión bibliográfica pertinente. Se realizó la búsqueda en las siguientes bases de datos: PubMed, Medline, ScienceDirect y Embase. Conclusiones: la situación actual del soporte nutricional enteral en Colombia es un equilibrio subóptimo, resultado de un problema de coordinación institucional que solo puede ser resuelto cuando los agentes miren más allá de sus incentivos locales, ya que el soporte nutricional es un componente fundamental de la atención hospitalaria y se constituye en un medio para lograr el objetivo de la salud de la población atendida.

  1. Effect of Enteral Nutrition Formula on Fat Absorption and Serum Free Fatty Acid Profiles in Rat with Short-Bowel Syndrome

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-Nong; TAN Li; WANG Xue-Hao; JU Huang-Xian

    2006-01-01

    The effects of enteral nutrition containing long chain triglycerides (LCT) and medium chain triglycerides (MCT) or L-arginine (Arg) on fat absorbability, serum free fatty acid profiles and intestinal morphology in rats with short-bowel syndrome (SBS) were studied using gas chromatography. Twenty-eight Sprague-Dawley rats were randomly assigned to 4 groups: sham operation fed with LCT as control; 85% small bowel resection fed with LCT,MCT/LCT, and Arg/LCT, respectively. SBS rats showed a decrease of fat absorptivity. Enteral nutrition supplemented with MCT could increase fat absorptivity. L-Arginine enhanced enteral nutrition was associated with the elevation of fat absorptivity, possibly due to its enterotrophic effect on remnant small bowel mucosa. LCT group showed a significant deficiency of total free fatty acid and the decreased essential fatty acid content, which was improved in other two SBS groups.

  2. Nutrición enteral domiciliaria en España: registro NADYA del año 2010 Home enteral nutrition in Spain: NADYA registry in 2010

    Directory of Open Access Journals (Sweden)

    L. Frías

    2012-02-01

    Full Text Available Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED del grupo NADYA-SENPE del año 2010. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero al 31 de diciembre de 2010. Resultados: Se registraron 6.591 pacientes (51% varones con 6.688 episodios de NED, procedentes de 32 hospitales. La edad media en los menores de 14 años (4% fue de 1 ± 2 años (m ± DS y de 69,9 ± 17,8 en los mayores de 14 años. El 76% de los pacientes recibieron la NED por un tiempo superior a 2 años. La patología más prevalente fue la neurológica 42%, seguida de la neoplasia 28% (en su mayoría cáncer de cabeza y cuello 18%. La información referente a la vía de acceso sólo se recogió en 626 casos (9,4%, el 51% de los pacientes utilizaron sonda nasogástrica, 27% gastrostomías, 10% vía oral y 3% yeyunostomías. Sólo 251 episodios finalizaron a lo largo del año, siendo el motivo más frecuente el fallecimiento del paciente en el 57% de los casos y el paso a la alimentación oral en el 14%. El 29% de los pacientes presentaban una actividad limitada y el 39% estaba confinado en cama/sillón. El 68% de los adultos requerían ayuda total o parcial. El suministro del producto se realizó desde el hospital o la farmacia de referencia en el 63% y 34%, respectivamente. El suministro del material fungible se realizó desde el hospital o atención primaria en el 83% y 16%, respectivamente. Conclusiones: Los resultados obtenidos en el registro de NED del año 2010 muestran características muy similares a las recogidas en los años previos en cuanto al número y características de los pacientes registrados. Seguimos encontrando problemas en la recogida de datos relativos a la vía de acceso y finalización de los episodios.Objective: To describe the results of the home enteral nutrition (HEN registry of the NADYA-SENPE group in 2010. Material and methods: We retrieved the data of the patients

  3. Factores pronósticos de morbi-mortalidad en nutrición enteral hospitalaria: estudio prospectivo Prognostic morbidity and mortality factors in hospital enteral nutrition: prospective study

    Directory of Open Access Journals (Sweden)

    O. Moreno Pérez

    2005-06-01

    Full Text Available Objetivos: Determinar aquellos factores pronósticos que mejor puedan prever el resultado de una intervención nutricional vía enteral y evaluar la calidad asistencial de una unidad de nutrición. Ámbito y sujetos: Pacientes que precisaron nutrición enteral en régimen de ingreso hospitalario, en un centro de 3.er nivel. Intervenciones: Estudio observacional, prospectivo, en el que se incluyeron 160 pacientes mediante muestreo consecutivo, durante un período de seguimiento de 6 meses. Se determinó: patología de base, grado de incapacidad, valoración nutricional, tipo de nutrición enteral, complicaciones, cuidados de enfermería y evolución clínica de los pacientes. Resultados: Se diagnosticó desnutrición calórica y protéica graves en el 48,4 y 52,9% de los pacientes; el grado de estrés fue moderado en el 52,2% y grave en el 36,5%. En el 88,2% de los pacientes la variación de los parámetros protéicos fueron de igual o mejor, con un incremento en las concentraciones de albúmina de 0,26 g/dl y prealbúmina de 2,4 mg/dl (p Objective: To determine the prognostic factors that may best for see the outcome of an enteral nutritional intervention and to assess the assistance quality of a nutrition unit. Setting and subjects: Patients that required enteral nutrition during hospital admission at a third level center. Interventions: observational prospective study in which 160 patients were included by means of consecutive sampling, for a 6-months follow-up period. Underlying pathology, disability degree, nutritional assessment, type of enteral nutrition, complications, nursing care, and clinical course of patients were determined. Results: severe caloric and protein hyponutrition was diagnosed in 48.4 and 52.9% of patients; stress degree was moderate in 52.2% and severe in 36.5%. In 88.2% of patients variation of protein parameters was unchanged or improved, with a 0.26 g/dL increase in albumin levels and 2.4 m/dL in prealbumin (p < 0

  4. Early enteral immune nutrition support after radical operation for gastric cancer on promoting the recovery of gastrointestinal function and immune function

    Institute of Scientific and Technical Information of China (English)

    Zhi-Gang Li

    2016-01-01

    Objective:To analyze the effect of early enteral immune nutrition support after radical operation for gastric cancer on the recovery of gastrointestinal function and immune function. Methods: A total of 106 cases of patients received radical operation for gastric cancer in our hospital were selected as research subjects, and according to different ways of postoperative nutrition intervention, all patients were divided into observation group (n=50) and control group (n=56). Control group received conventional enteral nutrition intervention, observation group received postoperative early enteral immune nutrition support, and then differences in postoperative intestinal mucosa barrier function, gastrointestinal hormone levels, immune function levels and nutrition-related indicator values were compared between two groups. Results:After observation group received enteral immune nutrition intervention, serum DAO, PS and D-lactate levels as well as urine L/M ratio were lower than those of control group; serum GAS, CCK, MTL and SP values of observation group after intervention were higher than those of control group, and GLU, VIP, GIP and SS values were lower than those of control group; CD4, IgG, NK cell, C3, C4, CH50 and S-IgA levels of observation group after intervention were higher than those of control group; serum ALB, PRE, TRF and RBP levels of observation group after intervention were higher than those of control group.Conclusion:Early enteral immune nutrition support after radical operation for gastric cancer is conducive to the recovery of gastrointestinal function and the promotion of immune state, eventually promotes patients’ postoperative overall recovery and has active clinical significance.

  5. ICU患者肠内营养并发症的护理%Care of Enteral Nutrition Complications in ICU Patients

    Institute of Scientific and Technical Information of China (English)

    王香君; 吴翠

    2013-01-01

    目的探讨ICU患者行肠内营养支持的护理。方法对63例ICU患者给予合理的、有计划的肠内营养,对患者并发症采取相应对症护理。结果肠内营养并发症减少,营养支持效果好,患者预后良好。结论加强对ICU患者肠内营养并发症的护理有利于患者康复。%Objective to probe the nursing care of the ICU patients with enteral nutrition. Methods Apply proper and planned enteral nutrition to the 63 cases of ICU patients and take relevant measures to the complications accordingly. Result Patients have sound conditions after recovery with fewer enteral nutrition complications and bet er nutrition support ef ect. Conclusion Enhancing the nursing care of the ICU patients with enteral nutrition complications does good to their recovery.

  6. The Effect of Emodin-Assisted Early Enteral Nutrition on Severe Acute Pancreatitis and Secondary Hepatic Injury

    Directory of Open Access Journals (Sweden)

    Gang Wang

    2007-01-01

    Full Text Available Severe acute pancreatitis (SAP characterized by atrocious progression and numerous complications often leads to a high mortality rate due to hypermetabolism, systemic inflammatory response syndrome (SIRS, and multiple organs dysfunction syndrome (MODS. Studies have revealed that both early enteral nutrition (EEN and emodin are potent agents in the management of SAP. However, whether the combined strategy is rational and more effective than either one alone remains unknown. In this regard, Wistar rats were treated with emodin-assisted EEN (EAEEN through enteral nutrient tubes after induction of SAP by retrograde infusion of 5.0% sodium taurocholate into the common pancreatic duct. Serum levels of amylase, tumor necrosis factor-alpha (TNF-α, angiotensin II (AngII, maleic dialdehyde (MDA, glutamic pyruvic transaminase (ALT, glutamic oxaloacetic transaminase (AST and C-reactive protein (CRP, intestinal secretory IgA (SIgA, pancreatic and hepatic myeloperoxidase (MPO activity as well as plasma levels of D-lactate and endotoxin were measured. In addition, pathologic alterations of pancreas and liver were observed microscopically. We found that EAEEN could significantly ameliorate these parameters and prevent pancreas and liver from serious damage. In conclusion, Our results indicated that EAEEN could exert beneficial effects on experimental SAP and obviously abate the severity of secondary hepatic injury. The combined strategy was safe and more effective than either one alone in the acute stage of SAP. This study also provided an experimental base for the clinical treatment of SAP patients with EAEEN.

  7. Short-term effects of supplementary feeding with enteral nutrition via jejunostomy catheter on post-gastrectomy gastric cancer patients

    Institute of Scientific and Technical Information of China (English)

    WU Quan; YU Jian-chun; KANG Wei-ming; MA Zhi-qiang

    2011-01-01

    Background Most gastric cancer patients who undergo gastrectomy develop malnutrition.It is,therefore,crucial to establish an effective means to provide nutrition for these patients.To perform home enteral nutrition (EN) to ensure adequate nutritional intake in gastric cancer patients,we placed a jejunostomy catheter during gastric surgery.Most patients showed improved nutritional status.Methods Twenty-nine inpatients at our hospital underwent radical gastrectomy and jejunostomy from December 2002 to December 2007 and were designated as the jejunostomy group,and 32 matched patients without a jejunostomy tube were designated as the tube-free group.The jejunostomy group was treated with EN from 72 hours to 3 months postoperatively.The tube-free group did not receive EN.Data including preoperative and postoperative body weight,body mass index (BMI),nutrition risk screening (NRS) score,Karnofsky performance score (KPS),and laboratory biochemical indicators were documented respectively and compared.Results Compared with preoperative week 1,both groups showed decreased body weight and BMI at 3 months postoperatively.The weight loss in the jejunostomy group ((7.1±3.3) kg) was significantly less than that in the tube-free group ((9.9±3.1) kg).Similarly,BMI decreased by (2.4+1.0) kg/m2 in the jejunostomy group,which was significantly less than in the tube-free group ((3.2±0.9) kg/m2).The number of patients with postoperative NRS ≥3 was decreased in the jejunostomy group,but was increased in the tube-free group,and this difference was significant.There were no significant differences between the two groups in total lymphocyte count,hemoglobin,albumin and prealbumin,and adverse drug effects.Conclusions Short-term (3 months) EN supplementation via jejunostomy tube can reduce the risk of malnutrition and weight loss,and improve tolerance of chemotherapy.Tube feeding is reliable for achieving these goals because it is not important whether or not the patients have appetites.

  8. 外科危重患者肠内营养支持治疗进展%Progress in Enteral Nutrition Support Treatment of Surgical Critical Patients

    Institute of Scientific and Technical Information of China (English)

    朱俊杰; 冯向英; 李秦; 尼春萍; 郭明贤

    2014-01-01

    Enteral nutrition can decrease postoperative complications, stress reaction, shorten length of hospital stay and improve patients′outcome. enteral nutrition′s superiority,indication,timing and route selec-tion were reviewed in order to provide scientific basis for effective nutrition treatment among surgical critically patients. As malnutrition Seriously affected rehabilitation of surgicalcritically ill patients So the nutrition ther-apy as an important means of treatment received wide attention and concern. With the development of tech-nology,enteral nutrition has become the primary method of the nutrition support for the surgical critical pa-tients. For the superiority of enteral nutrition awareness , indications, timing and other views have to grasp a breakthrough. However, the domestic application of knowledge of enteral nutrition is still insufficient,In the surgical treatment of critically ill patients, parenteral nutrition rather than enteral nutrition is the main strate-gy of nutrition therapy.%营养不良由于严重影响外科危重症患者康复,所以营养治疗被作为一项重要的治疗手段得到广泛的重视和关注。随着科技的发展,肠内营养逐渐代替肠外营养成为外科营养支持的首要途径。近年来,对于肠内营养优越性的认识、适应证、时机把握等观点都有了突破性的进展。尤其在危重患者的救治中日益发挥了重要的治疗作用。然而,国内对肠内营养应用认识尚不够充分,在外科危重患者的救治中,肠外营养而非肠内营养是营养治疗的主要策略。

  9. [Reduction in necrotising enterocolitis after implementing an evidence-based enteral nutrition protocol in very low birth weight newborns].

    Science.gov (United States)

    Sánchez-Tamayo, Tomás; Espinosa Fernández, María Gracia; Affumicato, Laura; González López, María; Fernández Romero, Verónica; Moreno Algarra, María Concepción; Salguero García, Enrique

    2016-12-01

    An unexpected increase in the incidence of necrotising enterocolitis (NEC) cases was observed in our hospital. Just in case, our feeding policy could be responsible, it was decided to conduct a systematic review and develop a clinical guideline regarding enteral nutrition of very low birth weight infants (VLBW). To assess the impact of the new feeding protocol in the incidence of NEC. A "before" (2011) and "after" (May 2012 - April 2013) study was performed on the new feeding protocol. This included initiation of enteral feeding in the absence of haemodynamic problems, a trophic feeding period of 5-7 days, and subsequent increments of 20-30ml/kg/day, of breast milk/donor human milk from the beginning. Probiotics were not administered. incidence of NEC II 2 Bell's stage. focal intestinal perforation, overall mortality and mortality due to NEC, nosocomial sepsis; weight at 28 days and 36 weeks; % of infants with weight enteral feeding protocol leads to a decrease in incidence of NEC, without increasing hospital stay or the incidence of sepsis. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

    Institute of Scientific and Technical Information of China (English)

    Guiping Yu; Guoqiang Chen; Bin Huang; Wenlong Shao; Guangqiao Zeng

    2013-01-01

    Objective:To explore the effect of early enteral nutrition (EN) on postoperative nutritional status,intestinal permeability,and immune function in elderly patients with esophageal cancer or cardiac cancer.Methods:A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study.They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes.The body weight,time to first flatus/defecation,average hospital stay,complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed.Peripheral blood samples were collected on the days 1,4 and 7 after surgery.The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability.The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier.The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzymelinked immunosorbent assay (ELISA).Results:After the surgery,the time to first flatus/defecation,average hospital stay,and complications were significandy less in the EN group than those in the PN group (P<0.05),whereas the EN group had significantly higher albumin levels than the PN group (P<0.05).On the 7th postoperative day,the DAO activity,D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05).In addition,the EN group had significantly higher IgA,IgG,IgM,and CD4 levels than the PN group (P<0.05) but significantly lower IL-2,IL-6,and TNF-α levels (P<0.05).Conclusions:In elderly patients with esophageal cancer or cardiac cancer,early EN after surgery can effectively improve the nutritional status,protect intestinal mucosal barrier (by reducing plasma endoxins),and enhance the

  11. 为糖尿病人用的肠内营养%Enteral nutrition for patients with diabetes

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Diabetes mellitus is a serious illness that affects over 140million people worldwide.It is estinated that by the year 2025,the worldwide incidence of diabetes will reach 300 million.The objectives of this presentation are:(1)To review some aspects of the pathophysiology of diabetes mellitus.(2)To review the current nutritional recommendations for diabetic ubduvudyaks.(3)To discuss relative effects om metabolic control of diets high in carbohydrate and diets reduced in carbohydrates and containg high levels of monounsaturated fatty acid(MUFA).(4)To discuss the need for specialized enteral formulas for diabetics requiring nutrition support.(5)To present the consensus guidelines for nutrition support of diabetics.Early diabnosis and treatment of diabetes can reduce the complications and consequently lower diabetes-related morbidity and mortality.Acute complications of diabetes include diabetic ketoacidosis and immune system dysfunction redulting in infections.Long-term complications of the disease include coronary artery disease,nephropathy.Two recently completed clinical trials,the Diabetes Control and Complication Trial and the United Kingdom Prospective Diabetes Study,have shown that tight glycemic control has positive effects on health outcomes in diabetic individuals.Optimal management of diabetes includes nutrition therapy.The American Diabetic Association has established guidelines for the proportion of dietary calories contributed from fat,carbohydrate and protein.The recommended distrigution is 10-20% of total calories as protein and the rest distributed bwtween fat and carbohydrates.There is no longer a linit placed on dietary fat,provided that sources of fat high in MUFA are used,and that saturated and polyunsaturated fatty acids are each linited to no more than 10 percent of total calories.Outcomes of clinical trials with vardicate that rapidly digested and absorbed carbohydrates in liquid enteral formulas result in poor metabolic control in patients with

  12. The parenteral nutrition and enteral nutrition in acute pancreatitis%急性胰腺炎肠外营养和肠内营养治疗的探讨

    Institute of Scientific and Technical Information of China (English)

    闫军; 樊茂宇

    2011-01-01

    目的 观察肠外和肠内阶段性营养治疗急性胰腺炎的临床效果.方法 急性胰腺炎患者60例,分为全胃肠外营养组和肠外加肠内阶段性营养组,全胃肠外营养组患者应用肠外营养持续至可以进食.肠外加肠内阶段性营养组患者在初期应用肠外营养,胃肠功能恢复后逐步减少肠外营养至全部用肠内营养替代,肠内营养持续至过渡饮食.观察两组临床指标及治疗效果.结果 肠外加肠内阶段性营养组患者均能耐受早期肠内营养.早期适时由肠外过渡到肠内营养后一周患者的血清总蛋白、白蛋白、血钙水平,与营养支持前、营养支持后全胃肠外营养组相比均增高(P<0.01);对肝脏功能的损害减小(P<0.01).肠外加肠内阶段性营养组血糖平均水平趋于正常且波动度小,与全胃肠外营养组相比,差异有统计学意义(P<0.05).肠外加肠内阶段性营养组平均住院天数(29.93±9.30)d,短于全胃肠外营养组平均住院天数(25.47±7.50)d(P<0.05),且每日营养费用及住院总费用减少.结论 肠内营养组患者的营养指标、对血糖的影响与全胃肠外营养组相比,效果更好.%Objective To assess the combined application of staged enteral and parenteral nutrition support in patients with acute pancreatitis. Methods Sixtypatients with acute pancreatitis who underwent conservative treatment were divided into total parenteral nutrition and staged parenteral and enteral nutrition. The changes of clinical indicators and clinical outcome were recorded. Results All of the 30 cases in the total parenteral nutrition + enteral nutrition group tolerated the enteral nutrition. One week after nutrition support from parenteral nutrition to enteral nutrition, total protein serum albumin and blood calcium significantly increased ( P <0. 01 ); ALT and AST significantly decreased ( P <0.01 ). The blood glucose was significantly decreased ( P <0.05 ). The average hospital stay

  13. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): gastrointestinal surgery].

    Science.gov (United States)

    Sánchez Álvarez, C; Zabarte Martínez de Aguirre, M; Bordejé Laguna, L

    2011-11-01

    Gastrointestinal surgery and critical illness place tremendous stress on the body, resulting in a series of metabolic changes that may lead to severe malnutrition, which in turn can increase postsurgical complications and morbidity and mortality and prolong the hospital length of stay. In these patients, parenteral nutrition is the most widely used form of nutritional support, but administration of enteral nutrition early in the postoperative period is effective and well tolerated, reducing infectious complications, improving wound healing and reducing length of hospital stay. Calorie-protein requirements do not differ from those in other critically-ill patients and depend on the patient's underlying process and degree of metabolic stress. In patients intolerant to enteral nutrition, especially if the intolerance is due to increased gastric residual volume, prokinetic agents can be used to optimize calorie intake. When proximal sutures are used, tubes allowing early jejunal feeding should be used. Pharmaconutrition is indicated in these patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. Parenteral nutrition should be started in patients with absolute contraindication for use of the gastrointestinal tract or as complementary nutrition if adequate energy intake is not achieved through the enteral route.

  14. Effect of intravenous GLutamine supplementation IN Trauma patients receiving enteral nutrition study protocol (GLINT Study): a prospective, blinded, randomised, placebo-controlled clinical trial.

    Science.gov (United States)

    Al Balushi, Ruqaiya M; Paratz, Jennifer D; Cohen, Jeremy; Banks, Merrilyn; Dulhunty, Joel; Roberts, Jason A; Lipman, Jeffrey

    2011-01-01

    Background Trauma patients are characterised by alterations in the immune system, increased exposure to infectious complications, sepsis and potentially organ failure and death. Glutamine supplementation to parenteral nutrition has been proven to be associated with improved clinical outcomes. However, glutamine supplementation in patients receiving enteral nutrition and its best route are still controversial. Previous trials have been limited by a small sample size, use of surrogate outcomes or a limited period of supplementation. The aim of this trial is to investigate if intravenous glutamine supplementation to trauma patients receiving enteral nutrition is associated with improved clinical outcomes in terms of decreased organ dysfunction, infectious complications and other secondary outcomes. Methods/design Eighty-eight critically ill patients with multiple trauma receiving enteral nutrition will be recruited in this prospective, triple-blind, block-randomised, placebo-controlled clinical trial to receive either 0.5 g/kg/day intravenous undiluted alanyl-glutamine or intravenous placebo by continuous infusion (24 h/day). Both groups will be receiving the same standard enteral nutrition protocol and the same standard intensive care unit care. Supplementation will continue until discharge from the intensive care unit, death or a maximum duration of 3 weeks. The primary outcome will be organ-dysfunction evaluation assessed by the pattern of change in sequential organ failure assessment score over a 10-day period. The secondary outcomes are: the changes in total sequential organ failure assessment score on the last day of treatment, infectious complications during the ICU stay, 60-day mortality, length of stay in the intensive care unit and body-composition analysis. Discussion This study is the first trial to investigate the effect of intravenous alanyl-glutamine supplementation in multiple trauma patients receiving enteral nutrition on reducing severity of organ

  15. 食疗剂型在肠内营养支持中的应用和前景%Application and Prospect of Enteral Nutrition With Diet Formulations

    Institute of Scientific and Technical Information of China (English)

    续延军

    2015-01-01

    目的:探讨食疗剂型在肠内营养支持中的应用前景。方法在中医辩证理论指导下,根据肠内营养制剂分类及食疗的理论基础,对食疗与肠内营养结合应用现状及发展趋势进行探讨。结果通过合理处方搭配,将食疗与肠内营养有机结合起来,为临床营养支持增添新的内容,可在改善患者食欲、呼吸、血脂,调节胃肠功能等诸多方面起到显著效果。结论食疗药膳现已在临床疾病预防和治疗中广泛应用,其与肠内营养支持相结合更有助于发挥功能改善的作用。%Objective To explore the application prospect of enteral nutrition with diet formulations. Methods Under the guidance of TCM dialectical theory, according to the theoretical basis of classification and enteral nutrition preparations diet,explored the application prospect of enteral nutrition with diet formulations. Results Through reasonable prescription,tie-in the organic combination of diet and enteral nutrition added new content for clinical nutrition support,and played a significant effect in improving patient appetite,breathing,blood lipid,regulating gastrointestinal function and many other aspects. Conclusion Dietotherapy medicinal food has been widely used in clinical disease prevention and treatment and play a better function of improvement with the combination of enteral nutrition support.

  16. Propuesta de perfil de ácidos grasos omega 3 en nutrición enteral Proposed profile of omega 3 fatty acids in enteral nutrition

    Directory of Open Access Journals (Sweden)

    A. Sanz París

    2012-12-01

    Full Text Available Revisamos las recomendaciones internacionales de ingesta oral de ácidos grasos n-3.y su contenido en las fórmulas de nutrición enteral. Sus acciones metabólicas dependen de su metabolización a EPA y DHA. La actividad de las 5D y 6D desaturasas, que catalizan este proceso, aumenta con el ejercicio, insulina, estrógenos de mujer fértil y proliferadores peroxisómicos, mientras que disminuye con el ayuno, déficit de proteínas y oligoelementos, edad > 30 años, sedentarismo, tabaco, alcohol, colesterol, ácidos grasos trans y saturados, insulinopenia y hormonas de estrés (adrenalina y glucocorticoides. La mayoría de las guías recomiendan 20-35% de la energía total en forma de grasas, repartidas en saturadas 7-10%, poliinsaturadas 6-10% y monoinsutaradas en España 20%. El de AG n-3 es de 0,5-2 g/día o bien 0,5-2% de la ingesta calórica total, con un límite superior de 3 g/día. El de AG n-6 es del 2,5-10% del aporte calórico total y el cociente recomendado n-6/n-3 no está bien definido pero la mayoría recomienan 5/1. El contenido en EPA y DHA, debe ser de al menos los 500 mg diarios. Por último, la ratio EPA/DHA en la mayoría es de 2/1. Las fórmulas de nutrición estándar presentan un contenido en grasas adecuado, pero la mayoría de los productos que contienen EPA y DHA exceden el límite de los 3 g/día. De los productos hiperproteicos y/o concentrados por vía oral sólo un producto de este grupo contiene EPA y DHA. Las del anciano frágil no todas aportan EPA y DHA y las que los contienen, su concentración puede ser incluso excesiva y en una relación poco parecida a la del aceite de pescado.We review the international recommendations on oral intake of n-3 fatty acids and their content in the enteral nutrition formulas. Their metabolic actions depend on their metabolization to EPA and DHA. The activity of desaturases catalyzing this process increases with exercise, insulin, estrogens in the fertile women, and peroxisomal

  17. [The Spanish Society of Parenteral and Enteral Nutrition (SENPE) and its relation with healthcare authorities].

    Science.gov (United States)

    García de Lorenzo, A; Alvarez, J; Celaya, S; García Cofrades, M; García Luna, P P; García Peris, P; León-Sanz, M; Jiménez, C P; Olveira, G; Smeets, M

    2011-01-01

    It has been well documented in medical literature that hyponutrition is a common issue at all healthcare levels, from primary to specialized health care, as well as geriatric healthcare facilities. This problem is not limited to countries with scarce economic resources or limited social development; it is also a universal issue in Europe. Hyponutrition increases the rates of morbidity, mortality, hospital admissions, and hospital stay. These higher figures also represent a higher use of healthcare resources. In spite of this, hyponutrition may often go undetected and the patient may not receive the necessary treatment. This problem requires the cooperation of multiple agents such as the Governments, the healthcare professionals, and the citizens themselves. The VIII Discussion Forum concludes on the need to establish a clear-cut plant for action (similar to the European Alliance for Health Nutrition) and the creation of a platform (coalition) encompassing the voices of healthcare professionals associations, institutions, professional colleges, patients associations, the pharmaceutical companies, and insurance companies. The goals of this platform will be to inform about the extent of this issue, to identity and promote leaders that will convey the aims of this initiative to regional and national healthcare authorities, to present solutions and to collaborate in their implementation, and finally to assess/control the actions taken.

  18. Consensus on paediatric enteral nutrition access: a document approved by SENPE/SEGHNP/ANECIPN/SECP Documento de consenso SENPE/SEGHNP/ANECIPN/SECP sobre vías de acceso en nutrición enteral pediátrica

    Directory of Open Access Journals (Sweden)

    C. Pedrón Giner

    2011-02-01

    Full Text Available Standardization of clinical procedures has become a desirable objective in contemporary medical practice. To this effect, the Spanish Society of Parenteral and Enteral Nutrition (SENPE has endeavoured to create clinical practice guidelines and/or documents of consensus as well as quality standards in artificial nutrition. As a result, the SENPE´s Standardization Team has put together the "Document of Consensus in Enteral Access for Paediatric Nutritional Support" supported by the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP, the National Association of Pediatric and Neonatal Intensive Care Nursery (ANECIPN, and the Spanish Society of Pediatric Surgery (SECP. The present publication is a reduced version of our work; the complete document will be published as a monographic issue. It analyzes enteral access options in the pediatric patient, reviews the levels of evidence and provides the team-members´ experience. Similarly, it details general and specific indications for pediatric enteral support, current techniques, care guidelines, methods of administration and complications of each enteral access. The data published by the American Society for Parenteral and Enteral Nutrition (ASPEN and several European Societies has also been incorporated.La estandarización de procedimientos clínicos se ha convertido en un objetivo deseable en la práctica médica actual. La Sociedad Española de Nutrición Parenteral y Enteral (SENPE está haciendo un considerable esfuerzo para desarrollar guías clínicas y/o documentos de consenso así como marcadores de calidad en nutrición artificial. Como fruto de ese esfuerzo el Grupo de Estandarización de SENPE ha elaborado un Documento de Consenso sobre Vías de Acceso en Nutrición Enteral Pediátrica, avalado también por la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP, la Asociación Nacional de Enfermería de Cuidados Intensivos

  19. A home enteral nutrition (HEN); spanish registry of NADYA-SENPE group; for the year 2013.

    Science.gov (United States)

    Wanden-Berghe, Carmina; Álvarez Hernández, Julia; Burgos Peláez, Rosa; Cuerda Compes, Cristina; Matía Martín, Pilar; Luengo Pérez, Luis Miguel; Gómez Candela, Carmen; Pérez de la Cruz, Antonio; Calleja Fernández, Alicia; Martínez Olmos, Miguel Ángel; Laborda González, Lucía; Campos Martín, Cristina; Leyes García, Pere; Irles Rocamora, José Antonio; Suárez Llanos, José Pablo; Cardona Pera, Daniel; Gonzalo Marín, Monserrat; Penacho Lázaro, María Ángeles; Ballesta Sáncez, Carmen; Rabasa Soler, Antoni; Garde Orbaiz, Carmen; Cánovas Gaillemin, Bárbara; Moreno Villares, José Manuel; del Olmo García, María Dolores; Carabaña Pérez, Fátima; Arraiza Irigoyen, Carmen; Mauri, Silvia; Sánchez-Vilar Burdiel, Olga; Virgili Casas, Nuria; Miserachs Aranda, Nuria; Apezetxea Celaya, Antxón; Pereira Soto, Manuel Ángel; Ponce González, Miguel Ángel

    2015-06-01

    Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) del año 2013 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2013, procediendo al análisis descriptivo y analítico de los datos. Resultados: durante este periodo se registraron 3.223 pacientes, (50,6% varones) y un total de 3.272 episodios de NED en 33 hospitales españoles. La tasa de prevalencia fue de 67,11pacientes/millón de habitantes/año 2013. El 98,24% de los enfermos tenía más de 14 años. La media de edad de los adultos fue de 69,14 años (dt 17,64) y la mediana se situó en 73 años (IIQ 58-83), siendo los varones más jóvenes que las mujeres; p-valor edad media de 2,38 años (dt 4,35). La enfermedad que con más frecuencia motivó el uso de la NED fue la patología neurológica en niños (49,1%) y en adultos (60,6%). La vía de administración más utilizada en los niños fue la gastrostomía (51%), siendo los niños más pequeños los que se alimentaban por SNG (p-valor 0,003) y en los adultos (48%), siendo estos pacientes los de mayor edad (p-valor.

  20. Improving the documentation of nasogastric tube insertion and adherence to local enteral nutrition guidelines.

    Science.gov (United States)

    Cole, Esther

    2015-01-01

    Fine bore nasogastric (NG) tubes are often required for patients who have insufficient nutrition to meet their daily requirements, as well as for feeding or medications when there are difficulties with swallowing. "Death or severe harm as a result of a naso […] gastric tubes being misplaced in the respiratory tract" is one of the Department of Health's list of "never events". Noble's Hospital, Isle of Man, has local guidelines based on the National Patient Safety Agency's 2005 guidelines and 2011 update, regarding the initial insertion and confirmation of placement of NG tubes. Retrospective baseline data looking at 13 case notes across 10 hospital wards showed that the majority of NG tube insertions took place on the stroke unit. A three-point quality of guidelines score showed that 8/13 (62%) cases were following guidelines appropriately. A seven-point quality of documentation score showed no case notes had full documentation. A teaching intervention for junior doctors and nurses was devised. However, there was no significant improvement in quality scores after 90 days (49 NG tube insertions). Therefore, an NG tube bundle, which included a pro forma for the case notes, information poster, and sticker for the nurse notes, was trialled on the stroke unit for six weeks. This showed that 10/12 (83%) cases were following guidelines appropriately. While only 2/12 (16%) of case notes had full documentation, this represented the two occasions when the pro forma was filled in and filed correctly. It is hoped that there could be a roll out of the intervention hospital-wide with identification of ways to improve usage of the NG tube bundle.

  1. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

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    Carla Adriana Santos

    2014-02-01

    Full Text Available Background and aims: Dysphagic patients who underwent endoscopic gastrostomy (PEG usually present protein-energy malnutrition, but little is known about micronutrient malnutrition. The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder. Methods: From patients that underwent gastrostomy a blood sample was obtained minutes before the procedure. Serum and whole blood zinc was evaluated using Wavelength Dispersive X-ray Fluorescence Spectroscopy. Serum albumin and transferrin were evaluated. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC and neurological dysphagia (ND. Results: The study involved 32 patients (22 males, aged 43-88 years: HNC = 15, ND = 17. Most (30/32 had low serum zinc, 17/32 presented normal values of whole blood zinc. Only two, with traumatic brain injury, presented normal serum zinc. Serum zinc levels showed no differences between HNC and ND patients. There was no association between serum zinc and serum albumin or transferrin. There was no association between serum and whole blood zinc. Conclusions: Patients had low serum zinc when gastrostomy was performed, similar in HNC and ND, being related with prolonged fasting and unrelated with the underlying disease. Decrease serum zinc was unrelated with low serum proteins. Serum zinc was more sensitive than whole blood zinc for identifying reduced zinc intake. Teams taking care of PEG-patients should include zinc evaluation as part of the nutritional assessment, or include systematic dietary zinc supply.

  2. Pretreatment with high-fat enteral nutrition reduces ondotoxin and tumor necrosis factor-alpha and preserves gut barrier function early after hemorrhagic shock

    NARCIS (Netherlands)

    Luyer, M.D.; Buurman, W.A.; Hadfoune, M.; Jacobs, J.A.; Konstantinov, S.R.; Dejong, C.H.; Greve, J.W.

    2004-01-01

    Gram-negative sepsis is a potentially fatal clinical syndrome characterized by a proinflammatory response (tumor necrosis factor-alpha) to bacterial (endo)toxins and gut barrier function loss. Recently, we found that high-fat enteral nutrition protects against late bacterial translocation in a model

  3. The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants : A randomized controlled trial

    NARCIS (Netherlands)

    van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

    2006-01-01

    Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as refl

  4. Pretreatment with high-fat enteral nutrition reduces ondotoxin and tumor necrosis factor-alpha and preserves gut barrier function early after hemorrhagic shock

    NARCIS (Netherlands)

    Luyer, M.D.; Buurman, W.A.; Hadfoune, M.; Jacobs, J.A.; Konstantinov, S.R.; Dejong, C.H.; Greve, J.W.

    2004-01-01

    Gram-negative sepsis is a potentially fatal clinical syndrome characterized by a proinflammatory response (tumor necrosis factor-alpha) to bacterial (endo)toxins and gut barrier function loss. Recently, we found that high-fat enteral nutrition protects against late bacterial translocation in a model

  5. A New Model For Non-Alcoholic Steatohepatitis in the Rat Utilizing Total Enteral Nutrition to Overfeed a High Polyunsaturated Fat Diet

    Science.gov (United States)

    We have used total enteral nutrition (TEN) to moderately overfeed rats high polyunsaturated fat diets to develop a model for non-alcoholic steatohepatitis (NASH). Male Sprague-Dawley rats were fed by TEN a 187 kcal/kg 3/4 /d diet containing 5% (total calories) corn oil or a 220 kcal/kg 3/4 /d diet i...

  6. Comparing Two Methods of Enteral Nutrition in Terms of their Complications and the Time Needed to Reach Goal Calorie in Children Hospitalized in ICU

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    Sedigheh Fayazi

    2016-07-01

    Full Text Available Background Nutrition support and noticing the required goal calories in patients having critical conditions are essential aspects of medical care in preventing malnutrition in these patients. Materials and Methods This research is a clinical trial which was done on 60 children aging between 5 to 17 years old hospitalized in Intensive Care Unit (ICU of Shiraz’s Namazee hospital, South West of Iran, during April to September 2015. Patients were separated randomly into two groups. Enteral nutrition was done with infusion pump for one of the groups and intermittently for the other one.  The data was collected for 7 days by a check list regarding enteral nutrition method, complications and the time needed to reach goal calories. Data analysis was done using SPSS-18 software through Chi-square and t-student test. Results The results of this study showed that there was a significant difference of the mean time needed to reach target goal calorie between the continuous and intermittent nutrition methods (P0.05. Conclusion This study showed that continuous enteral nutrition method has better outcomes in children hospitalized in ICU than intermittent method.

  7. Influences of enteral nutrition combined with probiotics on gut microflora and barrier function of rats with abdominal infection

    Institute of Scientific and Technical Information of China (English)

    Tong-Yi Shen; Huan-Long Qin; Zhi-Guang Gao; Xiao-Bing Fan; Xiao-Ming Hang; Yan-Qun Jiang

    2006-01-01

    AIM: To investigate the influences of enteral, parenteral nutrition and probiotics delivered by gut on intestinal microecology, epithelial tight junctions, immune and barrier function of rats with abdominal infection.METHODS: Rat abdominal infection models established with cecal ligation and perforation method, were divided into three groups: parenteral nutrition (PN group, n = 7), PN+enteral nutrition (EN group, n = 7) and PN EN + probiotics (probiotics group, n = 7) via the needle jejunostomy and neck vein for five days. The total nutritional supplement of the three groups was isonitrogenic and isocaloric. Probiotics was delivered by jejunostomy 10 mL/d (1 × 108 cfu/mL). The rats were killed on the sixth day. The feces in the cecum were cultured for anaerobic bacterial growth and analyzed with bacterial group DNA fingerprint profile with random amplified polymorphic DNA. The transmembrane binding proteins (occludin) and IgA level in plasma cells of intestine epithelium in colon and terminal ileum were measured by an immunohistochemistry method. The ultrastructure of intestinal epithelial tight junctions in colon and small intestine was observed by electronmicroscopy. Vena cava blood and the homogenated tissue of liver, lung and mesenteric lymph nodes were cultured to determine the bacterial translocations, and endotoxin in the blood from portal vein was detected.RESULTS: (1) The amount of bacteria of gut species in EN group and probiotic group was higher than that in PN group. The DNA-profiles in EN group and probiotic group were similar to that of normal rats. The number of DNAprofiles in probiotics group was much more than that in PN group and EN group. Moreover, there were strange stripes in PN group. (2) The expression of occludin and IgA in the small and large intestine in EN group (2.309± 0.336, 15.440 ± 2.383) and probiotic group (2.938 ±0.515, 16.230 ± 3.183) was improved as compared with PN group (1.207 ± 0.587, P < 0.05, 11.189 ± 2.108, P < 0

  8. Influence of methionine/valine-depleted enteral nutrition on nucleic acid and protein metabolism in tumor-bearing rats

    Institute of Scientific and Technical Information of China (English)

    Yin-Cheng He; Jun Cao; Ji-Wei Chen; Ding-Yu Pan; Ya-Kui Zhou

    2003-01-01

    AIM: To investigate the effects of methionine/valine-depleted enteral nutrition (EN) on RNA, DNA and protein metabolism in tumor-bearing (TB) rats.METHODS: Sprague-Dawlley (SD) rats underwent jejunostomy for nutritional support. A suspension of Walker256 carcinosarcoma cells was subcutaneously inoculated.48 TB rats were randomly divided in 4 groups: A, B, C and D. The TB rats had respectively received jejunal feedings supplemented with balanced amino acids, methioninedepleted, balanced amino acids and valine-depleted for 6days before injection of 740 KBq 3H- methionine/valine via jejunum. The 3H incorporation rate of the radioactivity into RNA, DNA and proteins in tumor tissues at 0.5, 1, 2, 4 h postinjection of tracers was assessed with liquid scintillation counter.RESULTS: Incorporation of 3H into proteins in groups B and D was (0.500±0.020) % to (3.670±0.110) % and (0.708±0.019) % to (3.813±0.076) % respectively, lower than in groups A [(0.659±0.055) % to (4.492±0.108) %]and C r(0.805±0.098) % to (4.180±0.018) %]. Incorporation of 3H into RNA, DNA in group B was (0.237±0.075) %and (0.231±0.052) % respectively, lower than in group A (P<0.01). There was no significant difference in uptake of 3H by RNA and DNA between group C and D (P>0.05).CONCLUSION: Protein synthesis was inhibited by methionine/valine starvation in TB rats and nucleic acid synthesis was reduced after methionine depletion, thus resulting in suppression of tumor growth.

  9. La fibra en nutrición enteral: revisión sistemática de la literatura Fibre in enteral nutrition: systematic review of the literature

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    D. del Olmo

    2004-05-01

    Full Text Available Se ha sugerido que añadir fibra a las fórmulas de nutrición enteral (NE consigue una normalización del funcionamiento del tracto gastrointestinal, disminuyendo la incidencia de diarrea y de estreñimiento. Sin embargo, esta suposición está basada en el efecto demostrado de la fibra en la alimentación natural. Hasta la fecha no existen recomendaciones firmes sobre el uso, la cantidad ni el tipo de fibra más aconsejable en NE. Objetivo: Establecer la evidencia científica que existe sobre el beneficio de la adición de fibra a las fórmulas de NE comparado con el uso de fórmulas sin fibra. Material y métodos:Búsqueda bibliográfia en PubMed, en el registro de Estudios Prospectivos Aleatorizados (EPA de la Biblioteca Cochrane y búsqueda manual. Criterio de inclusión: EPA que comparen fórmulas sin fibra con fórmulas isocalóricas e isonitrogenadas con fibra en NE total. Cuatro revisores independientes revisan las referencias seleccionadas. Para el análisis de los datos se utiliza el programa RevMan 4.1 de la Biblioteca Cochrane. Resultados: De 286 referencias 25 cumplen el criterio de inclusión. Los datos se agrupan por población y por variable de resultado. La adición de fibra fermentable a las fórmulas de NE tiende a disminuir la incidencia de diarrea en pacientes críticos y postquirúrgicos (OR = 0,66; IC 95% 0,46-0,95; p = 0,19. El uso de fórmulas con fibra insoluble parece aumentar la frecuencia de deposiciones y disminuir la necesidad de laxantes en pacientes inmovilizados con NE a largo plazo pero los datos son insuficientes. En personas con función gastrointestinal normal la frecuencia de las deposiciones es similar usando fórmulas con y sin fibra (DPM = -0,07; IC 95% -0,12-0,02, p It has been suggested that adding fibre to enteral nutrition (EN formulas may achieve a normalization of the gastrointestinal tract's functions by reducing the incidence of diarrhoea and constipation. Howerver, this supposition is based on

  10. Nursing for critically ill patients with enteral nutrition by nasogastric tube%重症脑卒中患者肠内营养的护理

    Institute of Scientific and Technical Information of China (English)

    李妍; 龚华霞; 白煜; 李霞; 赵静

    2011-01-01

    Objective To explore the effect of nursing for critically ill patients with enteral nutrition by nasogastric tube. Methods 118 critically patients in intensive care unit were treated by enteral nutrition with nasogastric tube. Nursing was conducted accordingly. The afterwards effect of this treatment and nursing was compared with the effect before the treatment and nursing care in serum prealbumin and serum - albumin. Results The serum prealbumin and serum - albumin were higher after the enteral nutrition with nasogastric tube were conducted (P<0.05), compared with effect before the treatment and nursing. Conclusion Enteral nutrition with nasogastric tube works well in critically ill patients' nutrition support. Professional and careful nursing measures would help guarantee the effect of this nutrition treatment.%目的 探讨重症脑卒中患者经鼻胃管肠内营养的护理效果.方法 对118例NICU的重症脑卒中患者进行经鼻胃管肠内营养治疗,并配合做好护理,比较营养支持前后患者血清白蛋白的变化.结果 经鼻胃管肠内营养支持后,患者的血清白蛋白较未行肠内营养支持前明显升高(均P<0.05),差别有统计学意义.结论 肠内营养对重症脑卒中患者有良好的营养支持作用.

  11. The effect of early enteral nutrition plus parenteral nutrition on short-term outcomes after radical gastrectomy%胃癌术后早期肠内营养联合肠外营养的近期效果

    Institute of Scientific and Technical Information of China (English)

    刘琳

    2015-01-01

    Objective: to compare the short-term effects of early enteral nutrition plus parenteral nutrition with those of early total parenteral nutrition on postoperative outcomes of gastric cancer and evaluate the effects on health economics. Method: 40 patients who underwent radical gastrectomy were randomly divided into two groups of early enteral nutrition plus parenteral nutrition and early total parenteral nutrition. the level of blood nutrition indicators was determined 7 days after surgery and anal exhaust time, complications, length of hospital stay and hospitalization cost were observed and analyzed between two groups. Results: the gradually early enteral nutrition plus parenteral nutrition which had a low intolerance rate shortened anal exhaust time, postoperative hospital stay and total hospitalization time, reduced the total hospitalization cost comparing with total parenteral nutrition. Conclusion: Gradually early enteral nutrition plus parenteral nutrition is well tolerated after 24 hours of radical gastrectomy and has better effect on health economics compared with early total parenteral nutrition.%目的:探讨早期肠内营养联合肠外营养以及早期完全肠外营养对胃癌术后患者近期临床结局的影响,并进行卫生经济学效果评价。方法选取胃癌根治术后患者40例,随机分为早期肠内营养联合肠外营养组和早期完全肠外营养组;记录并比较两组肛门排气/排便时间、术后7天营养指标、术后并发症发生率、术后住院时间、总住院时间、总住院费用。结果术后24小时渐进式肠内营养联合肠外营养不耐受率低;与早期完全肠外营养相比,明显缩短了肛门排气/排便时间,缩短了术后住院时间与总住院时间,减少了总住院费用。结论胃癌根治术后24小时实施渐进式早期肠内营养联合肠外营养耐受性好,与早期完全肠外营养相比具有更好的卫生经济效果。

  12. Evaluación del grado de satisfacción de un programa de nutrición enteral domiciliaria Patient satisfaction in a home enteral nutrition program

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    M. Planas

    2007-10-01

    Full Text Available La nutrición enteral a domicilio es un tratamiento cada vez más utilizado por las ventajas que comporta no sólo al paciente y familiares o cuidadores (menos riesgo de infecciones nosocomiales y mejor integración socio-familiar sino también a la administración en el sentido de representar un ahorro en coste económico además de disponer de mas camas de hospitalización. Objetivo: Analizar el grado de satisfacción de los pacientes y familiares o cuidadores en relación a un servicio de Nutrición Enteral Domiciliaria (NED controlado desde la Unidad de Nutrición del Hospital. Metodología: Un cuestionario para los pacientes y otro para los familiares/cuidadores fue remitido a los enfermos que recibiendo nutrición enteral por sonda en su domicilio quisieron voluntariamente colaborar. Cuestionarios similares se remitieron a pacientes ingresados en el hospital tratados con nutrición enteral así como a sus posibles cuidadores en el caso de que recibieran este tratamiento a domicilio. Resultados: De acuerdo con los resultados, en general los pacientes y cuidadores consideran bueno o muy bueno el servicio recibido. Si este tratamiento se ofrece en el domicilio lo habitual es que quieran seguir con esta modalidad y no volver al hospital para recibirlo. Finalmente, la posibilidad de disponer de contacto telefónico seguido de visita si es necesaria, es la preferencia de elección. Conclusiones: Los resultados de las encuestas realizadas en nuestros pacientes/familiares permiten concluir que la nutrición enteral domiciliaría dentro de un programa de atención y seguimiento a domicilio controlado desde la Unidad de Nutrición del hospital de referencia es un tratamiento muy bien aceptado tanto por pacientes como por familiares de los mismos o cuidadores.Home enteral nutrition is a treatment carried out frequently due to advantages for patients and caregivers (lower risk of nosocomial infections and better integration in socio-familiar media but

  13. Current status of pediatric home enteral nutrition in Spain: The importance of the NEPAD register Estado actual de la nutrición enteral pediátrica en España: la importancia del registro NEPAD

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    L. Gómez-López

    2010-10-01

    Full Text Available Abstract Home enteral nutrition (HEN is a type of enteral nutrition (EN which is becoming progressively more widespread in pediatrics due to the benefits it affords to patients, their families and to reducing hospital costs. However, the true extent of its use is unknown in Spain as the data-base set up for this purpose is still underused (Registro de Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria -NEPAD-. More thorough registration of patients in the NEPAD online register will provide information about the characteristics of HEN in Spain: prevalence, diagnosis, the population sector being administered HEN, complications and developments. Likewise, forecast and planning of the necessary resources could be made while those in use could be analysed.La nutrición enteral domiciliaria (NED es una modalidad de nutrición enteral (NE con una progresiva extensión en pediatría por los beneficios que supone para el paciente, sus familiares y la disminución de los costes hospitalarios. Sin embargo, se desconoce su verdadero alcance en España ya que el registro creado a tal efecto está aún infrautilizado (Registro de Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria -NEPAD-. La inclusión exhaustiva de pacientes en NEPAD permitiría conocer las características de la NED en España: prevalencia, indicaciones, población a la que se le está administrando, complicaciones y evolución. Así mismo se podría realizar una previsión y planificación de los recursos que se precisan y analizar los que se están utilizando.

  14. Effects of the Exclusive Enteral Nutrition on the Microbiota Profile of Patients with Crohn’s Disease: A Systematic Review

    Science.gov (United States)

    Gatti, Simona; Galeazzi, Tiziana; Franceschini, Elisa; Annibali, Roberta; Albano, Veronica; De Angelis, Maria; Lionetti, Maria Elena; Catassi, Carlo

    2017-01-01

    The mechanisms behind the efficacy of exclusive enteral nutrition (EEN) in Crohn’s disease (CD) remain poorly understood, despite the high rate of treatment response. Evidence accumulated in the last 20 years suggests that a positive shift of the disrupted microbiota is one of the treatment effects. The purpose of this study was to critically review and summarize data reporting the microbiological effects of EEN in patients with CD. Fourteen studies were considered in the review, overall involving 216 CD patients on EEN. The studies were heterogeneous in methods of microbiota analysis and exclusion criteria. The most frequently reported effect of EEN was a reduction in microbiota diversity, reversible when patients returned to a normal diet. The effect of EEN on specific bacteria was very variable in the different studies, partially due to methodological limitations of the mentioned studies. The EEN seem to induce some metabolomic changes, which are different in long-term responder patients compared to patients that relapse earlier. Bacterial changes can be relevant to explaining the efficacy of EEN; however, microbiological data obtained from rigorously performed studies and derived from last generation techniques are largely inconsistent. PMID:28777338

  15. Short-Term Efficacy of Exclusive Enteral Nutrition in Pediatric Crohn’s Disease: Practice in China

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    Youyou Luo

    2015-01-01

    Full Text Available Aims. The objective of this study was to compare the efficacy of exclusive enteral nutrition (EEN and corticosteroids in inducing remission in pediatric Crohn’s disease (CD and the effects of the treatment on growth improvements. Methods. Data was retrospectively collected for children and adolescents newly diagnosed with CD in a referral center. Patients who were followed up for more than 2 months with mild to moderate disease were included. Basic demographics, history, physical examination, the pediatric Crohn disease activity index (PCDAI, laboratory findings, endoscopic findings, and adverse effects were recorded. Remission was defined as PCDAI < 10 points. Results. Ten subjects received EEN and 18 patients received corticosteroids. The median follow-up in EEN group and steroid group was 9.2 weeks and 9.6 weeks, respectively. The remission rate in EEN group was significantly higher than that in steroid group (90.0% versus 50.0%, resp., P<0.05. Growth improvement, which was evaluated by changes in height for age z-score, was more apparent in EEN group than that in steroids group P<0.05. No adverse effects were observed in EEN group. Conclusions. In children with mild to moderate CD, EEN is more effective than corticosteroids in improving disease severity and growth deficiency, as well as providing less side effects.

  16. Motor neurone disease in Lancashire and South Cumbria in North West England and an 8 year experience with enteral nutrition.

    Science.gov (United States)

    Chhetri, Suresh Kumar; Bradley, Belinda Fay; Majeed, Tahir; Lea, Robert William

    2016-02-01

    Motor neurone disease (MND) is a fatal neurodegenerative disease of unknown aetiology. Malnutrition is a common occurrence and an independent risk factor for worse prognosis. However, it remains unclear whether provision of enteral nutrition (EN) through a gastrostomy tube offers any survival advantage. Our aim was to describe the demographic and clinical characteristics of MND in Lancashire and South Cumbria in North West England and the impact of EN on survival in the 8 year period of 2005-2012. Four hundred and seven patients with MND were identified through the Preston MND care and research centre registry giving a crude incidence rate of 3.15/100,000. Three hundred and forty patients with adequate information were included in the final analysis of whom 53.2% were male. The presentation was limb/spinal in 62.1% and bulbar in 37.9% of patients, bulbar onset being more common in elderly females. Mean age of onset was 67.28 years (standard deviation 11.06; range 22.78-93.06). Median survival was 1.98 years (range 1.18-3.05). Ninety-one patients received EN of whom 67% had bulbar onset disease. EN was not associated with a statistically significant survival advantage except for the subgroup who received EN more than 500 days after symptom onset. In conclusion, the early requirement for EN may indicate a prognostically less favourable subgroup.

  17. Verification of glycemic profiles using continuous glucose monitoring: cases with steroid use, liver cirrhosis, enteral nutrition, or late dumping syndrome.

    Science.gov (United States)

    Kishimoto, Miyako; Noda, Mitsuhiko

    2015-01-01

    Glycemic control is often difficult to achieve in patients with diabetes, especially in the presence of comorbid diseases or conditions such as steroid-use or liver cirrhosis, or in patients receiving enteral nutrition. Moreover, reactive hypoglycemia due to late dumping syndrome in people having undergone gastrectomy is also a matter of concern. Empirically and theoretically, the typical glycemic profiles associated with these conditions have been determined; however, what actually happens during a 24-h span is still somewhat obscure. In order to verify and provide information about the 24-h glycemic profiles associated with these conditions, 8 patients with the 4 above-mentioned conditions were monitored using a continuous glucose monitoring system (CGMS). For all 8 patients, CGMS provided detailed information regarding the 24-h glycemic profiles. The CGM results showed typical glycemic patterns for each condition, and we were moreover able to observe the effects of various practical treatments. Based on these cases, we conclude that the CGMS is highly useful for determining the glycemic patterns of patients with the aforementioned conditions in a practical setting; and this system may be used to monitor the treatment success of such cases.

  18. Partial Enteral Nutrition Preserves Elements of Gut Barrier Function, Including Innate Immunity, Intestinal Alkaline Phosphatase (IAP) Level, and Intestinal Microbiota in Mice.

    Science.gov (United States)

    Wan, Xiao; Bi, Jingcheng; Gao, Xuejin; Tian, Feng; Wang, Xinying; Li, Ning; Li, Jieshou

    2015-08-03

    Lack of enteral nutrition (EN) during parenteral nutrition (PN) leads to higher incidence of infection because of gut barrier dysfunction. However, the effects of partial EN on intestina linnate immunity, intestinal alkaline phosphatase (IAP) and microbiota remain unclear. The mice were randomized into six groups to receive either standard chow or isocaloric and isonitrogenous nutritional support with variable partial EN to PN ratios. Five days later, the mice were sacrificed and tissue samples were collected. Bacterial translocation, the levels of lysozyme, mucin 2 (MUC2), and IAP were analyzed. The composition of intestinal microbiota was analyzed by 16S rRNA pyrosequencing. Compared with chow, total parenteral nutrition (TPN) resulted in a dysfunctional mucosal barrier, as evidenced by increased bacterial translocation (p microbiota (p intestinal microbiota.

  19. Enteral nutrition therapy for critically ill adult patients: critical review and algorithm creation Terapia nutricional enteral para pacientes adultos en estado crítico: análisis crítico de la literatura y la creación de algoritmo

    OpenAIRE

    Araújo-Junqueira, L.; Daurea A. De-Souza

    2012-01-01

    Introduction: Undernutrition directly affects critically ill patient's clinical outcome and mortality rates. Objective: Interdisciplinar algorithm creation aiming to optimize the enteral nutrition therapy for critically ill adult patients. Data source: Pubmed, SciELO, Scholar Google, Web of Science, Scopus, with research of these key words: protocols, enteral nutrition, nutritional support, critical care, undernutrition, fasting. Setting: Intensive Care Unit, Hospital de Clínicas, Federal Uni...

  20. Nutrición enteral total vs. nutrición parenteral total en pacientes con pancreatitis aguda grave Total enteral nutrition vs. total parenteral nutrition in patients with severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    M. Casas

    2007-05-01

    Full Text Available Objetivo: comparar la eficacia de la instauración precoz de nutrición enteral total (NET frente a nutrición parenteral total (NPT en pacientes con pancreatitis aguda grave (PAG. Métodos: estudio prospectivo aleatorio. Se incluyeron consecutivamente 22 pacientes con PAG aplicando los criterios APACHE II, valores de PCR y graduación de Balthazar en la TC. El grupo I (n = 11 recibió NPT y el grupo II (n = 12 NET. Se valoró la respuesta inflamatoria (PCR, TNF-alfa, IL-6, las proteínas viscerales (pre-albúmina, albúmina, la tasa de complicaciones (síndrome de respuesta inflamatoria sistémica, fallo multiorgánico, infecciones, las intervenciones quirúrgicas, la estancia hospitalaria y la mortalidad. Resultados: no hubo diferencias significativas en los primeros 10 días entre los dos grupos en la evolución de los criterios APACHE II, en las concentraciones de PCR, TNF-alfa e IL-6 ni tampoco en los valores de pre-albúmina y albúmina. Siete pacientes del grupo I presentaron complicaciones graves frente a 4 del grupo II. Requirieron intervención quirúrgica 3 pacientes del grupo I. La estancia hospitalaria fue similar en los dos grupos. Dos pacientes del grupo I fallecieron. Conclusiones: se ha observado una tendencia a una mejor evolución de los pacientes con PAG que utilizaron NET frente a los que utilizaron NPT.Objective: to compare the efficacy of early total enteral nutrition (TEN vs. total parenteral nutrition (TPN in patients with severe acute pancreatitis (SAP. Methods: a total of 22 consecutive patients with SAP were randomized to receive TPN (group I or TEN (group II. SAP was defined applying APACHE II score, C-reactive protein (CRP measurements and/or Balthazar CT scan score. Acute inflammatory response (CRP, TNF-alpha, IL-6, visceral proteins (pre-albumin, albumin, complications (systemic inflammatory response syndrome, multiorgan failure, infections, surgical interventions, length of hospital stay and mortality were

  1. Nutrition screening and intervention effect of enteral nutrition on 60 abandoned and disabled children%60例孤残儿童营养筛查及肠营养干预效果分析

    Institute of Scientific and Technical Information of China (English)

    王季鸿; 龚佩花; 范玉玲; 艾梅荣

    2015-01-01

    目的::通过对孤残儿童定期营养监测,及时实施肠营养干预,改善营养状况,以利于孤残儿童健康成长。方法:定期进行营养筛查,对存在营养风险的孤残儿童进行营养评估和肠营养干预。结果:肠营养干预对营养不良孤残儿童显著有效,受干预孤残儿童体重增长速率与正常儿童比较P﹤0.01,出现部分赶上生长。结论:孤残儿童有必要定期进行营养筛查、评估和及时肠营养干预,改善营养状况,促进孤残儿童体格发育。%Objective:To improve the nutrition status of the abandoned and disabled children through the timely implementa-tion of enteral nutrition interventions and the regular nutrition monitoring, which will help them to grow up healthily. Methods:Through being screened the nutrition status regularly, the abandoned and disabled children with low nutritional status were given the as-sessment and enteral nutrition intervention. Results: The enteral nutrition intervention for the abandoned and disabled children with malnutrition was significantly effective. The weight growth rate of the children having received the nutrition intervention was comparable with that of other normal children (P﹤0. 01), and a part of these children had occurred the catch-up growth. Conclusions:It is nec-essary to do the regular nutritional screening, assessment and timely enteral nutrition interventions for the abandoned and disabled chil-dren, which will help them to improve the nutritional status and have a better physical development.

  2. Registro de Nutrición Enteral Domiciliaria en España en el año 2007 National registry of home enteral nutrition in Spain 2007

    Directory of Open Access Journals (Sweden)

    L. M. Luengo Pérez

    2009-12-01

    Full Text Available Objetivo: Comunicar los datos del registro nacional de nutrición enteral domiciliaria del grupo NADYA-SENPE de 2007. Material y métodos: Se incluyeron todos los pacientes con nutrición enteral domiciliaria del registro del grupo NADYA entre el 1 de enero y el 31 de diciembre de 2007. Resultados: El número de pacientes con nutrición enteral domiciliaria durante 2007 fue de 5107 (52% varones de 28 centros hospitalarios. El 95,4% tenían más de 14 años, con una edad media de 67,96 ± 18,12 años mientras en los menores de 15 años fue de 4,2 ± 3,38 años. Las patologías más prevalentes entre ellos fueron las neurológicas (37,8% y las neoplásicas (29,3%. La vía de administración más empleada fue la oral (63,5%, seguida de sonda nasogástrica (25,9%, mientras la gastrostomía sólo se empleó en el 9,2%. La duración media de la nutrición enteral fue de 9,4 meses y las causas de finalización más frecuentes fueron el fallecimiento (58,77% y el paso a ingesta oral (26,57%. La actividad estaba limitada en el 31,4% de los pacientes y realizaban vida cama-sillón el 36,01% y la mayoría de los pacientes precisaban ayuda parcial (26,51% o total (37,68%. El suministro de la fórmula se hacía desde el hospital en el 69,14% de los casos y en las farmacias de referencia en el 30,17%, mientras que el material fungible se suministraba desde el hospital en el 81,63% y desde Atención Primaria en el resto. Conclusiones: Durante 2007, ha habido un incremento de más del 30% de pacientes con nutrición enteral domiciliaria registrados respecto a 2006, sin que esto haya supuesto grandes diferencias en el resto de datos, salvo el mayor aumento de los casos de nutrición enteral-oral.Objective: To communicate the results from the registry of Home-Based Enteral Nutrition of the NADYASENPE group in 2007. Material and methods: We included every patient in the registry with home enteral nutrition any time from January 1st to December 31st of 2007

  3. Could enteral nutrition improve the outcome of patients with haematological malignancies undergoing allogeneic haematopoietic stem cell transplantation? A study protocol for a randomized controlled trial (the NEPHA study).

    Science.gov (United States)

    Lemal, Richard; Cabrespine, Aurélie; Pereira, Bruno; Combal, Cécile; Ravinet, Aurélie; Hermet, Eric; Bay, Jacques-Olivier; Bouteloup, Corinne

    2015-04-07

    Myeloablative allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a major procedure usually accompanied by multifactorial malnutrition, prompting the recommendation of systematic artificial nutritional support. Parenteral nutrition (PN) is usually administered during allo-HSCT, essentially for practical reasons. Recently published data suggest that enteral nutrition (EN), given as systematic artificial nutrition support, could decrease grade III-IV graft-versus-host disease (GVHD) and infectious events, which are associated with early toxicity after allo-HSCT and then have an impact on early transplant-related mortality (D100 mortality). We report on the NEPHA trial: an open-label, prospective, randomised, multi-centre study on two parallel groups, which has been designed to evaluate the effect of EN compared to PN on early toxicity after an allo-HSCT procedure. Two hundred forty patients treated with allo-HSCT for a haematological malignancy will be randomly assigned to two groups to receive either EN or PN. The primary endpoint will assess the effect of EN on D100 mortality. Secondary endpoints will compare EN and PN with regards to the main haematological, infectious and nutritional outcomes. The impacts of nutritional support should exceed the limits of nutritional status improvement: EN may directly reduce immunological and infectious events, as well as decrease early transplant-related morbidity and mortality. EN and PN need to be prospectively compared in order to assess their impacts and to provide treatment guidelines. (Clinical trials gov number: NCT01955772; registration: July 19th, 2013).

  4. Program Facilitates CMMI Appraisals

    Science.gov (United States)

    Sweetser, Wesley

    2005-01-01

    A computer program has been written to facilitate appraisals according to the methodology of Capability Maturity Model Integration (CMMI). [CMMI is a government/industry standard, maintained by the Software Engineering Institute at Carnegie Mellon University, for objectively assessing the engineering capability and maturity of an organization (especially, an organization that produces software)]. The program assists in preparation for a CMMI appraisal by providing drop-down lists suggesting required artifacts or evidence. It identifies process areas for which similar evidence is required and includes a copy feature that reduces or eliminates repetitive data entry. It generates reports to show the entire framework for reference, the appraisal artifacts to determine readiness for an appraisal, and lists of interviewees and questions to ask them during the appraisal. During an appraisal, the program provides screens for entering observations and ratings, and reviewing evidence provided thus far. Findings concerning strengths and weaknesses can be exported for use in a report or a graphical presentation. The program generates a chart showing capability level ratings of the organization. A context-sensitive Windows help system enables a novice to use the program and learn about the CMMI appraisal process.

  5. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): cardiac patient].

    Science.gov (United States)

    Jiménez Jiménez, F J; Cervera Montes, M; Blesa Malpica, A L

    2011-11-01

    Patients with cardiac disease can develop two types of malnutrition: cardiac cachexia, which appears in chronic congestive heart failure, and malnutrition due to the complications of cardiac surgery or any other type of surgery in patients with heart disease. Early enteral nutrition should be attempted if the oral route cannot be used. When cardiac function is severely compromised, enteral nutrition is feasible, but supplementation with parenteral nutrition is sometimes required. Sustained hyperglycemia in the first 24 hours in patients admitted for acute coronary syndrome, whether diabetic or not, is a poor prognostic factor for 30-day mortality. In critically-ill cardiac patients with stable hemodynamic failure, nutritional support of 20-25 kcal/kg/day is effective in maintaining adequate nutritional status. Protein intake should be 1.2*-1.5 g/kg/day. Routine polymeric or high protein formulae should be used, according to the patient's prior nutritional status, with sodium and volume restriction according to the patient's clinical situation. The major energy source for myocytes is glutamine, through conversion to glutamate, which also protects the myocardial cell from ischemia in critical situations. Administration of 1 g/ day of omega-3 (EPA+DHA) in the form of fish oil can prevent sudden death in the treatment of acute coronary syndrome and can also help to reduce hospital admission for cardiovascular events in patients with chronic heart failure.

  6. Arginine-supplemented enteral nutrition in critically ill diabetic and obese rats: a dose-ranging study evaluating nutritional status and macrophage function.

    Science.gov (United States)

    Bonhomme, Sandra; Belabed, Linda; Blanc, Marie-Céline; Neveux, Nathalie; Cynober, Luc; Darquy, Sylviane

    2013-01-01

    Critically ill diabetic and obese patients are at high risk of complications. Arginine availability is lowered in diabetes and in stress situations, yet arginine is necessary for immune response, mainly by its action through nitric oxide (NO). These facts argue for arginine-supplemented diets in critically ill patients. However, studies have raised concerns about possible adverse effects of such diets in intensive-care patients. We therefore analyzed the metabolic and immunologic effects of an arginine-enriched diet in stressed diabetic-obese rats. Zucker Diabetic Fatty rats (fa/fa) were made endotoxemic by an intraperitoneal injection of lipopolysaccharide and then fed 4-d enteral nutrition enriched with arginine (ARG group) or a non-essential amino acid mix (NEAA group). The two groups each were subdivided into three subgroups: the ARG subgroups received 0.5 g (ARG0.5), 2 g (ARG2), and 5 g (ARG5) of arginine per kilogram daily, and the NEAA groups were made isonitrogenous with the corresponding ARG subgroups (NEAA0.5, NEAA2, and NEAA5). Plasma and urinary biomarkers were measured. Cytokine and NO production levels and inducible NO synthase and arginase protein levels were determined from peritoneal macrophages. The survival rate was lower in the ARG5 and NEAA5 subgroups than in all the other subgroups. The nitrogen balance was higher in the ARG5 group than in the NEAA5 group. Plasma triacylglycerol levels were lower in the ARG2 group than in the NEAA2 group. Interleukin-6, tumor necrosis factor-α, and NO production in the macrophages decreased and arginase-1 was upregulated in the ARG-treated rats. In this model, mortality was increased by the nitrogen burden rather than by arginine per se. Arginine improved nitrogen balance and had an anti-inflammatory action on macrophages by regulating NO production, probably through arginase-1 expression. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Diabetes-specific enteral nutrition formula in hyperglycemic, mechanically ventilated, critically ill patients: a prospective, open-label, blind-randomized, multicenter study

    OpenAIRE

    Mesejo, Alfonso; Montejo-González, Juan Carlos; Vaquerizo-Alonso, Clara; Lobo-Tamer, Gabriela; Zabarte-Martinez, Mercedes; Herrero-Meseguer, Jose Ignacio; Acosta-Escribano, Jose; Blesa-Malpica, Antonio; Martinez-Lozano, Fátima

    2015-01-01

    Introduction Although standard enteral nutrition is universally accepted, the use of disease-specific formulas for hyperglycemic patients is still controversial. This study examines whether a high-protein diabetes-specific formula reduces insulin needs, improves glycemic control and reduces ICU-acquired infection in critically ill, hyperglycemic patients on mechanical ventilation (MV). Methods This was a prospective, open-label, randomized (web-based, blinded) study conducted at nine Spanish ...

  8. Administración de la alimentación enteral en salas generales de internación Nutrition delivery in general wards

    Directory of Open Access Journals (Sweden)

    MV Bertona

    2009-12-01

    Full Text Available La interrupción de la alimentación enteral conduce a un aporte calórico inadecuado, circunstancia que se agrava debido al estado catabólico que presentan los pacientes, contribuyendo ambos al deterioro de su estado nutricional. La malnutrición calóricoproteica se asocia a mayor número de complicaciones, aumento de la estancia hospitalaria, y por lo tanto mayores costos. Los objetivos del presente trabajo fueron establecer en qué porcentaje se administran inadecuadamente las alimentaciones enterales por sonda nasogástrica prescriptas y cuales son las causas de administración inadecuada en los pacientes internados. Se realizó un estudio descriptivo, observacional, transversal y prospectivo entre julio de 2008 y febrero de 2009. Se estudiaron 43 pacientes internados en el Hospital Argerich en las salas de Clínica Médica, Cirugía General y Neurocirugía que recibieron alimentación enteral por sonda nasogástrica como vía de alimentación exclusiva. La administración global de la alimentación enteral por sonda nasogástrica tuvo una inadecuación del 79.10% (IC 95%: 64-90%. Las causas más comunes de interrupción de la alimentación enteral fueron las relacionadas con el personal de enfermería (35.85% y con el paciente (30.19%. Estas últimas incluyeron intolerancia gastrointestinal y extracción de la sonda nasogástrica. De acuerdo a los resultados obtenidos a través de la presente investigación se considera que se debería promover la implementación de protocolos específicos en cada sala de internación ya que la utilización de los mismos está claramente asociada con una mejoría en la administración de alimentación enteral en los pacientes internados y son un método simple y efectivo.Discontinuation of enteral nutrition leads to an inadequate caloric intake, a circumstance that is aggravated by the patient's catabolic state, which in turn contributes to an impaired nutritional status. Protein-energy malnutrition is

  9. Glutamine-enriched enteral nutrition in very low birth weight infants. Design of a double-blind randomised controlled trial [ISRCTN73254583

    Directory of Open Access Journals (Sweden)

    Twisk Jos WR

    2004-09-01

    Full Text Available Abstract Background Enteral feeding of very low birth weight (VLBW infants is a challenge, since metabolic demands are high and administration of enteral nutrition is limited by immaturity of the gastrointestinal tract. The amino acid glutamine plays an important role in maintaining functional integrity of the gut. In addition, glutamine is utilised at a high rate by cells of the immune system. In critically ill patients, glutamine is considered a conditionally essential amino acid. VLBW infants may be especially susceptible to glutamine depletion as nutritional supply of glutamine is limited in the first weeks after birth. Glutamine depletion has negative effects on functional integrity of the gut and leads to immunosuppression. This double-blind randomised controlled trial is designed to investigate the effect of glutamine-enriched enteral nutrition on feeding tolerance, infectious morbidity and short-term outcome in VLBW infants. Furthermore, an attempt is made to elucidate the role of glutamine in postnatal adaptation of the gut and modulation of the immune response. Methods VLBW infants (gestational age

  10. La fibra en nutrición enteral: revisión sistemática de la literatura Fibre in enteral nutrition: systematic review of the literature

    OpenAIRE

    D. del Olmo; T. López del Val; P. Martínez de Icaya; P. de Juana; Alcázar, V; Koning, A; Vázquez, C.

    2004-01-01

    Se ha sugerido que añadir fibra a las fórmulas de nutrición enteral (NE) consigue una normalización del funcionamiento del tracto gastrointestinal, disminuyendo la incidencia de diarrea y de estreñimiento. Sin embargo, esta suposición está basada en el efecto demostrado de la fibra en la alimentación natural. Hasta la fecha no existen recomendaciones firmes sobre el uso, la cantidad ni el tipo de fibra más aconsejable en NE. Objetivo: Establecer la evidencia científica que existe sobre el ben...

  11. Nutrición enteral domiciliaria (NED): Registro Nacional del año 2000 Enteral nutrition at home: National register for 2000

    OpenAIRE

    M. Planas; M. Castellá; P. P. García Luna; J. Chamorro; C. Gómez Candela; M. D. Carbonell; J. A. Irles; Jiménez, M; E. Morejón; A. Pérez de la Cruz; M.ª A. Bobis; A. Rodríguez Pozo; G. Adrio; Salas, J.; A. J. Calañas

    2003-01-01

    Objetivo: Un año más, el Grupo de Trabajo NADYA-SENPE, presenta el análisis del registro de los pacientes con Nutrición Enteral Domiciliaria (NED) de nuestro país correspondiente al año 2000. Material y métodos: La información se ha recogido en un cuestionario cerrado incluido en nuestra página web (www.nadya-senpe.com). Este formulario incluye datos epidemiológicos, indicación del motivo de este tratamiento, pauta de tratamiento y vía de acceso, complicaciones y hospitalizaciones, seguimient...

  12. 食道、胃术后早期肠内营养支持对患者康复效果的影响%The effect of early enteral nutritive support on patients after esophageal and gastric operation

    Institute of Scientific and Technical Information of China (English)

    朱文钿; 张文; 赵志毅; 冯平; 黄擎雄; 岑庆君; 苏巴丽; 梁有芳

    2003-01-01

    AIM:To investigate the availability and safety of early enteral nutritive support after esophageal and gastric operation.METHODS:The postoperative patients of esophageal and gastric operation were randomly divided into enteral nutrition(EN) group(n=20) and parenteral nutrition(PN)group(n=20) and were given nutritive support of same ammoni and same quantity of heat after postoperative 24 hours,continuously for 7 days.RESULTS:The patients of both groups recovered and were discharged after treatment.The assessing index of nutrition of EN group was better than PN group(see table of clinical index).And the hospitalization fees of EN group were lower than PN group.The time of hospitalization of EN group was also shorter than PN group.CONCLUSION:Early enteral nutritive support after esophageal and gastric operation was safety and the rehabilitation effect was obvious and had extensive clinical application values.

  13. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): neurocritical patient].

    Science.gov (United States)

    Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

    2011-11-01

    Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  14. Performance Appraisal.

    Science.gov (United States)

    Holloway, Mary Louise

    1988-01-01

    Reviews general facets of performance appraisal pointing out the similarities and differences in methods and instruments used to assess the performance of administrative, academic, and nonacademic personnel. Relates the concepts of merit pay and tenure to performance appraisal. (DMM)

  15. 为中国制造的肠内营养制剂%Harmonic M powder-enteral nutrition made in Germany for China

    Institute of Scientific and Technical Information of China (English)

    BerndKasten

    2001-01-01

    Nutrichem Diat+Pharma GmbH is focused on nutrition products forspecial requirements like clinical nutrition,sports nutrition,and nutritional supplements.Founded in the late seventies as a trading company for pharmaceutical raw materials,it turned very soon towards nutrition products.It started with supplying oral rehydration salts for relief organisations like UNICEF.Very soon thereafter Nutrichem dedicated its activities towards the development of enteral nutrition products with the highlight of developing the first ready to use liquid tube feeding with oligopeptides in 1983.During the eighties it established its engagement in sports nutrition by founding the lnko companies.lnko is today an important player in the fitness-clubmarket.Nowadays with a state of the art production plant,Nutrichem offers a variety of different products for an international clientele.The latest development is entering new paths in developing also convenient packaging,like a soft-bag for liquid products,the nutriBay.We are producing over 250 different product codes in powder,glass,and plastic pouches.Our main goal is producing solely high quality products,monitored by a sophisticated total quality management system.Our production is certified to produce according to different European and intenational standards.We have GMP production facilities for enteral nutrition that is why drug standards are applied in production and quality control.Nutrichem has established business partnerships with major pharmaceutical companies over the time and is today one of the leading producers for enteral nutrition products in Europe.The company produces approximately 25% of all enteral nutrition products marketed in Europe.In Asia,we have been very much engaged in Japan for about 15 years.Being the exclusive supplier for our mother company the Japanese company SSP,we are covering about 12% of the Japanese market for enteral nutrition substrates.With the Harmonic product range we have proven our image of

  16. An Appraisal of the Clinical Features of Pediatric Enteric Fever: Systematic Review and Meta-analysis of the Age-Stratified Disease Occurrence.

    Science.gov (United States)

    Britto, Carl; Pollard, Andrew J; Voysey, Merryn; Blohmke, Christoph J

    2017-06-01

    Children bear a substantial proportion of the enteric fever disease burden in endemic areas. Controversy persists regarding which age groups are most affected, leading to uncertainty about optimal intervention strategies. We performed a systematic review and meta-analysis of studies in Asia and Africa to compare the relative proportion of children with enteric fever in the age groups <5 years, 5-9 years, and 10-14 years. Overall, studies conducted in Africa showed a relatively smaller occurrence of disease in the youngest age group, whereas in Asia the picture was more mixed with a very large degree of heterogeneity in estimates. The clinical features of enteric fever reviewed here differ between younger and older children and adults, likely leading to further uncertainty over disease burden. It is evident from our review that preschool children and infants also contribute a significant proportion of disease burden but have not been adequately targeted via vaccination programs, which have been focusing primarily on school-based vaccination campaigns. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  17. 胃癌术后肠内营养支持治疗的护理%Gastric Cancer Postoperative Enteral Nutrition Support Nursing Care

    Institute of Scientific and Technical Information of China (English)

    房孝红

    2014-01-01

    Objective To explore the postoperative patients with gastric cancer. Methods The complications of enteral nutrition in patients with the implementation of 54 cases of postoperative gastric cancer and given the prevention and nursing measures. Results The early postoperative enteral nutrition in patients with mild abdominal pain occurred in 8 cases, abdominal distension, diarrhea, 3 cases of nausea, vomiting, plugging in 2 cases, and regurgitation in 1 case. Conclusion In patients with gastric cancer early enteral nutrition support is safe, ef ective way of nutritional support after operation.%目的探讨胃癌术后早期肠内营养支持治疗的护理及并发症的预防。方法对54例胃癌术后实施肠内营养的患者观察其并发症的发生并给予相应的预防和护理措施。结果术后早期肠内营养的患者发生轻度腹痛、腹胀、腹泻8例,恶心、呕吐3例,堵管2例,返流1例,所有患者经过对症处理,并发症得到了解决,无吻合口瘘、腹膜炎发生,肠内营养顺利进行。结论胃癌患者术后早期肠内营养支持是术后营养支持的安全、有效途径,做好相应的护理,能减少并发症的发生,减轻患者痛苦,降低患者经济负担,使患者尽快恢复健康。

  18. Enteral bile acid treatment improves parenteral nutrition-related liver disease and intestinal mucosal atrophy in neonatal pigs

    DEFF Research Database (Denmark)

    Jain, Ajay Kumar; Stoll, Barbara; Burrin, Douglas G

    2012-01-01

    Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly...

  19. Enteral bile acid treatment improves parenteral nutrition-related liver disease and intestinal mucosal atrophy in neonatal pigs

    Science.gov (United States)

    Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly des...

  20. Proteínas y péptidos en nutrición enteral Proteins and peptides in enteral nutrition

    Directory of Open Access Journals (Sweden)

    O. Martínez Augustin

    2006-05-01

    essential macronutrient for the growth and maintenance of corporal structures. An important concept in proteic nutrition is the protein's quality, mainly determined by the profile and proportion of the amino acids making up the protein, although other factors such as solubility and degree of glycosylation may be involved. There are different ways to evaluate protein quality that can be classified as chemical, biological and microbiological. Currently Protein Digestibility-Corrected Amino Acid Score (PDCAAS is routinely used. Protein quality can be altered by the technological and culinary processes to which food is subjected and also by the presence in food of anti-nutritional factors affecting the bioavailability of amino acids. Protein complementation through the formulation of low-quality protein mixtures lets us improve bioavailability, and therefore the quality of this protein mix. In the past few years, nutrition and food technology are undergoing a profound transformation due to the development of the concept of functional and nutraceutic foods. Functional proteins and bioactive peptides are gaining in importance since, in addition to their nutritional role as a source of amino acids, they are capable of exerting different biological effects on the immune system, the cardiovascular system or the gastrointestinal tract. In addition, these peptides and proteins have been described as having anticancer, antibacterial or antiviral effects. This paper reviews the most relevant functional proteins and bioactive peptides from a functional standpoint, with special emphasis on those coming from milk, eggs and soy.

  1. Effect of early enteral and parenteral nutrition on visceral ischemic lesion of rat burn model%早期肠道营养对烧伤大鼠模型内脏缺血损害的效应

    Institute of Scientific and Technical Information of China (English)

    徐世伟; 冯怀志; 尤忠义; 王裴; 汪仕良

    2003-01-01

    AIM:To compare the effects of early enteral nutrition and early parenteral nutrition on ameliorating visceral ischemia and relieving free radical damage.METHODS:66 Wistar rats were divided into 3 groups: control group(C),parenteral nutrition group( PN) and enteral nutrition group( EN), PN and EN groups made up of 30% TBSAⅢ degree burn model.We delivered nutrient solution with same calorie and calorie- nitrogen ratio via vein or enteral tract respectively.Blood flow of liver,kidney and change of SOD of heart,liver and kidney at 6,12,24,48,72 h after burn were tested.RESULTS:Tissue blood flow and SOD of EN group were higher than those of PN group in many phase( P< 0.05-0.01) .CONCLUSION: Early enternal nutrition can relieve the increase of visceral vascular permeability and damage of oxygen free radical.

  2. 老年鼻饲患者肠内营养泵的使用及其护理%Application and nursing of enteral nutrition pump in elderly patients with nasal feeding

    Institute of Scientific and Technical Information of China (English)

    王妍

    2012-01-01

    Objective To observe the effect and nursing strategies of enteral nutrition support for elderly patients with enteral nutrition pump. Methods Ninety elderly patients with enteral nutrition support were randomly divided into three groups. The experiment group received enteral nutrition support with enteral nutrition pump while the control groups received syringe intermittent perfusion and enteral nutrition device intermittent infusion,respectively. The complications among the three groups were observed and nursing strategies were summarized. Results The incidence rate of complications was significantly lower in the experiment group than in the control groups. Conclusion Enteral nutrition pump treatment combined with effective nursing measures can improve the effect of enteral nutritional support and reduce the incidence rate of complications.%目的 观察老年患者应用肠内营养泵行肠内营养支持的效果及护理要点.方法 90例行肠内营养支持的老年患者分为3组,实验组采用肠内营养泵行肠内营养支持,对照组分别采用注射器间断灌注和肠内营养输液器间歇滴注,对照观察3组患者的并发症,并总结护理要点.结果 采用肠内营养泵的患者并发症发生率明显低于对照组.结论 采用肠内营养泵,并辅以有效的护理措施,可以提高肠内营养支持的效果,减少并发症的发生.

  3. ICU重症患者的肠内营养的护理管理%Of Enteral Nutrition in Patients with ICU Intensive Care Management

    Institute of Scientific and Technical Information of China (English)

    徐静

    2015-01-01

    因为重症监护病人代谢状态非常高,有很大概率会发生免疫衰竭和代谢障碍状况,从而增加感染几率,甚至引起细胞功能的损坏。一般情况下这种病人不能自主进食,常选择肠内营养补给办法确保病人摄取营养。针对这种情况,该研究分析了ICU重症病房患者肠内营养护理管理效果。%Because ICU patients’s metabolism is fast, the probability of immune failure and metabolic disorders is high as a result of increasing the risk of infection and even lead to the damage of cellular function. Generally speaking,patients can-not eat independently,so we can choose enteral nutrition supply method to ensure their nutrition intake ability. According to this situation, this thesis analyzes the effect of enteral nutrition for ICU patients of nursing management.

  4. 食管癌术后肠内营养基础研究进展%Research progress in postoperative enteral nutrition in patients with esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    彭忠民; 杨旭东

    2014-01-01

    Esophageal cancer is one of the tumors with high morbidity rates in China, and surgery remains to be the preferred treatment. However, certain complications such as anastomotic fistula, lung infection, respiratory failure, and circulatory failure occur after surgery. Postoperative enteral nutritional support could not only maintain and improve the nutritional status of the body but also re-duce complications and maintain normal immune function. This review focuses on the progress in postoperative enteral nutrition in pa-tients with esophageal cancer.%食管癌是我国常见恶性肿瘤之一,手术是首选的治疗方案。食管癌患者术后常发生吻合口瘘、肺部感染及呼吸循环衰竭等并发症。术后正确给予肠内营养支持不仅有利于维持患者各组织器官的代谢功能,而且能够减少各种术后并发症,维持正常的免疫反应。本文就食管癌术后肠内营养相关研究进展进行综述。

  5. 胃癌术后早期肠内营养的临床应用%Application of early enteral nutrition in post - operative patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    汪杰斌; 王晓亮

    2011-01-01

    Objective To investigate the feasibility, safety, fees and clinical effects of early enteral nutrition following gastric cancer operation. Methods 122 patients performed gastric cancer operation were randomly divided into early enteral nutrition group (cases) and parenteral nutrition group (cases). Results The time of flatus (46.98 ± 6.87,73.51 ± 11.53 ), bowel movement ( 83.89 ± 12.78,130.80 ± 22.93 ), and of hospital stay after operation in the EN group was significantly shorter than the PN group (9.79 ± 0.76,12.48 ± 1.46). In the first seven days after surgery, various parameter recovery rates in group EN were better than those in group PN. Also lower hospital costs in EN group(9548.17 ± 1754.86,14721.11 ± 2965.59). Conclusion Early enteral nutrition can modulate nutrition states, decrease the expense of nutritional support as well as the length of stay,in this EN is the best choice.%目的 探讨对胃癌患者术后早期肠内营养支持的方法、效果、费用及应用中注意事项.方法 通过对122例胃癌患者随机分组为早期肠内营养组(EN:n=61)和肠外营养组(PN:n=61)临床资料进行分析.结果 EN组术后在排气(46.98±6.87比73.51±11.53)、排便时间(83.89±12.78比130.80±22.93)、费用(9548.17±1754.86比14721.11±2965.59)及术后平均住院时间(9.79±0.76比12.48±1.46)、身体营养状况等方面均短于PN组,差异有统计学意义(P<0.05).结论 早期肠内营养能提高机体营养状况、缩短住院时间、减少住院费用,可作为最佳选择.

  6. Therapeutic value of enteral and parenteral nutrition in patients with cirrhosis%肠内外营养对肝硬化患者的治疗价值

    Institute of Scientific and Technical Information of China (English)

    于泳; 姚芳芳; 张倩; 贾润萍

    2014-01-01

    目的:探讨肠内外营养治疗对肝硬化患者的临床价值。方法肝硬化患者77例,随机分为两组,实验组给予肠内外营养治疗,对照组给予营养膳食指导,对比两组患者治疗后营养指标及肝功能的变化情况。结果治疗结束后,实验组谷草转氨酶、谷丙转氨酶和血浆前白蛋白等肝功能指标得到明显改善,与对照组比较差异具有统计学意义(P<0.05)。结论对肝硬化患者实施肠内外营养支持,有助于缓解患者的临床症状,提高治疗效果,具有十分积极的临床意义。%Objective To investigate the clinical value of enteral and parenteral nutrition therapy for patients with liver cirrhosis. Methods Divided 77 patients with cirrhosis into two groups:treatment group and control group. Treatment group was given enteral and parenteral nutrition therapy, and control group was given a healthy diet guiding. Then compared liver function and clinical symptoms between the two groups. Results After treatment, patients’aspartate transaminase, glutamic transaminase and serum albumin and other liver function of treatment group improved significantly, and the difference was significant (P<0.05). Conclusion Enteral and parenteral nutritional support for patients with cirrhosis has a very positive clinical significance in relieving clinical symptoms of patients and improving the therapeutic effect.

  7. Effect observation of elderly total enteral nutrition support comprehensive nursing%老年肠内营养支持综合护理效果观察

    Institute of Scientific and Technical Information of China (English)

    李加琼

    2015-01-01

    目的:探讨分析老年肠内营养支持综合护理的临床效果。方法:2012年2月-2014年2月收治肠内营养支持治疗老年患者68例,回顾性分析其临床资料。结果:管饲期间,观察组不良反应发生率17.65%,低于对照组41.18%,差异具有统计学意义(P<0.05);观察组紊乱发生率也低于对照组,差异具有统计学意义(P<0.05)。结论:综合护理可提高老年肠内营养支持的有效率和安全性,值得临床推广应用。%Objective:To explore and analyze the clinical effect of elderly total enteral nutrition support comprehensive nursing. Methods:68 elderly patients with total enteral nutrition support treatment were selected from February 2012 to February 2014.The clinical data were retrospectively analyzed.Results:During tube feeding period, the incidence rate of adverse reaction in the observation group was 17.65% ,which was lower than 41.18% of the control group,and the difference was statistically significant(P<0.05).The disorder incidence rate of the observation group was also lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:Comprehensive nursing can improve the effective rate and safety of elderly total enteral nutrition support.It is worthy of clinical popularization and application.

  8. Optimization of post-operative early enteral nutrition with sequential therapy%"序贯疗法"优化手术后早期肠内营养

    Institute of Scientific and Technical Information of China (English)

    于健春

    2011-01-01

    肠内营养较肠外营养更符合生理,具有保护肠屏障功能、肝功能和免疫功能,促进胃肠道功能及蛋白质合成,降低应激反应及胰岛素抵抗,降低感染并发症和医疗费用等重要作用和优势.肠内营养实施的关键是对肠内营养适应证、并发症和禁忌证的认识,以及对肠内营养制剂、置管途径及器械装置配套的合理选择.为增加手术后肠内营养耐受性,降低并发症,提高营养支持治疗效果,提出了肠内营养临床应用新方法.手术后早期肠内营养"序贯疗法".%Compared with parenteral nutrition (PN) , enteral nutrition (EN) is more favorable in maintaining physiological status, protecting intestinal barrier function, liver function, immune function, and gastrointestinal function, promoting protein synthesis, reducing the stress response and insulin resistance, reducing infectious complications, and lowering healthcare costs. Successful implementation of EN depends on the good knowledge of indications, complications, and contraindications and on the proper choice of EN preparations, tube placement route, and equipment In this article, with an attempt to increase the tolerance of EN after surgery, reduce complications , and improve the therapeutic effect of nutritional support, we propose a new method of clinical application-optimization of post-operative early enteral nutrition with sequential therapy.

  9. ICU重症患者肠内营养的护理%Nursing of Enteral Nutrition in Patients with Severe ICU

    Institute of Scientific and Technical Information of China (English)

    文冬香

    2016-01-01

    ICU critically ill patients under stress factors after major surgery and (or) severe trauma,the body in high resolution,high metabolic state, increased energy consumption,protein,increased lipolysis,gluconeogenesis increase,over time,the rapid emergence of malnutrition,low immunity,body resistance weakened.Nutritional support is an important therapy in critically ill patients,and enteral nutrition as a convenient,safe,effective nutritional support methods are widely used in clinical.Our department enteral nutrition support process,to take effective care measures,and achieved satisfactory clinical results.%ICU重症患者在大手术后和(或)严重创伤等应激因素作用下,机体处于高分解、高代谢状态,能量消耗增加,蛋白、脂肪分解增加,糖异生增加,时间一长,则迅速出现营养不良、免疫力低下、机体抵抗力减弱[1-4]。营养支持是重症患者的重要治疗手段之一,而肠内营养作为一种方便、安全、有效的营养支持方式在临床得到广泛应用[5-9]。我科进行肠内营养支持过程中,采取了有效的护理措施,取得满意的临床效果。

  10. Precisión en flujo de infusión programado de bombas de nutrición enteral Precision in programmed infusion flow of enteral nutrition pumps

    Directory of Open Access Journals (Sweden)

    Juan Ignacio Padilla-Cuadra

    2008-09-01

    Full Text Available Justificación y objetivo: Se evaluó in vitro la precisión en el flujo de nutrición enteral en bombas peristálticas de nutrición enteral con el fin de determinar si ésta puede ser una variable que cause errores en la administración de la fórmula. Materiales y Métodos: Se evaluaron 13 bombas de infusión enteral del tipo peristáltico mediante la aplicación de un modelo de laboratorio que simulaba la administración a un paciente. Se usó para todos los casos una fórmula estándar diluida de la manera recomendada por el fabricante. Con un volumen meta de 240 mL. Se programó en cada bomba un flujo de infusión de 40 mL por hora. Para cada caso según el tiempo de infusión, se calculó el flujo de infusión real y a partir de la diferencia se calculó el porcentaje de error. Resultados: En 12 de las 13 bombas se detectó un error por exceso que fue de 7.5% hasta 52.5%. Solo una bomba, de marca distinta a todas las demás demostró un error de 0 mL/h con respecto a lo programado. Ninguna bomba mostró un déficit en el volumen de infusión. Conclusión: En la mayoría de las bombas evaluadas se detectó un porcentaje de error por exceso que supera lo estipulado por el fabricante.Justification and aim: To evaluate in vitro the accuracy of volume infusion of peristaltic enteral nutrition pumps to determine if this variable may be responsible for error’s in the administration of nutrition support. Materials and Methods: Thirteen pumps were evaluated through simulation using a model that resembles the administration of enteral nutrition to a patient. For every case, we used an standard formula diluted as recommended by the manufacturer. A volume of 240 mL was programmed to be infused at 40 ml per hour. For each case, time was measured until finishing the volume, comparing to the programmed time and calculating the delivery error. Results: In 12 of 13 pumps, we detected error by excess, which varied from 7.5% to 52.5%. Only one pump showed

  11. Sobrevida e complicações em idosos com doenças neurológicas em nutrição enteral Occurrence of complications and survival rates in elderly with neurological disorders undergoing enteral nutrition therapy

    Directory of Open Access Journals (Sweden)

    Aline Stangherlin Martins

    2012-12-01

    Full Text Available OBJETIVO: Avaliar a sobrevida e complicações de pacientes idosos com doenças neurológicas em uso de nutrição enteral (NE. MÉTODOS: Avaliaram-se pacientes acima de 60 anos acompanhados pelo serviço de atenção domiciliar de um plano de saúde de Belo Horizonte, MG, Brasil. A avaliação ocorreu no domicílio após a alta hospitalar com NE, após três e seis meses e ao término do estudo. Foram realizadas avaliação nutricional, coleta de dados em prontuários e entrevistas com familiares ou cuidadores. RESULTADOS: Foram avaliados 79 pacientes, idade 82,9 ± 10,4 anos, 49,4% com demência e 50,6% com outros diagnósticos neurológicos, 100% com elevado grau de dependência avaliada pelo índice de Katz. A maioria dos pacientes (91,2% apresentou complicações (pneumonia, perda da sonda, diarreia, constipação, vômito, extravasamento periostomia, obstrução da sonda, refluxo e miíase. Pneumonia foi a mais frequente, ocorrendo em 55,9%. A mortalidade foi de 15,2% aos três meses, 22,8% aos 6 meses e 43% ao término do estudo. A mediana de sobrevida após iniciada a NE foi de 364 dias. Não se observaram diferenças entre mortalidade e diagnóstico neurológico, vias de acesso de NE e complicações. A sobrevida foi menor em pacientes com estado nutricional inadequado e albumina OBJECTIVE: To evaluate the occurrence of complications, as well as the survival rates, in elderly people having neurological diseases and undergoing enteral nutrition therapy (ENT. METHODS: Patients aged over 60 years, assisted by a home medical service from a healthcare plan in the city of Belo Horizonte, MG, Brazil, were thoroughly evaluated. The mentioned evaluation occurred at their homes after hospital discharge with enteral nutrition (EN after a three-month period, a six-month period, and at the end of the study. A nutritional assessment was performed along with data collection performed on the patients' electronic medical records, and interviews

  12. Advances in the enteral nutritional support treatment for patients after digestive tract reconstruction%消化道重建术后的肠内营养支持治疗进展

    Institute of Scientific and Technical Information of China (English)

    卞晓洁; 王萌; 葛卫红(综述); 管文贤(审校)

    2014-01-01

    消化道重建术后患者存在营养不良及吸收障碍风险,肠内营养支持能更有效地维持和改善机体的营养状态,缩短住院时间以及减少并发症的发生,是术后首选的营养支持方式。本文将消化道重建术后患者肠内营养支持开始的时机、营养支持途径、营养制剂、输注方式的选择,以及并发症的治疗等方面进行综述。%Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.

  13. Early enteral nutrition in stroke patients%早期肠内营养支持对脑卒中病人疗效影响的研究

    Institute of Scientific and Technical Information of China (English)

    王自勤; 刘艳荣; 陈永春; 杨盛

    2011-01-01

    目的:观察早期肠内营养(EEN)对脑卒中病人疗效的影响. 方法:将122例脑卒中病人分为EEN和完全肠外营养(TPN)组,每组61例.两组病人于入院后24h开始实施营养支持.由营养师计算热量,即按照Harris-Benedict公式确定基础能量消耗(BEE),再根据BEE×活动系数×应激系数×体温系数来确定总热量,按照每个病人理论所需的热量选择合适的营养制剂,连续支持治疗7d.观察两组病人的营养监测指标、胃肠道等主要并发症情况和两组日均营养支持费用,并对结果进行统计. 结果:营养支持7d后,除清蛋白(ALB)指标和胃肠道等主要并发症外,EEN组病人前清蛋白(PA)、淋巴细胞总数(TLC)均显著高于TPN组,两组营养支持后ALB、PA、ILC显著高于营养支持前,EEN组营养支持日均费用显著低于TPN组,经统计学分析有显著性差异(P<0.05). 结论:对于脑卒中病人早期给予EN,能促进病人营养状况的恢复,达到良好的治疗效果.%Objective: To observe the early enteral nutrition on the efficacy of stroke patients. Methods-, 122 stroke patients in our hospital were divided into enteral nutrition (EN) group (61 cases). Nutrition indicators were observed, gastrointestinal and other major complications, and nutritional support costs were analyzed. Results: The prealbumin (PA) and blood total lymphocyte count (TLC) were significantly higher and the average daily cost of nutritional support was significantly lower in EN group. Conclu-sion: For patients with stroke, EN can promote the recovery of the nutritional status and the cost is cheap.

  14. Malnutrition Identified by the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Consensus Criteria and Other Bedside Tools Is Highly Prevalent in a Sample of Individuals Undergoing Treatment for Head and Neck Cancer.

    Science.gov (United States)

    Mulasi, Urvashi; Vock, David M; Kuchnia, Adam J; Jha, Gautam; Fujioka, Naomi; Rudrapatna, Venkatesh; Patel, Manish R; Teigen, Levi; Earthman, Carrie P

    2016-10-07

    Using the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition (Academy/ASPEN) Consensus malnutrition definition, we estimated malnutrition prevalence in a sample of individuals with head and neck cancer (HNC) and compared it with the Patient-Generated Subjective Global Assessment (PG-SGA). We also investigated the utility of the 50-kHz phase angle (PA) and 200-kHz/5-kHz impedance ratio (IR) to identify malnutrition. Nineteen individuals (18 males, 1 female) scheduled to undergo chemoradiotherapy were seen at 5 time points during and up to 3 months after treatment completion. Multiple-frequency bioelectrical impedance analysis, PG-SGA, nutrition-focused physical examination, anthropometry, dietary intake, and handgrip strength data were collected. Using the Consensus, 67% were found to be malnourished before treatment initiation; these criteria diagnosed malnutrition with overall good sensitivity (94%) and moderate specificity (43%) compared with PG-SGA. Over all pooled observations, "malnourished" (by Consensus but not PG-SGA category) had a lower mean PA (5.2 vs 5.9; P = .03) and higher IR (0.82 vs 0.79; P = .03) than "well-nourished" categorizations, although the clinical relevance of these findings is unclear. PA and IR were correlated with higher PG-SGA score (r = -0.35, r = 0.36; P Academy/ASPEN Consensus and the PG-SGA were in good agreement. It is unclear whether PA and IR can be used as surrogate markers of nutrition status or muscle loss. © 2016 American Society for Parenteral and Enteral Nutrition.

  15. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): patient with sepsis].

    Science.gov (United States)

    Ortiz Leyba, C; Montejo González, J C; Vaquerizo Alonso, C

    2011-11-01

    Nutritional metabolic management, together with other treatment and support measures used, is one of the mainstays of the treatment of septic patients. Nutritional support should be started early, after initial life support measures, to avoid the consequences of malnutrition, to provide adequate nutritional intake and to prevent the development of secondary complications such as superinfection or multiorgan failure. As in other critically-ill patients, when the enteral route cannot be used to ensure calorie-protein requirements, the association of parenteral nutrition has been shown to be safe in this subgroup of patients. Studies evaluating the effect of specific pharmaconutrients in septic patients are scarce and are insufficient to allow recommendations to be made. To date, enteral diets with a mixture of substrates with distinct pharmaconutrient properties do not seem to be superior to standard diets in altering the course of sepsis, although equally there is no evidence that these diets are harmful. There is insufficient evidence to recommend the use of glutamine in septic patients receiving parenteral nutrition. However, given the good results and absence of glutamine-related adverse effects in the various studies performed in the general population of critically-ill patients, these patients could benefit from the use of this substance. Routine use of omega-3 fatty acids cannot be recommended until further evidence has been gathered, although the use of lipid emulsions with a high omega-6 fatty acid content should be avoided. Septic patients should receive an adequate supply of essential trace elements and vitamins. Further studies are required before the use of high-dose selenium can be recommended.

  16. 国内外肠内营养最佳组成的研究进展%Research Progress on the Best Enteral Nutrition Constitution

    Institute of Scientific and Technical Information of China (English)

    周旋; 于锋

    2012-01-01

    This article summarizes the progress in ihe constitution of enteral nutrition, including basic components (such as the proportion of glucose/fat ratio, the protein ratio, the selection of peptides or whole protein, pH, etc) and various additives (such as fiber, fish oil. glutamine, arginine, immunostimulanl ornithine-a-ketoglutaric acid. etc.). It may improve the clinical use of enteral nutrition and enhance its safety and effectiveness.%本文汇总国内外关于肠内营养各种组成的研究进展,内容包括基本组成(如糖脂比例、蛋白质含量、选用多肽还是整蛋白、pH等)和添加剂(如纤维素、鱼油、谷氨酰胺、精氨酸、鸟氨酸α-酮戊二酸等),以期对临床肠内营养制剂使用提供参考,进而增加临床使用的安全性和有效性.

  17. Research progress on enteral nutrition for patients with craniocerebral injury%颅脑损伤病人肠内营养的研究进展

    Institute of Scientific and Technical Information of China (English)

    谢彩霞; 朱京慈; 尹华华

    2011-01-01

    颅脑损伤病人机体能量代谢增高,蛋白质分解代谢加速,糖、脂肪代谢紊乱,机体处于负氮平衡,急性营养不良,免疫低下,不利于病人神经系统功能修复和预后.及时、有效、安全地补充营养物质显得尤为重要.现从肠内营养配方、途径和给予时间3个方面对重型颅脑损伤病人肠内营养研究进展进行综述.%Energy metabolism of craniocerebral injury patients is high.And protein catabolism of them is accelerated.Both carbohydrate and lipid metabolism of them are in disorder.Patients with craniocerebral injury are in negarive nitrogen balance, acute malnutrition, and their immune functions are low.These conditions are disadvantageous for the restoration of nervous system function and prognosis of patients.Therefore, prompt, effective and safe to supply nutrient substances is very important.It summarized research progress on enteral nutrition of patients with severe craniocerebral injury from three aspects including formula, path,supply time of enteral nutrition.

  18. Pacientes afectos de neoplasia de cabeza-cuello con nutrición enteral domiciliaria por sonda Head and neck cancer patients included at home enteral nutrition by tube

    Directory of Open Access Journals (Sweden)

    I. Cots Seignot

    2009-10-01

    Full Text Available Objetivo: Conocer las características y la evolución de los pacientes diagnosticados de neoplasia de cabeza y cuello (NCC que precisaron recibir tratamiento de radioterapia y que fueron atendidos en un programa de nutrición enteral por sonda a domicilio (NESD. Análisis del peso en función de administrar la nutrición enteral antes o después del inicio de la radioterapia. Material y métodos: Estudio observacional de pacientes con NCC incluidos en el programa de NESD de nuestro hospital durante 2 años. Variables analizadas: sexo, edad, índice de masa corporal (IMC, índice de Karnofsky (IK, motivo del inicio de soporte nutricional, tipo de sonda para la administración de la nutrición, tipo de fórmula nutricional y aporte calórico prescrito, necesidad de cambio de vía y días de NESD. Resultados: Se incluyeron 62 pacientes (77,4% varones y 22,6% hembras con una edad media de 64 años ± 10,1 (rango entre 39 y 90. La disfagia fue el motivo principal de colocación de sonda en estos pacientes. Predominio de sonda nasogástrica (67,7%. La fórmula más utilizada fue la polimérica hipercalórica con un aporte calórico de 1.629 ± 267,09 kcal/día. Globalmente, se observó una pérdida de peso en todos los pacientes durante el período de estudio. Sin embargo, aquellos en los que se inició la NESD antes de la radioterapia el IMC no disminuyó. Conclusión: Los pacientes que iniciaron nutrición por sonda con anterioridad al tratamiento oncológico no perdieron peso durante el periodo de estudio.Objective: To know characteristics and the patients' evolution with head and neck cancer who received radiotherapy treatment and they were included at a home enteral nutrition (HEN by feeding tube programme. To analyse the weight evolution according to the start of HEN before or after radiotherapy. Methods: Observational study of tube feeding patients with head and neck cancer who were included in HEN programme in our hospital for two years

  19. Appraisal Report

    DEFF Research Database (Denmark)

    Schleimann, Finn; Enemark, Ulrika; Vagnby, Bo Hellisen

    Appraisal of continued support to Ghana's health sector for a third phase covering 2003 - 2007. Funding recommended with DKK 340 million over five years.......Appraisal of continued support to Ghana's health sector for a third phase covering 2003 - 2007. Funding recommended with DKK 340 million over five years....

  20. CLINICAL NUTRITION INVOLVING A SPECIALIZED PROTEINAND CALORIE-RICH PEDIATRIC MILK PRODUCT FOR ENTERAL FEEDING OF INFANTS WITH PROTEIN-CALORIE DEFICIENCY

    Directory of Open Access Journals (Sweden)

    L. S. Namazova-Baranova

    2016-01-01

    Full Text Available Background: Premature infants with extremely low and very low birth weight with a severe overlapping perinatal pathology often feature slower growth rate within the first year of life and require special nutritional support.Objective: Our aim was to study physical development of infants with protein-calorie deficiency in the setting of using a specialized protein- and calorie-rich pediatric milk product for enteral feeding.Methods: We analyzed tolerability and efficacy of clinical nutrition within the framework of a prospective two-month-long case series. We assessed actual children’s diets and the chemical composition thereof. We determined body weight and length, body mass index (BMI, adipodermal flap thickness over the triceps. Anabolic effect of clinical nutrition was assessed on the basis of transthyretin concentration dynamics.Results: The study involved 30 infants with protein-calorie deficiency (7 term infants and 23 premature infants with a severe perinatal pathology. High tolerability of the formula under analysis was registered in most patients. Termination of functional gastrointestinal tract disorders (posseting, colics, flatulence, constipations was observed in 23 (87% patients. In most cases, the use of a protein- and calorie-rich formula as a part of a therapeutic diet helped to satisfy children’s protein demand and improve their weight/length parameters: BMI increased in 19 (72% children, body weight — in 16 (63%, body length — in 24 (92%, adipodermal flap thickness over the triceps — in all the children (100%. We observed transthyretin concentration increase from 162 (157; 171 in the beginning of the study to 187 (170; 208 mg/l in the end thereof (p = 0.028.Conclusion: A specialized protein- and calorie-rich product for enteral feeding may be used for feeding infants with protein-calorie deficiency born with a severe a perinatal pathology, including premature infants.

  1. Comparison of amino acid v peptide based enteral diets in active Crohn's disease: clinical and nutritional outcome.

    OpenAIRE

    Royall, D; Jeejeebhoy, K. N.; Baker, J. P.; Allard, J P; Habal, F. M.; Cunnane, S. C.; Greenberg, G R

    1994-01-01

    Elemental diets are considered an effective primary treatment for active Crohn's disease. This study examined the hypothesis that improvement occurs because of the presence of amino acids or the low fat content, or both. A randomised, controlled trial was undertaken in 40 patients with active Crohn's disease to evaluate clinical and nutritional outcomes after an amino acid based diet containing 3% fat was given by a feeding tube compared with a peptide based diet containing 33% fat. After thr...

  2. Nursing Intervention on Surgical Patients with Enteral Nutrition%外科重症患者肠内营养的护理干预

    Institute of Scientific and Technical Information of China (English)

    李冬梅

    2015-01-01

    目的:探讨外科重症患者肠内营养的护理干预效果。方法收集我院收治的外科重症80例患者资料,将患者随机分为干预组和对照组,各40例。干预组患者给予肠内营养护理干预,对照组患者给予常规护理干预,比较两组患者胃肠功能恢复情况。结果干预组患者的肛门排便时间和排气时间均明显短于对照组,差异均有统计学意义(均P<0.05)。结论外科重症患者给予肠内营养护理有助于补充患者身体所需的营养和能量,增加患者机体的免疫力,避免患者术后因营养不良而给康复带来的影响,促进患者早日康复。%Objective To discuss the effect of surgical patients with enteral nutrition nursing intervention.Methods 80 surgical critical y il patients in our hospital were selected were randomly divided into intervention group and control group,each of 40 cases.The patients in the intervention group were given enteral nutrition nursing intervention,the control group patients were given routine nursing care,compared two groups of gastrointestinal function recovery. Results The after care,patients in the intervention group were anal defecation time and exhaust time were significantly shorter than the control group,the difference was statistical y significant(P<0.05).Conclusion Surgical patients with enteral nutrition nursing intervention is helpfulto supplement the patient body needed nutrients and energy,and increase patients immunity,prevent patients due to malnutrition and to influence rehabilitation brings,and promote an early recovery of patients.

  3. Influence of G308A polymorphism of tumor necrosis factor-alpha gene on inflammatory markers in postsurgical head and neck cancer patients with early enteral nutrition.

    Science.gov (United States)

    de Luis, Daniel Antonio; Sagrado, Manue Gonzalez; Vallejo, Luis Angel; Carcedo, Luis María Gil; Izaola, Olatz; Cuellar, Luis; Terroba, María Concepción; Aller, Rocío

    2007-01-01

    Although immune dysfunction in patients with cancer could be multifactorial, the immune system may be modulated by nutritional substrates and genetic background. Our study evaluated the effect of G308A polymorphism of the tumor necrosis factor-alpha (TNF-alpha) gene on inflammatory markers in patients after surgery for head and neck cancer who received early enteral nutrition. A population of 60 patients with oral and laryngeal cancer was enrolled. At surgery patients were treated with a hyperproteic enteral diet. Perioperatively and on postoperative day 6 the following parameters were evaluated: serum values of prealbumin, transferrin, total number of lymphocytes, interleukin-6, TNF-alpha, and C-reactive protein. In addition, genotyping of G308A gene polymorphism was assessed. Patients' mean age was 61.1 +/- 14.6 y (four women, 56 men) with a body mass index of 25.4 +/- 5.2 kg/m(2) and a previous weight loss of 0.35 +/- 0.2 kg. Forty patients (37 men, 3 women; 66.6%) had the genotype G308/G308 (wild group) and 20 patients (19 men, 1 woman; 23.4%) had the genotype G308/A308 (mutant group). A significant increase in prealbumin and transferrin levels was detected in both groups. C-reactive protein decreased in both groups (wild group: 105.1 +/- 60 versus 53.8 +/- 62.3 mg/dL, P < 0.05; mutant group: 99.5 +/- 46 versus 43.9 +/- 51.9 mg/dL, P < 0.05). Interleukin-6 decreased in both groups (wild group: 20.1 +/- 22 versus 6.2 +/- 4.1 pg/mL, P < 0.05; mutant group: 22.3 +/- 38 versus 9.2 +/- 7.4 pg/mL, P = NS). Lymphocytes increased in both groups (wild group: 1102 +/- 468 versus 1600 +/- 537 10(3)/mL, P = NS; mutant group: 1441 +/- 739 10(3)/mL versus 1669 +/- 614 10(6)/mL, P = NS). TNF-alpha showed no changes. The G308A polymorphism of the TNF-alpha gene did not affect levels of inflammatory markers in patients after surgery for head and neck cancer who were treated with early enteral nutrition.

  4. Adequação calórico-proteica da terapia nutricional enteral em pacientes cirúrgicos Protein-calorie adequacy of enteral nutrition therapy in surgical patients

    Directory of Open Access Journals (Sweden)

    Marília Freire Isidro

    2012-10-01

    Full Text Available OBJETIVO: Avaliar a adequação calórico-proteica da terapia nutricional enteral (TNE empregada em pacientes cirúrgicos. MÉTODOS: Estudo prospectivo, realizado em pacientes cirúrgicos que receberam TNE de março a outubro de 2011. Os pacientes foram avaliados antropometricamente e pela avaliação subjetiva global (ASG. Os valores de calorias e proteínas prescritos e administrados e as causas de interrupção da dieta foram registrados diariamente. O valor de 90% foi utilizado como referencial de adequação. A diferença entre o prescrito e o administrado foi verificada pelo teste t de Student. RESULTADOS: Uma amostra de 32 pacientes, com idade de 55,8 ± 14,9 anos, apresentou 40,6 a 71,9% de desnutrição dependendo da ferramenta utilizada. A neoplasia gástrica e as gastrectomias foram o diagnóstico e as cirurgias mais frequentes. Dos pacientes, 50% conseguiram atingir suas necessidades calórico-proteicas. A adequação da dieta recebida em relação à prescrita foi de 88,9 ± 12,1% e de 87,9 ± 12,2% para calorias e proteínas, respectivamente, com um déficit significativo (p OBJECTIVE: To evaluate the protein-calorie adequacy of enteral nutrition therapy (ENT in surgical patients. METHODS: A prospective study was performed in surgical patients who received ENT from March to October 2011. Patients were evaluated anthropometrically and by subjective global assessment (SGA. The amount of calories and protein prescribed and administered were recorded daily, as well as the causes of discontinuation of the diet. A 90% value was used as the adequacy reference. The difference between the prescribed and administered amount was verified by Student's t-test. RESULTS: A sample of 32 patients, aged 55.8 ± 14.9 years, showed a malnutrition rate of 40.6% to 71.9%, depending on the assessment tool used. Gastric cancer and gastrectomy were the most common diagnosis and surgery, respectively. Of the patients, 50% were able to meet their caloric and

  5. 高龄食管癌患者术后早期肠内营养并发症的防治%Prevention and treatment of early postoperative enteral nutrition complications in elderly esophageal cancer patients

    Institute of Scientific and Technical Information of China (English)

    夏晓明; 施仁忠; 张亚锋

    2012-01-01

    Objective To study the prevention and treatment of the complications during early postoperative enteral nutrition in the elderly patients with esophageal cancer.Methods The early enteral nutrition were carried out in 67 cases of esophageal cancer over 70 years old.The prevention and treatment of the complications during the early enteral nutrition were analyzed.Results There were 39 cases with diarrhea(58.21%),7 cases with metabolic disorder( 10.45% ),15 cases with the nutritional tube obstruction ( 22.39% ).After receiving active treatment for the complications,48 cases complete enteral nutrition.14 cases (20.90%) changed to mixed nutrition,5 cases changed to parenteral nutrition (7.46% ).Conclusions The complications of the early enteral nutrition in the elderly patients have some relation with the injected method of nutrient solution,the status of intestine function,and other diseases accompanied,etc.After receiving positive treatment,most patients were able to tolerate enteral nutrition.The early postoperative enteral nutrition is still the preferred option in the elderly patients with esophageal cancer.%目的 探讨高龄食管癌患者术后早期肠内营养并发症的防治对策.方法 对67例70岁以上食管癌患者术后进行早期肠内营养,分析早期肠内营养期间并发症的预防与治疗.结果 67例患者中发生腹泻39例,占58.21%,代谢紊乱7例,占10.45%,营养管方面并发症15例,占22.39%.针对并发症原因进行积极处理,48例完成肠内营养,占71.64%,14例改为混合营养,占20.90%,5例改为肠外营养,占7.46%.结论 高龄患者肠内营养并发症主要与营养液输入方法、肠道功能、伴随疾病等因素有关,经过积极处理后大多数患者均能够耐受肠内营养,肠内营养仍然是高龄患者优先选择的营养方法.

  6. [The metoclopramide effect on enteral nutrition tolerance and mechanical ventilation associated pneumonia in neuro critically ill patients].

    Science.gov (United States)

    Acosta-Escribano, Jose; Almanza López, Susana; Plumed Martín, Lidia; García Martinez, Miguel Angel; Tajadura Manjarín, Nuria

    2014-06-01

    Introducción: El uso de procinéticos en el paciente crítico con nutrición enteral, tienen como objetivo el reducir el aumento del residuo gástrico (RG). Analizamos su eficacia en la mejoría del aporte enteral y sobre la reducción en la incidencia complicaciones gastrointestinales (CGI) y neumonía, en pacientes críticos, con lesión neurológica Objetivos: Medir los efectos en la administración metoclopramida (MCG) durante los primeros cinco días con nutrición enteral, versus control (GC), sobre el volumen de dieta enteral administrada, el número de complicaciones gastrointestinales y la incidencia de neumonía asociada a ventilación mecánica (NAVM); en enfermos neurocríticos de etiología traumática y vascular. Métodos: De los 150 pacientes NC ingresados de forma consecutiva, 109 fueron aleatorizados en dos grupos: 58 MCG y 51 GC. Los objetivos primarios fueron: nutricionales: el volumen de dieta administrada (VDA), el volumen eficaz (VEM), el número de complicaciones gastrointestinales (CGI) y la tasa de suspensión temporal y definitiva de la dieta. Infecciosos: incidencia de neumonía asociada a ventilación mecánica (NAVM). Fueron objetivos secundarios: la duración de la ventilación mecánica, la estancia en UCI y hospitalaria, la secuela neurológica grave al alta y la mortalidad a los 30 días. Resultados: No se observaron diferencias en los parámetros de gravedad entre grupos al ingreso. Un incremento significativo fue observado en el análisis global y a los cinco días (p suspensiones parciales y definitivas de la dieta o el número de NAVM fueron similares en ambos grupos, no significativos. Tampoco se observaron diferencias en los diferentes objetivos secundarios Conclusión: El uso de metoclopramida en el enfermo neurocrítico, no es eficaz en la disminución de las CGI, en las dosis y tiempo de tratamiento reflejados en el estudio.

  7. Terapia nutricional enteral em unidade de terapia intensiva: infusão versus necessidades Nutrition support in an intensive care unit: delivery versus requirements

    Directory of Open Access Journals (Sweden)

    Ana Carolina de Castro Teixeira

    2006-12-01

    critically ill patients nutritional deficiency is common. Considering this fact, the diary monitoring of energy delivered is extremely important. The objective of this study is to assess the adequacy of enteral nutrition (EN in an Intensive Care Unit (ICU and identify the reasons for interruptions in feeding. METHODS: Prospective study of adult patients admitted to ICU in period of 53 days. Patients receiving continuous enteral tube feeding (22 hours/day exclusively and post-pyloric tube feeding position were followed. The feeding volume started at 25 mL/h and was increased until nutritional goal, guided by a feeding protocol. RESULTS: 33 patients between 18 and 85 years old were studied. 58% were male. The main admission diagnoses were cardiovascular diseases (27% and septic shock (21%. The mean time to feeding was 25.3 hours after the patient admission and nutritional goal was achieved in a mean time of 32 hours. The total volume prescribed per day was sufficient to guarantee a mean of 26.1 kcal/kg of body weight and 1.04 g of protein/kg of body weight. Patients received a mean of 19.5 kcal/kg of body weight and 0.8 g of protein/kg of body weight, which correspond a 74% of adequacy. Interruptions of feeding for routine procedures related to patients accounted for 40.6% of the total reasons. CONCLUSIONS: The nutritional support is adequate considering the literature for these patients, who clinical instability causes gastrointestinal intolerance. The effective participation of the Nutrition Therapy Team can contribute positively on nutritional therapy.

  8. Trends in home enteral nutrition in Spain: analysis of the NADYA registry 1992-2007 Tendencias en nutrición enteral domiciliaria en España: análisis del registro NADYA 1992-2007

    Directory of Open Access Journals (Sweden)

    C. Cuerda

    2009-06-01

    Full Text Available Background: There are few data on trends in home enteral nutrition (HEN practice in different countries. NADYA is the Spanish home artificial nutrition (HAN group, and is responsible for the Spanish HAN registry. Method: We performed a 16-year retrospective study (1992-2007 of the Spanish HEN registry by retrieving data from the NADYA database and from publications of the working group. People receiving more than 1000 kcal/d with an enteral formula were included regardless of the access route (oral/tube feeding. Results: The number of patients registered increased more than 8 times during the study period: the current prevalence is 113 patients/10(6 inhabitants (oral and tube feeding, or 41 patients/10(6 inhabitants (tube feeding. The distribution of the patients was not uniform, and most came from six autonomous communities (Catalonia, Galicia, Castilla-León, Madrid, Andalusia and Extremadura. Gender distribution was nearly 1:1. The number of paediatric patients was very low, representing less than 10% of the total. Mean age in adults was above 65 years in most of the reports. We observed an increase in the age of the patients over the years. The most common underlying diseases were neurological disorders, followed by cancer. We observed an increase in the use of the oral route, from 5.8% in 1992 to 64% in 2007, with a parallel decrease in the use of nasogastric tubes. Gastrostomy tubes were used in 15-20% of the patients. The number of complications was low (less than one complication/patient/year, the most frequent being change of tube, followed by gastrointestinal complications. The principal reasons for discontinuing treatment were death related to the underlying disease (40-50% and switch to oral diet (30-40%. Most of the patients (75% were followed by the hospital nutrition unit. Provision of the enteral formula and disposables varied according to the autonomous community. Most of the patients had limited physical activity or were chair

  9. Sistema aberto ou fechado de nutrição enteral para adultos críticos: há diferença? Open versus closed enteral nutrition systems for critically ill adults: is there a difference?

    Directory of Open Access Journals (Sweden)

    Stella Marys Rigatti Silva

    2012-04-01

    Full Text Available OBJETIVO: Comparar o volume, calorias totais e proteínas recebidos pelos pacientes críticos quando utilizada nutrição enteral (NE por sistema aberto (SA e sistema fechado (SF; identificar os principais motivos para interrupção da NE. MÉTODOS: Estudo de coorte em que foram acompanhados adultos internados no Centro de Terapia Intensiva (CTI em dois períodos: em novembro de 2009, quando se adotava SA de NE para a totalidade dos pacientes (n = 85; e entre outubro de 2010 e abril de 2011, quando foi utilizado SF de NE (n = 170. Foram utilizados testes paramétricos e não paramétricos para comparação das variáveis respeitando-se sua distribuição. RESULTADOS: Os grupos assemelharam-se quanto às características clínicas e demográficas. Diferenças de mínima magnitude matemática e de nenhuma relevância clínica foram observadas entre os grupos: mais calorias/quilo foram prescritas ao grupo SA (p OBJECTIVE: To compare the volume, total calories, and protein received by critically ill patients between open and closed enteral nutrition (EN systems and identify the main reasons for EN discontinuation. METHODS: A cohort study in which adult patients admitted to the intensive care unit (ICU were followed-up in two periods: throughout November 2009 with all patients (n = 85 receiving EN using the open system (OS group; and from October 2010 to April 2011 with patients (n = 170 receiving EN using the closed system (CS group. Parametric and nonparametric tests were used to compare the variables, taking into account their distribution. RESULTS: Demographic and clinical characteristics were similar in both groups. There were minor differences with no statistical significance between groups: more calories/kg were prescribed to the OS group (p < 0.001, and a higher volume (mL/kg, p = 0.002 and protein (g/kg, p = 0.001 were prescribed to the CS group. Fasting, enteral feeding or gastrointestinal problems, and performance of procedures and ICU

  10. THE EVOLUTION OF HOME ENTERAL NUTRITION (HEN) IN POLAND DURING FIVE YEARS AFTER IMPLEMENTATION: A MULTICENTRE STUDY.

    Science.gov (United States)

    Klek, Stanislaw; Pawlowska, Dorota; Dziwiszek, Grzegorz; Komon, Henryk; Compala, Piotr; Nawojski, Mariusz

    2015-07-01

    Antecedentes: el inicio con nutrición enteral (HEN) es la mejor opción para los pacientes crónicos sin capacidad de tragar, pero con el tracto digestivo intacto. A pesar del aumento en el uso de la alimentación por sonda enteral domiciliaria (HETF), hay poca información publicada sobre los tipos de pacientes que reciben nutrición enteral domiciliaria. El propósito de este trabajo es presentar la evolución de HETF. Material y métodos: el estudio observacional multicéntrico retrospectivo se realizó mediante cuestionarios que se distribuyeron entre los mayores centros HEN polacos. El estudio abarcó a todos los pacientes tratados entre enero de 2007 y enero de 2014. Resultados: en total fueron evaluados 196 pacientes adultos en 2008 (M: 104 F: 92, edad media 58,1 [41-75]) y 2.842 en 2013 (M: 1541, F: 1.301, con una edad media de 61,4 rango: 1-91). El número de pacientes aumentó significativamente entre 2008 y 2013 (p estudio). La enfermedad primaria predominante fue la neurología en ambos períodos de tiempo, pero el perfil cambia de neurovascular a neurodegenerativa (p > 0,05). La gastrostomía endoscópica percutánea fue el acceso GI más frecuentes (> 60%), su uso y el uso de gastrostomías aumentó significativamente desde 2008 (p < 0,05). Aunque el reembolso de HETF comenzó en 2007, los centros de HEN expresaron dudas sobre las reglas poco claras para la calificación para HEN y su uso. Conclusiones: HETF es un procedimiento seguro, bien tolerado y rentable. El perfil de los pacientes y las técnicas puede variar al principio, pero se vuelve similar a otros países HETF relativamente pronto. El número de pacientes crece rápidamente, y ese hecho sugiere que la prevalencia de HETF es similar en todos los países.

  11. Infant Nutritional Status and Markers of Environmental Enteric Dysfunction are Associated with Midchildhood Anthropometry and Blood Pressure in Tanzania.

    Science.gov (United States)

    Locks, Lindsey M; Mwiru, Ramadhani S; Mtisi, Expeditho; Manji, Karim P; McDonald, Christine M; Liu, Enju; Kupka, Roland; Kisenge, Rodrick; Aboud, Said; Gosselin, Kerri; Gillman, Matthew; Gewirtz, Andrew T; Fawzi, Wafaie W; Duggan, Christopher P

    2017-08-01

    To assess whether growth and biomarkers of environmental enteric dysfunction in infancy are related to health outcomes in midchildhood in Tanzania. Children who participated in 2 randomized trials of micronutrient supplements in infancy were followed up in midchildhood (4.6-9.8 years of age). Anthropometry was measured at age 6 and 52 weeks in both trials, and blood samples were available from children at 6 weeks and 6 months from 1 trial. Linear regression was used for height-for-age z-score, body mass index-for-age z-score, and weight for age z-score, and blood pressure analyses; log-binomial models were used to estimate risk of overweight, obesity, and stunting in midchildhood. One hundred thirteen children were followed-up. Length-for-age z-score at 6 weeks and delta length-for-age z-score from 6 to 52 weeks were associated independently and positively with height-for-age z-score and inversely associated with stunting in midchildhood. Delta weight-for-length and weight-for-age z-score were also positively associated with midchildhood height-for-age z-score. The 6-week and delta weight-for-length z-scores were associated independently and positively with midchildhood body mass index-for-age z-score and overweight, as was the 6-week and delta weight-for-age z-score. Delta length-for-age z-score was also associated with an increased risk of overweight in midchildhood. Body mass index-for-age z-score in midchildhood was associated positively with systolic blood pressure. Serum anti-flagellin IgA concentration at 6 weeks was also associated with increased blood pressure in midchildhood. Anthropometry at 6 weeks and growth in infancy independently predict size in midchildhood, while anti-flagellin IgA, a biomarker of environmental enteric dysfunction, in early infancy is associated with increased blood pressure in midchildhood. Interventions in early life should focus on optimizing linear growth while minimizing excess weight gain and environmental enteric

  12. Difference in Composite End Point of Readmission and Death Between Malnourished and Nonmalnourished Veterans Assessed Using Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Clinical Characteristics.

    Science.gov (United States)

    Hiller, Lynn D; Shaw, Robert F; Fabri, Peter J

    2016-09-08

    Previous studies have demonstrated an association between malnutrition and poor outcomes. The primary objective of this study was to explore the difference in the composite end point of readmission rate or mortality rate between hospitalized veterans with and without malnutrition. This was a retrospective chart review comparing veterans with malnutrition based on a modified version of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus characteristics that used 5 of the 6 clinical characteristics to a matched control group of nonmalnourished veterans based on age, admitting service, and date of admission who were admitted between August 1, 2012, and December 1, 2014. Data were extracted from the medical record. Multivariate analysis was used to identify predictors of outcomes. In total, 404 patients were included in the final analysis. All end points were found to be statistically significant. The malnourished group was more likely to meet the composite end point (odds ratio [OR], 5.3), more likely to be readmitted within 30 days (OR, 3.4), more likely to die within 90 days of discharge (OR, 5.5), and more likely to have a length of stay >7 days (OR, 4.3) compared with the nonmalnourished group. Length of stay was significantly longer in the malnourished group, 9.80 (11.5) vs 4.38 (4.5) days. Malnutrition was an independent risk factor for readmission within 30 days or death within 90 days of discharge. Malnourished patients had higher rates of readmission, higher mortality rates, and longer lengths of stay and were more likely to be discharged to nursing homes. © 2016 American Society for Parenteral and Enteral Nutrition.

  13. Nutrition

    Science.gov (United States)

    ... for staff development or offered staff development on nutrition and dietary behavior to those who teach health education increased ... for staff development or offered staff development on nutrition and dietary behavior to those who teach health education increased ...

  14. Nutritional Evaluation of Raw Materials Entering the Structure to Mixed Fodder for the Specie Poecilia reticulata (Guppy

    Directory of Open Access Journals (Sweden)

    Adrian Gruber

    2011-05-01

    Full Text Available In the ornamental pisciculture is a especial emphasis on the exterior shape and color to the fishes, issues that are dependent directly to the structure of compound feeds in relation to the nutritional characteristics of the raw materials.Own research or focused on analyzing the crude chemical composition with Weende scheme (water content and dry matter, crude ash, crude protein, crude fat, crude fiber, SEN of raw materials can be used in the structure of a compound feeds for the Poecilia reticulata (guppy species, for most of these materials there are no current data in the literature.These materials were analyzed: gelatin, wheat flour, sunflower meal, soybean meal, meal Spirulina platensis, carrot (Daucus carota, Pangasius fillet, Daphnia pulex, grount dandelion (Taraxacum officinale, grount nettle (Urtica dioica and yeast.

  15. Perspectivas en el diseño y desarrollo de productos para nutrición enteral Perspectives in the design and development of new products for enteral nutrition

    Directory of Open Access Journals (Sweden)

    A. J. Pérez de la Cruz

    2006-05-01

    Full Text Available La Nutrición Enteral es una técnica que aunque utilizada desde tiempos inmemoriales, ha sido en los últimos 25 años cuando ha experimentado un desarrollo considerable, pasando de ser un elemento terapéutico secundario, destinado exclusivamente a alimentar al paciente, a ocupar en la actualidad un papel importante que va mucho más allá del simple acto de nutrir. La composición cuantitativa pero sobre todo la cualitativa, es objeto de un interesante debate en el que se busca un perfil que permita modular determinados aspectos de la respuesta del organismo mediante el enriquecimiento con distintos nutrientes. Ello incluye desde el mantenimiento del trofismo intestinal y de la "barrera intestinal" antibacteriana, tan importante para prevenir el temido fracaso multiórgánico, hasta la atenuación del Síndrome de la Respuesta Inflamatoria Sistémica, pasando por los conceptos de alimentación inmunomoduladora, alimentación organoespecífica, farmaconutrientes o econutrición. En ésta nueva dinámica han adquirido importancia determinados nutrientes como la glutamina, arginina, nucleótidos, ácidos grasos de la serie ω-3 y antioxidantes diversos, así como la manipulación de otras moléculas de naturaleza no nutricional, como hormonas, factores de crecimiento, citoquinas y bloqueantes. Estos aspectos que suponen para el futuro unas apasionantes vías de investigación, nacen del mejor conocimiento que se va teniendo de la fisiopatología de procesos tan graves como la sepsis, y de la reacción del organismo ante el ayuno y la agresión grave, de modo que se está intentando modular dicha respuesta a través de cambios en la composición cuantitativa y cualitativa de las fórmulas.Enteral nutrition is a technique that even though it was used in times immemorial, in the last 25 years has suffered a considerable development, from being considered a secondary therapeutic weapon destined only to feed the patient, to occupying an important

  16. Valoración de la ingesta de nutrientes y energía en paciente crítico bajo terapia nutricional enteral Nutrients and energy intake assessment in the critically ill patient on enteral nutritional therapy

    Directory of Open Access Journals (Sweden)

    J. Abilés

    2005-04-01

    vitaminas y minerales. Las recomendaciones utilizadas como referencia corresponden a ingestas suficientes para cubrir requerimientos de individuos sanos, por lo tanto, los valores obtenidos en nuestro estudio muestran una adecuación superior al 75%, salvo casos particulares como la vitamina A y el magnesio. Sin embargo al observar la figura 3, el cual nos muestra la adecuación de las ingestas vitamínicas a las dosis recomendadas para pacientes enfermos, la ingesta es inferior al 25% de lo requerido en todos los casos, estas deficiencias repercuten de manera significativa en la cicatrización, el sistema inmune, el cardiovascular y el nervioso así como en el metabolismo del resto de macronutrientes, provocando un desequilibrio en el sistema antioxidante y empeorando la situación clínica del paciente. Conclusiones: El presente estudio nos confirma la necesidad de monitorizar de una manera personalizada las necesidades nutricionales en el paciente crítico y adaptar las recomendaciones a sus cambios metabólicos, ya que las mismas no están claramente definidas para estas situaciones en la actualidad. Es necesario aportar dosis de micronutrientes que se acerquen más a sus necesidades y así preservar o mejorar el estado nutricional y el equilibrio del sistema antioxidante, haciendo más eficaz el tratamiento clínico aplicado.Introduction and objectives: The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. Methodology: This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de

  17. 营养不良与儿童危重症的关系及肠内肠外营养对病情的影响%Malnutrition in the critically ill children: the importance of enteral and parenteral nutrition

    Institute of Scientific and Technical Information of China (English)

    梁兵

    2015-01-01

    营养不良在危重症患儿中存在较高的发病率.营养支持对危重患儿的病情转归具有重要影响,合理的营养支持不仅能够纠正危重患儿营养状态,亦可以改善患儿的临床预后.肠内营养及肠外营养支持方式各自有优缺点,如何将肠内及肠外营养均衡地结合,提供更好的个体化营养支持及治疗方案,将成为营养支持主要的研究方向.该文对危重患儿营养不良风险、危重患儿营养不良筛查及肠内肠外营养对病情的影响进行综述.%The incidence of malnutrition is high among critically ill children.Thus, nutritional support has a major influence on the prognosis of critically ill children.Appropriate nutritional support can not only correct the poor nutritional status of critically ill children, but also improve the clinical prognosis.Fortunately, there are enteral and parenteral nutrition support available, but both have advantages and disadvantages.How to combine enteral and parenteral nutrition for a better personalized nutrition support plan, has become the major focus of nutritional support.In this regard, the nutrition risk, malnutrition screening and the effect of enteral/parenteral nutrition on the disease severity are summarized in this review.

  18. [INFLUENCE OF THE NUTRITIONAL COMPOSITION OF DIFFERENT FIBER-ENRICHED ENTERAL NUTRITION FORMULAS ON THE ADMINISTRATION TIME BY GRAVITY AND THE RISK OF TUBE FEEDING OBSTRUCTION].

    Science.gov (United States)

    Bonada Sanjaume, Anna; Gils Contreras, Anna; Salas-Salvadó, Jordi

    2015-08-01

    Introducción: la administración de nutrición enteral por gravedad es un método de administración muy útil en la práctica clínica, pero a la vez muy poco preciso y que presenta unas limitaciones importantes, como la dificultad a la hora de establecer una velocidad de goteo precisa y la probabilidad de enlentecimiento del goteo según la fórmula administrada. Objetivos: evaluar el tiempo de paso de caída libre y el riesgo de obturación de cinco fórmulas de nutrición enteral ricas en fibra con diferente concentración proteica y densidad calórica, administradas por gravedad a través de sondas nasogástricas (SNG) de diferentes calibres. Valorar la influencia de la composición en la velocidad de paso por gravedad de las fórmulas estudiadas. Métodos: se compararon cinco fórmulas de NE ricas en fibra de distintos tipos y se utilizaron SNG con un calibre de 8, 10 y 12 Fr. La fluidez de las fórmulas de NE por gravedad se estimó cronometrando el tiempo de paso de cada fórmula a máxima velocidad y se calculó el tiempo medio de caída libre (TMCL), registrándose las posibles obturaciones. Posteriormente se realizó una simulación in vitro de la administración de 1.500 ml de cada una de las fórmulas a una velocidad determinada para que el producto pasara en cinco horas. Se registró el enlentecimiento y la detención del paso como indicadores de riesgo de obturación. Resultados: los dos productos que con diferencia presentaron un mayor TMCL fueron los productos de mayor concentración energética. El tiempo de paso en caída libre de estos dos productos a través de la sonda de 8 Fr superó las cuatro horas. Para el resto de los productos y SNG utilizadas el tiempo fue inferior a dos horas y cinco minutos. No se detectó enlentecimiento del paso ni obturación de la sonda en ningún caso cuando se determinó el tiempo de caída libre a máxima velocidad. Cuando se ajustó la velocidad para que el producto pasara en cinco horas, en tres de los

  19. Complicaciones de la nutrición enteral domiciliaria: Resultados de un estudio multicéntrico Complications of enteral nutrition at home: Results of a multi-centre trial

    Directory of Open Access Journals (Sweden)

    C. Gómez Candela

    2003-06-01

    Full Text Available Objetivo: A pesar del número creciente de nutrición enteral domiciliaria (NED, sólo algunos artículos recogen la frecuencia de sus complicaciones. Este estudio multicéntrico analiza estas complicaciones en relación a la vía de acceso y la duración del soporte nutricional. Método: Seleccionamos aleatoriamente 92 pacientes con NED de 8 hospitales y se distribuyeron en relación a la duración del soporte y a la vía de acceso: sonda nasogástrica (SNG y gastrostomías percutánea o quirúrgica. Tras un programa educativo, los pacientes completaron un cuestionario inicial que se repitió en los días 15 y 30. Recibieron una media de 1.650 kcal de fórmula enteral. Se analizaron un total de 2.760 días prospectivos de NED. Resultados: En la fase prospectiva, el 42% de los pacientes tuvo alguna complicación (112 episodios. Los más frecuentes fueron digestivos (55% y mecánicos (29%; se registraron 0,16 complicaciones por paciente-año. Las complicaciones más comunes fueron: extracción (15%, estreñimiento (13%, vómitos (12% y diarrea (10%. El grupo de gastrostomía tuvo más complicaciones digestivas. En el análisis retrospectivo, el grupo de gastrostomía percutánea tuvo menos complicaciones y el de SNG requirió más recambios de sondas (4 frente a 2 y tuvieron 1,96 complicaciones/paciente (grupo de gastrostomía percutánea 1,85 y quirúrgica 3,1. Conclusión: La NED es segura y presenta una baja incidencia de complicaciones. Un programa educativo adecuado es muy útil y esperamos, en el futuro, contribuir a un mejor sistema de atención domiciliaria.Aim: In spite of the increasing number of home enteral nutrition (HEN patients, only few articles had reported the frequency of complications related to this treatment. Our multicentric study analyzes the HEN complications in relation to access device and time of treatment. Method: 92 HEN patients from 8 hospitals were randomly selected. Patients were distributed in relation to the

  20. [Improvement in diurnal oral ingestion in the malnourished newborn infant induced by the administration of nocturnal enteral nutrition].

    Science.gov (United States)

    Thompson-Chagoyán, O C; López-Ayllón, R M; Ríos-Espinosa, E; Arteaga-Noriega, M M; Camacho-Gutiérrez, J

    1995-01-01

    The purpose of this study was evaluate the impact of nocturnal nasogastric tube feeding on diurnal caloric intake in children with severe energy protein-calorie malnutrition. Sixteen infants admitted to the Pediatric Nutrition Department with severe malnutrition were randomly assigned into groups: eight children in group A and eight in group B. Infants in both groups received 100% of their caloric requirements by oral feeding ad libitum. An additional 30% caloric charge was given to patients in group A by nocturnal nasogastric tube feeding. At admission and at their 7th day, weight, height, arm circumference, triceps and subscapular skinfold thickness were recorded. Weight for age, weight for height, height for age and upper arm muscle circumference were estimated. Every meal was weighted and measured before and after being eaten in order to calculate the child caloric intake using food composition tables. There were no statistically differences in all parameters between groups at admission. At discharge significant differences on caloric intake were found (179.7 +/- 75.34 kcal vs. 98.38 +/- 37.73 kcal; p 0.02). This findings suggest that nocturnal support with an extra caloric supply over the normal requirements for age improve the diurnal caloric intake of children with severe protein energy malnutrition.

  1. 12 CFR 323.3 - Appraisals required; transactions requiring a State certified or licensed appraiser.

    Science.gov (United States)

    2010-01-01

    ... State certified or licensed appraiser is required for all real estate-related financial transactions... lease of real estate is entered into, unless the lease is the economic equivalent of a purchase or sale... that the services of an appraiser are not necessary in order to protect Federal financial and...

  2. Impact of enteral supplements enriched with omega-3 fatty acids and/or omega-6 fatty acids, arginine and ribonucleic acid compounds on leptin levels and nutritional status in active Crohn's disease treated with prednisolone

    DEFF Research Database (Denmark)

    Nielsen, Aneta Aleksandra; Nielsen, Jens Nederby; Grønbaek, Henning;

    2007-01-01

    BACKGROUND: Patients with Crohn's disease (CD) often develop malnutrition due to disease activity. We aimed to assess the effect of two different enteral supplements of Impact(R) Powder (IP; Novartis, Switzerland) on leptin levels and nutritional status in active CD patients during prednisolone t...

  3. The efficacy of glutamine combined with enteral nutrition in the treatment of chemotherapy-induced diarrhea%谷氨酰胺联合肠内营养对化疗性腹泻的影响

    Institute of Scientific and Technical Information of China (English)

    张琳; 刘嫦玉

    2013-01-01

      目的探讨谷氨酰胺(glutamine Gln)联合肠内营养对化疗性腹泻的影响。方法将患者随机分为两组,观察组给予Gln联合肠内营养,对照组单纯肠内营养。结果观察组腹泻发生率和腹泻反应程度均低于对照组(P<0.01)。结论Gln联合肠内营养有助于防治化疗性腹泻。%  Objective: To evaluate the efficacy of glutamine combined with enteral nutrition in the treatment of chemotherapy-induced diarrhea.Methods: Eligible patients were randomly divided to two groups. The experimental group were treated with glutamine and enteral nutrition.The control group were treated with enteral nutrition only.Results:The incidence and severity of diarrhea was significantly lower in the experimental group compared with the control group ( P<0.01 )..Conclusion: Glutamine combined with enteral nutrition is effective in the treatment of chemotherapy-induced diarrhea.

  4. Impact of enteral supplements enriched with omega-3 fatty acids and/or omega-6 fatty acids, arginine and ribonucleic acid compounds on leptin levels and nutritional status in active Crohn's disease treated with prednisolone

    DEFF Research Database (Denmark)

    Nielsen, Aneta Aleksandra; Nielsen, Jens Nederby; Grønbaek, Henning

    2007-01-01

    BACKGROUND: Patients with Crohn's disease (CD) often develop malnutrition due to disease activity. We aimed to assess the effect of two different enteral supplements of Impact(R) Powder (IP; Novartis, Switzerland) on leptin levels and nutritional status in active CD patients during prednisolone t...

  5. Registro español de Nutrición Enteral Domiciliaria del año 2009: Grupo NADYA-SENPE The Spanish Home Enteral Nutrition registry of the year 2009: from the NADYA-SENPE group

    Directory of Open Access Journals (Sweden)

    C. Wanden-Berghe

    2010-12-01

    Full Text Available Objetivo: Describir las características de la Nutrición Enteral Domiciliaria (NED en España, registrada por el grupo NADYA-SENPE durante el año 2009. Material y métodos: Recopilación y análisis descriptivo de los datos del registro de NED del grupo NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2009. Resultados: Se registraron 6.540 pacientes, 5,11% más que en el año anterior y 6.649 episodios de NED (3.135 en mujeres, 47,93% pertenecientes a 32 centros hospitalarios. Siendo 6.238 (95,38% mayores de 14 años. La edad media en los menores de 14 años fue de 3,67 ± 2,86 y de 72,10 ± 16,89 en los mayores de 14 años. La enfermedad de base que se registró con más frecuencia fue la neurológica en 2.732 (41,77% ocasiones, seguida de la neoplasia en 1838; 28,10%. La vía de acceso se registró en 1.123 (17,17% de los episodios, siendo más frecuente la administración por sonda nasogástrica 562 (50,04%. El tiempo medio de tratamiento nutricional fue de 323 días (10,77 meses. Finalizaron 606 episodios de NED, siendo el motivo más frecuentes el fallecimiento del enfermo, lo que aconteció en 295 (48,68% ocasiones y el paso a alimentación oral en 219 (36,14%. Los pacientes mantenían una actividad normal en 2162 episodios de NED (32,55% y en 2468 (37,13% hacían vida "cama-sillón". El grado de dependencia fue "total" en 2598 (39,07% de los episodios registrado. El suministro de la fórmula nutricional se realizó desde el hospital en 4.183 (62,91% casos y por la farmacia de referencia en 2.262 (el 34,02% y el material fungible se suministró desde el hospital en 3.531 (53,11% de los casos. Conclusiones: El número de pacientes con NED registrados es superior al del año 2008, continuando con el incremento progresivo desde el inicio del registro. Las características de los mismos mantiene el mismo perfil que en años anteriores con pequeñas variaciones.Objective: To describe the Home Enteral Nutrition Characteristics (HEN

  6. 含益生元膳食纤维的早期肠内营养用于腹部外科术后的随机对照研究%Early Enteral Nutrition with Prebiotic Fiber Supply in Major Abdominal Surgery venus Conventional Enteral Nutrition: A Prospective Controlled Trial

    Institute of Scientific and Technical Information of China (English)

    彭俊文

    2011-01-01

    目的 探讨强化益生元膳食纤维的肠内营养在腹部外科术后患者中的临床应用.方法 2008年7月-2010年11月30例接受腹部外科中等以上手术的患者术前随机分为研究组和对照组,每组15例.研究组患者于术后接受肠内营养,并予以强化益生元膳食纤维;对照组只接受相同的肠内营养支持.观察指标为术后感染并发症、胃肠道并发症、住院时间、抗生素治疗时间、C反应蛋白水平和病死率等.结果 研究组术后住院时间为(10±5)d,对照组为(15±7)d,两组差异有统计学意义(t=2.251,P=0.033);研究组C反应蛋白水平为(6.6±3.2) mg/L,对照组为(9.8±2.1) mg/L,两组差异有统计学意义(t=3.238,P=0.003);研究组抗生素治疗时间为(5.0±3.5)d,对照组为(6.0±4.8)d,两组差异无统计学意义(t=0.652,P=0.520).两组均无死亡病例;术后研究组2例发生感染并发症,对照组3例,两组感染并发症发生率差异无统计学意义(P=1.000).两组患者均能耐受经肠内补充营养素.结论 与常规肠内营养比较,给予强化益生元膳食纤维的肠内营养能减少腹部外科术后患者的住院时间,降低急性期炎症反应.%Objective To investigate the effect of early enteral supply of prebiotic fiber in patients undergoing major abdominal surgery. Methods Between July 2008 and November 2010, 30 patients undergoing major gastrointestinal surgery were randomized into the study group and the control group before operation with 15 patients in each group. Prebiotic fiber was administered combined with enteral nutrition support for patients in the study group. Patients in the control group only received conventional enteral nutrition without fiber. The main endpoints included the development of bacterial infection, the duration of hospital stay, antibiotic therapy, the serum level of C-reaction protein (CRP), side effects of the enteral nutrition and morbidity. Results Compared with the control group

  7. Nursing Care of Enteral Nutrition through Nasointestinal Tube after Pancreatoduodenectomy%胰十二指肠切除术后经鼻肠管行肠内营养的护理

    Institute of Scientific and Technical Information of China (English)

    徐成云

    2014-01-01

    目的:探讨胰十二指肠切除术患者经鼻肠管给予肠内营养方法及护理措施。方法:对56例胰十二指肠切除术患者术中置入鼻肠管,术后行肠内营养。结果:通过妥善固定鼻肠管,保持鼻肠管的通畅,控制经鼻肠管输入肠内营养液的量、方法、速度,有效减少并发症的发生。结论:胰十二指肠切除术后经鼻肠管实施肠内营养是经济安全有效的营养支持的方法,有效的护理对于确保手术的成功和达到预期治疗目的有十分重要意义。%Objective:To explore the nursing methods of enteral nutrition by nasointestinal tube for patients un-dergoing pancreatoduodenectomy.Methods:Fifty-six patients who had been performed pancreatoduodenectomy were treated with enteral nutrition through nasointestinal tube, which were inserted intra-operative. Results:The speed and the volume of enteral nutrition were regulated appropriately.The rate of post-operative complication of pancreatoduo-denectomy decreased by properly enteral nutrition which were performed by nursing methods.Conclusion:It is effective and imperative to use enteral nutrition for patients who have undergone pancreatoduodenectomy by appropriate nurs-ing methods.

  8. Nutrition.

    Science.gov (United States)

    Durnin, J V

    1976-07-01

    Nutrition appeared somewhat late on the scene in the I.B.P. projects in the U.K., but eventually it occupied an integral part of many of the H.A. (human adaptability) investigations. The nutritional data obtained in the studies of isolated and nearisolated communities in Tristan da Cunha and in New Guinea provided information of wide nutritional significance. There were also detailed and extensive studies in Israel which, similarly to those in New Guinea, attempted to relate nutritional factors to enviroment, working conditions, and physical fitness. Some extraordinarily low energy intakes found in Ethiopians have induced much speculation on the extent which man can adequately adapt to restricted food supplies. Interesting nutritional observations, of general importance, have also arisen from results obtained on such disparate groups as Glasgow adolescents, Tanzanian and Sudanese students, children in Malawi and vegans in the U.K.

  9. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): nutritional assessment].

    Science.gov (United States)

    Ruiz-Santana, S; Arboleda Sánchez, J A; Abilés, J

    2011-11-01

    Current parameters to assess nutritional status in critically-ill patients are useful to evaluate nutritional status prior to admission to the intensive care unit. However, these parameters are of little utility once the patient's nutritional status has been altered by the acute process and its treatment. Changes in water distribution affect anthropometric variables and biochemical biomarkers, which in turn are affected by synthesis and degradation processes. Increased plasma levels of prealbumin and retinol -proteins with a short half-life- can indicate adequate response to nutritional support, while reduced levels of these proteins indicate further metabolic stress. The parameters used in functional assessment, such as those employed to assess muscular or immune function, are often altered by drugs or the presence of infection or polyneuropathy. However, some parameters can be used to monitor metabolic response and refeeding or can aid prognostic evaluation.

  10. 脑血管疾病患者经皮内镜下胃造瘘行肠内营养的效果观察及护理%Nursing of CVD patients receiving enteral nutrition for percutaneous endoscopic gastrostomy

    Institute of Scientific and Technical Information of China (English)

    张洁

    2012-01-01

    Objective To investigate the strategies for nursing the cerebrovascular disorder (CVD) patients who were treated with enteral nutrition for percutaneous endoscopic gastrostomy (PEG). Methods 16 CVD patients were managed with enteral nutrition for PEG. The preoperative and postoperative cares were performed in collaboration with PEG. Results By enteral nutrition, the severe malnutrition in 6 of the patients were markedly improved, the mediate malnutrition in 7 and the mild malnutrition in 3 were improved to the normal level. 2 of the patients had a little inflammatory exudation at incisions, 3 had abdominal distention and 1 oral fungus infections. Conclusion For CVD patients, enteral nutrition for percutaneous endoscopic gastrostomy is safe and supportive nutritionally. The nursing strategies including the care of ostomy catheter, monitoring of enteral nutrition and prevention of complications may ensure the smooth implementation of enteral nutrition, propel their recovery and improve their quality of life.%目的 探讨脑血管疾病患者经皮内镜下胃造瘘(percutaneous endoscopic gastrostomy,PEG)行肠内营养的效果及总护理要点.方法 对16例脑血管疾病无法经口进食而需要肠内营养患者,在经皮胃镜下行PEG,并配合做好术前后护理工作.结果 经PEG管饲后,6例重度营养不良患者情况明显改善,7例中度和3例轻度营养不良患者恢复正常;PEG肠内营养期间2例患者伤口伴少量炎症渗出,3例患者出现腹胀或腹痛,1例出现口腔真菌感染.结论 脑血管疾病患者经皮内镜下PEG行肠内营养是一种安全、有效的营养支持方法.护士做好造瘘管护理、肠内营养护理、口腔护理及预防相关并发症等工作,可保证脑血管疾病患者肠内营养顺利实施,促进疾病康复,提高患者生活质量.

  11. 不同肠内营养在高龄鼻饲患者中临床应用对比%Clinical Application and Comparison of Different Enteral Nutrition in the Elderly Patients With Nasal Feeding

    Institute of Scientific and Technical Information of China (English)

    惠博雅

    2016-01-01

    Objective The effect of differententeral nutrition in elderly patients with nasal feeding were compared.Methods 53 cases of elderly patients with nasal feeding from our hospital were randomly selectedas the experimental group,giving enteral nutrition emulsion. Another 53 cases as the control group,given homogenate diet. After one month,observed the nutritional status of the patients in the two groups.Results Afternasal feeding,the nutritional status of patients in experimental group with related indexes were higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion In elderly patients with nasal feeding using enteral nutrition support,enteral nutrition emulsion was more to improve the nutritional status of patients and improve the quality of life of patients.%目的:对比临床中高龄鼻饲患者应用不同肠内营养的效果。方法随机抽取本院收治的行鼻饲的高龄患者58例,作为实验组,给予肠内营养乳剂,另抽取58例作为对照组,给予匀浆膳,1个月后,观察两组患者的营养状况。结果鼻饲后,实验组患者营养状况相关指标均高于对照组,差异具有统计学意义(P<0.05)。结论高龄鼻饲患者应用肠内营养支持时,肠内营养乳剂能够有效改善患者的营养状况,提高患者的生活质量。

  12. Enteral or parenteral nutrition in traumatic brain injury: a prospective randomised trial Nutrición enteral o parenteral en lesión traumática cerebral: un estudio prospectivo y randomizado

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    C. Mª Justo Meirelles

    2011-10-01

    Full Text Available Introduction: Few studies have evaluated the route of nutritional therapy in patients with head trauma. Objective: We aimed at investigating whether early enteral (EN or parenteral nutrition (TPN may differ in protein/ calorie supply, serum glucose modifications, and acute phase response in patients with traumatic brain injury (TBI. Methods: Twenty two patients with moderate TBI (Glasgow score between 9-12 were randomized to receive isocaloric and isonitrogeneous either EN (n = 12 or TPN (n = 10. The daily amount of calories and nitrogen (N supplied, the nitrogen balance, and the daily serum level of glucose, C-reactive protein, and albumin were collected for 5 consecutive days. Clinical endpoints as length of stay and mortality were also compared. Results: Mortality was 9.1% (two cases with one case in each group. A progressive caloric deficit occurred in both groups (p = 0.001 without difference between them. The mean serum glucose level in TNP patients (134.4, 95% CI = 122.6 to 146.2 mg/dl was significantly higher than in the EN group (102,4; 95% CI 91.6 to 113.2 mg/dL (p Introducción: Pocos estudios han evaluado la ruta de la terapia nutricional en pacientes con traumatismo craneoencefálico. Objetivo: El objetivo fue investigar si la nutrición enteral (EN o parenteral (TPN precoz puede ser diferente en suministro de calorías y proteinas, en las modificaciones de glucosa sérica, y en la respuesta de fase aguda en pacientes con lesión cerebral traumática (TBI. Métodos: Veintidós pacientes con TBI moderado (puntuación de Glasgow entre 9 a 12 fueron aleatorizados para recibir de forma isocalórica y isonitrogenada EN (n = 12 o TPN (n = 10. La cantidad diaria de calorías y el nitrógeno (N que se suministra, el balance de nitrógeno, y el nivel sérico de glucosa al día, la proteína C-reactiva, y la albúmina fueron recolectados durante 5 días consecutivos. Criterios de valoración clínicos como la duración de la estancia y la

  13. Food and nutritional safety of hospitalized patients under treatment with enteral nutrition therapy in the Jequitinhonha Valley, Brazil Seguridad alimentaria y nutricional de los pacientes hospitalizados de un tratamiento con nutrición enteral en el Valle del Jequitinhonha, Brasil

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    B. Amaral Felicio

    2012-12-01

    Full Text Available The Enteral Nutrition Therapy (ENT has been widely used in hospital and home care assistance. However, research works are needed to make this technique more efficient and cheaper. Objective: Evaluate the nutritional quality of handmade enteral diets used in a charity hospital in the Jequitinhonha Valley, Brazil, and propose qualitative and quantitative adjustments, when necessary, and compare the data available in tables of chemical composition of foods with the data achieved by laboratory analyses. Materials and methods: The study was carried out in partnership with a charity organization of the region and the Universidade Federal dos Vales do Jequitinhonha e Mucuri, where the collection of the handmade enteral diets was performed. The analyses of the physical-chemical and centesimal composition of 36 samples of diets were carried out in the laboratories of the university. Results: It was observed that the daily energy offer of the diets was below the recommended standards and presented a percentage distribution different from that estimated for patients receiving ENT. Besides, it can be seen that the nutrient values of the data achieved in laboratory do not agree with those available in tables of food chemical composition. Conclusions: Significant losses of nutrients were verified during the processing and preparation of handmade enteral diets. It challenges nutritionists to standardize these diets and corroborates the relevance of new studies to determine the nutritional content of handmade enteral diets, since these diets have been widely used in poor regions of Brazil and in other countries.La terapia de nutrición enteral (TNE se ha utilizado ampliamente en la asistencia hospitalaria y domiciliaria. Sin embargo, se necesitan trabajos de investigación para hacer que esta técnica sea más eficiente y barata. Objetivo: Evaluar la calidad nutricional de dietas enterales elaboradas de forma casera en un hospital de caridad del valle de

  14. Changes in fecal microbiota and metabolomics in a child with juvenile idiopathic arthritis (JIA) responding to two treatment periods with exclusive enteral nutrition (EEN).

    Science.gov (United States)

    Berntson, Lillemor; Agback, Peter; Dicksved, Johan

    2016-06-01

    The microbiome and immune system of the digestive tract are highly important in both health and disease. Exclusive enteral nutrition (EEN) is a common anti-inflammatory treatment in children with Crohn's disease in the European countries, and the mechanism is most likely linked to changes in the intestinal microbiome. In the present study, EEN was given in two treatment periods several months apart to a patient with very severe, disabling juvenile idiopathic arthritis (JIA), with a remarkable clinical response as the result. The aim of the present study was to study how the EEN treatment influenced the microbiome and metabolome of this patient. Fecal samples from before, during, and between treatments with EEN were studied. The microbiome was analyzed by sequencing of 16S rRNA amplicons using Illumina MiSeq, and the metabolome was analyzed using nuclear magnetic resonance. The microbiome changed markedly from treatment with EEN, with a strong reduction of the Bacteroidetes phylum. Metabolic profiles showed clear differences before, during, and between treatment with EEN, where butyrate, propionate, and acetate followed a cyclic pattern with the lowest levels at the end of each treatment period. This patient with JIA showed remarkable clinical improvement after EEN treatment, and we found corresponding changes in both the fecal microbiome and the metabolome. Further studies are needed to explore the pathophysiological role of the intestinal canal in children with JIA.

  15. Determination of Vitamin C in Enteral Nutrition Emulsion by HPLC%HPLC法测定肠内营养乳剂中维生素C的含量

    Institute of Scientific and Technical Information of China (English)

    朱虬; 朱卫红

    2012-01-01

    An HPLC method was established for the determination of vitamin C (VC) in enteral nutrition emulsion.The mobile phase consisted of 0.02 mol o L-1' potassium dihydrogen phosphate-acetonitrile (27:73, pH 5.3).The determination was performed on a Merck LiChrospher 100 NH2 column (250 mm× 4.0 mm, 5μm).The UV detection wavelength was set at 254 nm.The proposed method gained a linear range at 2.2868~7.5466 μg·-mL-1' (r=0.9999, n=5) with good accuracy and recovery.%建立肠内营养乳剂中维生素C的高效液相色谱测定法.用Merck LiChrospher100 NH2柱(250 mm ×4.0 mm,5μm),0.02 mol· L-1磷酸二氢钾溶液-乙腈(27∶73)为流动相(pH为5.3),进行分离,检测波长为254 nm.该法线性范围为2.2868~7.5466μg· mL-1,精密度和平均回收率良好.

  16. Oral L-carnitine supplementation in low-birth-weight newborns: a study on neonates requiring combined parenteral and enteral nutrition.

    Science.gov (United States)

    Melegh, B; Kerner, J; Sándor, A; Vincellér, M; Kispál, G

    1986-01-01

    Effect of L-carnitine supplementation on plasma ketone body (KB) and triglyceride (TG) concentrations was studied in ten premature infants requiring combined enteral and parenteral nutrition. At the second week of life (9 to 14 days of age) the infants were randomly divided into two groups. Five of them (plasma carnitine value, 33.77 +/- 2.48 mumol/l; mean +/- SEM) received oral L-carnitine supplementation (60 mumol/kg daily) added to pasteurized pooled human milk for seven consecutive days; additional five (plasma carnitine value, 36.70 +/- 5.19 mumol/l) served as controls. Composition of the daily diet was nearly constant in the study period. On the seventh day, prior to an Intralipid infusion, plasma carnitine and ketone body levels were significantly increased in the supplemented group as compared to controls or to previous values of the same group. In response to lipid infusion the fat load induced ketone body production was significantly higher in the supplemented group as compared to controls, whereas the triglycerides reached higher levels in the control group. It is suggested that L-carnitine supplementation in low-weight newborns promotes ketone body formation from endogenous stores as well as from exogenous fat supply, and thus may enhance triglyceride utilization.

  17. Evolución de la nutrición enteral domiciliaria en Madrid 2002-2007 Evolution of home-based enteral nutrition in Madrid 2002-2007

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    A. Castaño Escudero

    2009-04-01

    Full Text Available Introducción: La Nutrición Enteral Domiciliaria en Madrid utiliza como soporte la receta oficial lo que facilita el uso de sistemas de información para el análisis de su consumo y evolución. Objetivos: Análisis cuali y cuantitativo de la evolución del consumo de NED de 2002 a 2007. Tendencia e identificación de los productos con mayor impacto en el periodo 2006-2007. Características de los pacientes. Métodos: Selección de recetas facturadas de productos de NED, clasificación por tipos y análisis de la evolución en importe y en envases para el periodo 2002 -2007. Estudio de la evolución consumo 2006-2007 identificando los productos con mayor impacto, la distribución de su prescripción y las características de los pacientes a los que se indica. Resultados: En el periodo 2002-2007, los envases han aumentado mas del doble y el importe económico se ha triplicado, observándose un desplazamiento hacia las dietas completas hiperproteicas. El análisis 2006-2007 de las mismas nos lleva a identificar 5 productos cuyo incremento en envases ha superado el 210%. La edad media de los pacientes es 60,33 años, siendo los diagnósticos más frecuentes oncológicos y neurológicos. El 69% de los tratamientos están prescritos como suplementos a una dieta de consumo ordinario. Discusión: En los últimos 6 años se evidencia la tendencia al alza y el desplazamiento hacia dietas del tipo completas hiperproteicas que suponen ya en 2007 casi la tercera parte del consumo. Dos terceras partes de los tratamientos están dirigidos a pacientes geriátricos con patologías oncológicas o degenerativas del sistema nervioso central.Introduction: Home-based enteral nutrition in Madrid uses the official prescription form which facilitates the use of information systems for analyzing consumption and evolution. Objectives: Qualitative and quantitative analysis of the evolution of HBEN use from 2002 to 2007. Trend and identification of the products with

  18. Effects of continuous versus bolus infusion of enteral nutrition in critical patients Efeitos da administração contínua versus intermitente da nutrição enteral em pacientes críticos

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    Letícia Faria Serpa

    2003-01-01

    Full Text Available PURPOSE: Enteral alimentation is the preferred modality of support in critical patients who have acceptable digestive function and are unable to eat orally, but the advantages of continuous versus intermittent administration are surrounded by controversy. With the purpose of identifying the benefits and complications of each technique, a prospective controlled study with matched subjects was conducted. PATIENTS AND METHODS: Twenty-eight consecutive candidates for enteral feeding were divided into 2 groups (n = 14 each that were matched for diagnosis and APACHE II score. A commercial immune-stimulating polymeric diet was administered via nasogastric tube by electronic pump in the proportion of 25 kcal/kg/day, either as a 1-hour bolus every 3 hours (Group I, or continuously for 24 hours (Group II, over a 3-day period. Anthropometrics, biochemical measurements, recording of administered drugs and other therapies, thorax X-ray, measurement of abdominal circumference, monitoring of gastric residue, and clinical and nutritional assessments were performed at least once daily. The principal measured outcomes of this protocol were frequency of abdominal distention and pulmonary aspiration, and efficacy in supplying the desired amount of nutrients. RESULTS: Nearly half of the total population (46.4% exhibited high gastric residues on at least 1 occasion, but only 1 confirmed episode of pulmonary aspiration occurred (3.6%. Both groups displayed a moderate number of complications, without differences. Food input during the first day was greater in Group II (approximately 20% difference, but by the third day, both groups displayed similarly small deficits in total furnished volume of about 10%, when compared with the prescribed diet. CONCLUSIONS: Both administration modalities permitted practical and effective administration of the diet with frequent registered abnormalities but few clinically significant problems. The two groups were similar in this regard

  19. Clinical observation of early enteral nutrition in postoperative gastric cancer patients%早期肠内营养在胃癌术后应用的疗效观察

    Institute of Scientific and Technical Information of China (English)

    罗嘉; 吴飞跃

    2011-01-01

    目的 观察胃癌术后患者早期肠内营养支持的近期疗效.方法 将 117 例患者随机分为肠内营养组与肠外营养组,于术后 24h 开始分别给予肠内与肠外营养,比较两组患者术后营养状况、免疫水平和临床恢复情况的差异.结果 在供能基本相同的情况下,肠内营养组在术后短期内免疫水平和临床恢复及住院时间方面都优于肠外营养组(均P<0.05).结论 术后早期肠内营养能够有效改善胃癌术后患者的免疫功能,加快胃肠道功能的恢复.%Objective To observe the effect of early enteral nutrition in postoperative gastric cancer patients.Methods There were 117 cases of postoperative gastic cancer patients who were divided randomly into enteral nutrition group ( EN ) or parenteral nutrition group ( PN ). Nutrition support was started 24 hours after the operation. Nutritional condition, immunological level and variables of clinical recovery were measured and compared after the operation. Results EN group showed better immunological level and clinical recovery than the PN group ( P < 0. 05 ); and the hostal stay of EN group was also shorter than that of PN group (P <0.05 ). Conclusions Early enteral nutrition in postoperative gastric cancer patients can improve the patients immunological level and enhance the restoration of gastrointestinal function.

  20. Perioperative enteral nutrition:a clinical analysis of elderly patients with cardiaoesophagus carcinoma%老年食管贲门癌患者围手术期肠内营养临床应用

    Institute of Scientific and Technical Information of China (English)

    王毅生

    2013-01-01

    Objective To summarize the experience of elderly patients with cardiaoesophagus carcinoma perioperative enteral nutrition and to discuss the method for preoperative and postoperative early enterl nutrition and management of related complications. Methods We selected surgery patients with cardiaoesophagus carcinoma operation, a total of 151 patients from the Second People' s Hospital of Chaohu between May 2009 and February 2012. Intravenous nutrition and enteral nutrition were given according to their nutrition status before surgery. Nasal duodenal nutrition tube or jejunal-made fistula were placed during the operation. Enteral nutrition was fed by duodenal nutrition tube or jejunal-made fistula in the early postoperative period. Results All patients had rapid recovery of gastrointestinal function,and their nutrition was close to normal. Part of the patients experienced abdominal distension, diarrhea, reflux. There were two cases of anastomotic fistula and two cases recurred by the postoperative enteral nutrition and intravenous nutrition. Conclusions In older patients with cardiaoesophagus carcinoma,preoperative and postoperative early enteral nutrition is safe and effective to promote the recovery of gastrointestinal function, maintain intestinal mucous membrane barrier, prevent and cure infectious complications, and improve the airframe nutrition status.%目的 总结老年食管贲门癌患者围手术期肠内营养的经验,探讨术前与术后早期肠内营养的方法及相关并发症的处理.方法 选取该院2009年5月-2012年2月接受食管贲门癌手术的患者共151例,术前根据其营养状况,给予静脉营养与肠内营养,术中予置经鼻十二指肠营养管或空肠造瘘管,术后早期经鼻肠管或空肠造瘘管肠内营养.结果 所有病人胃肠道功能恢复较快,营养状况接近正常水平,部分患者出现腹胀、腹泻、返流,其中有2例吻合口瘘,经术后肠内营养及静脉营养

  1. Comparative observation of enteral and parenteral nutrition support for critical ill patients%危重症患者肠内与肠外营养支持效果对比观察

    Institute of Scientific and Technical Information of China (English)

    张科

    2015-01-01

    目的:比较肠内和肠外营养支持疗法在治疗危重症患者方面的临床效果。方法72例危重症患者随机分为肠内营养支持组和肠外营养支持组,各36例。比较两组患者治疗后的营养指标和并发症发生率。结果治疗后,两组患者营养指标差异有统计学意义(P<0.05);肠内营养支持组患者并发症发生率显著低于肠外营养支持组,差异具有统计学意义(P<0.05)。结论与肠外支持治疗相比,肠内营养支持治疗不仅有效地改善危重症患者营养不良,还能明显减少并发症的发生。%Objective To compare the clinical effects between enteral and parenteral nutrition support therapies in treating critical ill patients. Methods A total of 72 critical ill patients were randomly divided into enteral nutrition support group and parenteral nutrition support group, with 36 cases in each group. Nutrition index and incidence of complications after treatment of the two groups were compared. Results After treatment, there was a statistically significant difference of nutrition index between the two groups (P<0.05). The enteral nutrition support group had lower incidence of complications than the parenteral nutrition support group, and their difference had statistical significance (P<0.05). Conclusion Compared with parenteral support therapy, enteral nutrition support therapy can not only effectively improve malnutrition in critical ill patients, but also remarkably reduce incidence of complications.

  2. Cryptosporidium enteritis

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000617.htm Cryptosporidium enteritis To use the sharing features on this page, please enable JavaScript. Cryptosporidium enteritis is an infection of the small intestine that ...

  3. Effect of Different Enteral Nutrition Infusion on Nutritional Tolerance of ICU Patients%不同肠内营养输注方式对ICU重症病人营养耐受情况的影响研究

    Institute of Scientific and Technical Information of China (English)

    郑文博

    2016-01-01

    目的:探讨不同肠内营养输注方式对ICU重症病人营养耐受情况的影响。方法方便选取该院2013年5月—2015年5月收治的240例需要经胃肠道营养支持的ICU重症病人,根据病情、不同置管适应症将患者平均分为4组:A1组采用鼻饲泵间断24 h泵入,A2组采用鼻饲泵持续24 h泵入;B1组采用的是鼻饲泵间断24 h泵入,B2组采用的是鼻饲泵持续24 h泵入。结果 A1组、A2组、B1组、B2组ICU重症病人置管喂养后血清总蛋白值分别为(54.97±5.30)、(53.77±5.33)、(56.10±4.53)、(54.27±4.76)g/L,APACHE-Ⅱ评分分别为(20.53±3.48)分、(20.17±3.35)分、(20.10±2.82)分、(19.13±1.83)分,各组差异无统计学意义(P﹥0.05);A1、B1组治疗前后血清总蛋白差异有统计学意义(P﹤0.05);各组患者比较治疗前后 APACHEⅡ评分差异有统计学意义(P﹤0.05);各组患者并发症发生情况差异无统计学意义(P﹥0.05)。结论间断泵入在患者营养方面疗效要优于持续泵入方式,通过不同肠内营养输注方ICU重症病人病情均处于好转中,无显著差异,输注方式和并发症发生情况之间未发现关联性,在临床中,必须根据病人实际情况合理选择肠内营养输注方式。%Objective To investigate the effects of different enteral nutrition infusion for ICU patients with severe nutritional situation of tolerance. Methods Convenient selection 240 cases require parenteral nutritional support in critically ill ICU patients in our hospital in May 2013 to May 2015 admitted , according to the disease, different indications for catheteriza-tion patients were divided into four groups: A1 group were pumped into the nasal feeding pump intermittent 24 h, A2 group with nasal feeding pump pumped continuous 24 h; B1 group uses a nasal feeding pump intermittently 24 h pumped, B2 group It uses a nasal feeding pump pumped continuous 24 h. Results A1 group, A2 group, B1 group, B2 group of ICU pa-tients with

  4. Clinical observation of early enteral nutrition in prevention of pulmonary infections after esophageal cancer surgery%食管癌术后早期肠内营养预防肺部感染的临床观察

    Institute of Scientific and Technical Information of China (English)

    徐锦红; 李敏; 魏琳

    2013-01-01

    目的 探讨食管癌术后早期肠内营养对于肺部感染临床预防效果,为临床工作提供帮助.方法 选取医院2011年5月-2012年5月行食管癌手术切除患者50例,采用随机数字表法分为肠外营养组和肠内营养组,每组各25例,分别术后给予全静脉肠外营养支持和鼻肠管滴注肠内营养支持;比较两组患者肺部感染发生率、治疗前后血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平、术后排气时间、体重下降等.结果 肠外营养组患者肺部感染发生率为32.0%0,明显高于肠内营养组患者肺部感染发生率的12.0%,组间比较,差异有统计学意义(P<0.05);肠外营养组和肠内营养组患者血清白蛋白、血红蛋白、丙氨酸转氨酶及天冬氨酸转氨酶水平组间比较差异无统计学意义;肠内营养组患者疗后血清白蛋白、血红蛋白、丙氨酸转氨酶及天冬氨酸转氨酶指标分别为(35.5±6.1) g/L、(90.2±10.4) g/L、(63.7±8.8) U/L、(73.3±13.7)U/L,均明显优于肠外营养组的(39.7±7.5) g/L、(99.6±13.8) g/L、(37.1±6.2) U/L、(36.4±7.4) U/L,组间比较差异有统计学意义(P<0.05);同时肠内营养组患者术后排气时间及体重下降指标分别为(67.2±5.0)h、(1.9±0.5) kg,均明显优于肠外营养组的(90.8±7.5)h、(2.6±1.0) kg,组间比较差异有统计学意义(P<0.05).结论 食管癌术后早期肠内营养可有效改善术后营养水平,降低肺部感染发生风险,具有临床使用价值.%OBJECTIVE To investigate clinical preventive effects of early enteral nutrition on lung infections after esophageal cancer surgery so as to guide the clinical treatment.METHODS Totally 50 children with surgical resection of esophageal cancer were chosen from the hospital in the period from May 2011 to May 2012 and were randomly divided into two groups including the parenteral nutrition group (25 children) with parenteral nutrition support and the enteral

  5. 两种肠内营养制剂血糖指数的测定%Determination of Glycemic Index of Two Types of Enteral Nutrition Preparation

    Institute of Scientific and Technical Information of China (English)

    王莹; 张玉珍; 蔡东联; 冯晓慧; 金瑱琪; 周金花; 王巍; 何笑丛

    2013-01-01

    To determine the glycemic index of enteral nutrition preparation for the diabetic (EN1) and fiber-homogenate (EN2),twelve healthy adults were randomly divided into EN1 group and EN2 group.The reactions of blood glucose to oral administration of 86.2 g EN1 or 58.2 g EN2 (containing 50 g glucose) and 50 g glucose in discontinuous three days were observed.The glycemic indexes of EN1 and EN2 were calculated.Results showed that the glycemic index of EN1 was 44.58±3.82 and that of EN2 was 50.33±3.42.EN1 and EN2 are low glycemic index food,and maybe good for the diabetic.%测定一种糖尿病专用肠内营养制剂(EN1)和一种纤维型匀浆膳(EN2)的血糖指数.12名健康成年人随机分为EN1组和EN2组,分别在不连续的3d内测定口服相当于含有50 g碳水化合物的EN1或EN2及50 g葡糖糖后引起的血糖反应,计算EN1和EN2的血糖指数.结果显示,EN1的血糖指数为44.58±3.82,EN2的血糖指数为50.33±3.42.结果表明,EN1和EN2均属低血糖指数食物,可用于糖尿病患者饮食.

  6. Nutritional status and adequacy of enteral nutrition in pediatric cancer patients at a reference center in northeastern Brazil El estado nutricional y la adecuación de la nutrición enteral en pacientes de oncología pediátrica en un centro de referencia del noreste de Brasil

    Directory of Open Access Journals (Sweden)

    J. Maciel Barbosa

    2012-08-01

    Full Text Available Introduction: Individualized nutritional support is important to pediatric cancer patients and should be integrated to the overall treatment of these patients. Objective: Analyze the nutritional status of cancer patients submitted to enteral nutrition (EN and assess the adequacy of this form of nutrition. Methods: A case series study was carried out at the Pediatric Oncology Unit of the Institute of Integrative Medicine Professor Fernando Figueira (IMIP, Brazil, Recife-PE between January and December 2009. Clinical and anthropometric data were obtained from medical charts and nutritional follow-up charts. Z scores for height for age, weight for age and body mass index for age indicators (H/A, W/A and BMI/A, respectively were calculated using the AnthroPlus® program. Caloric and protein requirements were calculated based on the recommendations of the Brazilian National Council of Oncologic Nutrition. Results: At the beginning of EN, 32.4% of the sample had short stature and 23.9% were underweight based on the BMI/A indicator. The assessment of EN adequacy demonstrated that 49.3% reached the caloric requirements and 76.1% reached the protein requirements, with maximal intakes of 65.6 Kcal/Kg/day and 1.95 g of protein/kg/day. Malnourished patients had greater mean Z scores for W/A and BMI/A at the end of EN, whereas no significant changes were found among patients with adequate nutritional status and significant reductions in these indicators were found among those with overweight or obesity. Conclusion: The patients either maintained or achieved a significant improvement in nutritional status, which demonstrates the importance of nutritional support and follow up during hospitalization.Introducción: El soporte nutricional individualizado se considera una terapia importante en oncología pediátrica y, como tal, debe integrarse en el tratamiento global de estos pacientes. Objetivo: Evaluar el estado nutricional de los pacientes sometidos a

  7. 机械通气病人肠内营养应用时机的临床对照研究%Early enteral nutrition support in mechanical ventilation patients

    Institute of Scientific and Technical Information of China (English)

    戴幼竹; 臧芝栋

    2011-01-01

    Objective: To explore the effect of early enteral nutrition support on nutritional status and clinical therapeutic effect in mechanical ventilation patients. Methods: 118 mechanical ventilation patients were randomly divided into two groups: early enteral nutrition group ( n = 59) and late enteral nutrition group ( n = 59). The levels of serum albumin, prealbumin, transferrin and nitrogen balance were assessed for 7 days since the onset of mechanical ventilation. Mechanical ventilation time, ICU length of stay and hospital length of stay and the incidence of ventilated-associated pneumonia (VAP) were compared between the groups. Results: The serum prealbumin level and nitrogen balance were much higher in early enteral nutrition group than that in late enteral nutrition group on the 7th day (P <0.05). Compared with the late enteral nutrition group, mechanical ventilation time, ICU length of stay and hospital length of stay was shorter and incidence of VAP was lower in early enteral nutrition group (P < 0.05 ).Conclusion: Early feeding can improve nutrition status and the outcome of mechanical ventilation patients.%目的:探讨早期肠内营养(EEN)对机械通气病人营养状态和临床疗效的影响. 方法:将118例行机械通气的重症病人随机分为早期EN组(机械通气开始后48 h内实施EN)和晚期EN组(机械通气开始48 h后实施EN),每组各59例.检测机械通气开始当天和治疗后第7天血清清蛋白、前清蛋白、转铁蛋白和氮平衡的变化.比较两组病人机械通气时间、入住ICU时间、住院时间和呼吸机相关肺炎(VAP)的发生率. 结果:机械通气第7天,早期EN组病人前清蛋白水平明显高于晚期EN组(P<0.05).早期EN组病人机械通气后恢复至正氮平衡早于晚期EN组;机械通气时间、入住ICU时间和住院时间均短于晚期EN组病人(P<0.05);VAP发生率也低于晚期EN组病人(P<0.05). 结论:机械通气的病人应尽早给予EN,有利于病人营养

  8. Tratamiento dietético-nutricional en la enteritis rádica crónica: A propósito de un caso clínico complejo Dietetic-nutritional treatment in chronic radiation enteritis: Apropos of a complex clinical case

    Directory of Open Access Journals (Sweden)

    A. Fernández de Bustos

    2003-08-01

    were as follows: A 60-year-old female patient with adenocarcinoma of the rectum who required a left hemicolectomy (Hartmann, receiving chemotherapy with fluorouracil and external radiation therapy (45 Gy, presenting sub-occlusive episodes five months later that required a first surgical treatment with release of adhesive bands suggesting radiation enteritis. The patient presented progressive intolerance to oral feeding and nutritional supplements, accompanied by severe malnutrition, requiring parenteral nutrition (PN, endovenous fluid therapy and requiring a second surgical intervention due to persistence of the occlusive condition, with resection of 70 cm of the terminal ileum with ileum-colon anastomosis. The pathological analysis of the segment confirmed chronic radiation enteritis, persisting with clinical manifestations of sub-occlusion and radiological alterations compatible with radiation enteritis on the remaining intestine. The dietetic and nutritional management following admission was exclusive parenteral nutrition for 3 months, receiving formula food with glutamine for four months, associated, after 79 days of intestinal rest, with oral formula diets (Basic formula with amino acids as protein source and Standard diet and with a gradual reduction in the number of weekly infusions until nutritional autonomy was restored after 10 months with PN, with her nutritional needs being covered completely by the digestive route. Subsequently, a mixed regime was established combining diet therapy with good tolerance and normalization of the nutritional status with a return to weight prior to illness and an improvement in radiation enteritis and biochemical parameters.

  9. COMPARATIVE STUDY FOR DIFFERENT NASOGASTRIC ENTERAL NUTRITION APPROACHES IN PATIENTS WITH ACUTE STROKE%不同鼻饲途径肠内营养应用于急性脑卒中患者的比较研究

    Institute of Scientific and Technical Information of China (English)

    蒋丽君; 吕蔚萍

    2012-01-01

    [目的]探讨经鼻肠管肠内营养与经鼻胃管肠内营养两种途径应用于急性脑卒中患者的安生性.[方法]某院2009年2月~2011年9月期间共收治急性脑卒中患者120例,均行肠内营养,根据鼻饲途径的不同分为观察组和对照组各60例,观察组采用鼻肠管,对照组采用传统的鼻胃管,观察、记录两组患者胃潴留、呕吐、误吸和反流等并发症的发生情况,并进行比较.[结果]观察组并发症(胃潴留、呕吐、误吸和反流)的发生率明显低于对照组,两组比较差异有统计学意义(P<0.01).[结论]经鼻肠管肠内营养较传统鼻胃管肠内营养并发症发生率低,安生可靠、营养均衡,有利于患者的早期康复,值得临床推广.%[Objective] To investigate the safely of the two ways of enteral nutrition and intestinal nasal enteral nutrition by nasogastric tube used in patients with acute stroke. [Methods] 120 patients admitted with acute stroke in our hospital from February 2009 to September 2011 were all took enteral nutrition. According to the nasal pathways, they were divided into the observation group with 60 cases and the control group with 60 patients. The control group took nasal intestine, the control group usd traditional nasogastric tube. The gastric retention, vomiting, aspiration, and reflux and other complications for patients of the the two groups were observed and record, and then compared. [ Results] The study showed that the complications of the observation group (gastric retention, vomiting, aspiration and reflux) were significantly lower than the control group, the difference was statistically significant (P< 0.01). [Conclusion] The incidence of complications for enteral nutrition by nasogaslric tube was low, safe and reliable, and nutritionally balanced as to intestinal nasal enteral nutrition by nasogastric tube. It is beneficial in patients with early rehabilitation, and worthy of promotion in clinical application.

  10. 胃癌术后早期瑞素肠内营养对患者机体营养状况的影响%Nutritional effects of early Enteral fresubin nutrition on the postsurgical patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    王静东; 郭倩; 王琦三; 阿地里

    2011-01-01

    [Objective] To investigate the nutritional effects of early Fresubin enteral nutrition on the postsurgical patients with gastric cancer. [Methods] Sixty postsurgical patients with gastric cancer were randomly divided into early enteral nutrition (EEN) group and parenteral nutrition (PN) group. Starting at the day 1 post surgery, the subjects in EEN group received early Fresubin enteial nutrition, whereas the subjects in CPN group received conventional total parental nutrition for 7 days. At the day before surgery and the day 1 and day 8 post surgery, we collected the blood samples from the all subjects and measured plasmid albumin (ALB), prealbumin (PA), transferring (TF), unconjugated bilirubin (UCB), conjugated bilirubin (CB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (CREAT), and blood urea nitrogen (BUN). We also monitored clinical demographics and illness severity parameters. [Results] Plasma ALB, PA, and TF were significantly decreased in the two groups at the day 1 post surgery versus before surgery (P < 0.05), but no significant difference in the two groups at the day 8 post surgery. Additionally, no significant difference was observed for UCB, CB, ALT, AST, CREAT, and BUN between two groups before and after nutrition administration. However, the subjects in EEN group showed significantly shorter time in restoring bowel movement compared to the subjects in the PN group post surgery (P < 0.01). [Conclusion ] In VPC from RVOT the width of R wave in lead H , HI, AVF was sensitive to localize VPC from free wall or septal. QRS configuration in lead I was of use to distinguish VPC from anterior or posterior part within RVOT. The amplitude of R wave in leadII , HI, AVF combined with R/S transition in precordial lead could predict VPC adjacent to pulmonary valve or tricuspid valve.%[目的]探讨早期瑞素肠内营养对胃癌患者术后机体营养状况的影响.[方法]选取我院和新疆

  11. 重症脑卒中患者早期肠内和肠外营养支持的对比分析%Enteral Nutrition Versus Parenteral Nutrition for Early Support of Patients with Severe Stroke

    Institute of Scientific and Technical Information of China (English)

    钱平安; 王碧炯; 査芹

    2011-01-01

    Objective To compare the effectiveness of enteral nutrition ( EN ) and parenteral nutrition ( PN ) for the early support of patients with severe stroke. Methods Totally 91 patients with severe stroke accompanied with dysphagia were randomly divided into EN group ( n =46 ) and PN group ( n =45 ). The complications, intensive care unit ( ICU ) stay, survival, hospital costs. and nutritional parameters were compared between the two groups. Results The incidence of complications was 50. 0% ( 22/46 ) in EN group and 93. 3% ( 42/45 ) in control group ( P <0. 05 ). The nutritional parameters were significantly superior in EN group than in PN group. Compared with PE group , albumin significantly increased and alanine aminotransferase/blood sugar significantly decreased in EN group ( P < 0. 05 ). Conclusion Early EN support in patients with severe stroke can improve the body's nutritional indicators , reduce the incidence of complications, shorten ICU stay , prolong survival,and lower hospital costs.%目的 探讨重症脑卒中患者早期接受营养支持治疗对并发症及营养指标的影响.方法 选择重症脑卒中伴吞咽障碍患者91例,随机分为肠内营养组46例和肠外营养组45例,进行对照研究,观察两组患者的并发症、入住ICU时间、死亡患者的生存时间、住院费用及营养指标的变化.结果 肠内营养组并发症发生率为47.8%(22/46);肠外营养组并发症发生率为93.3%(42/45),两组比较差异有统计学意义(P<0.05).肠内营养组在入住ICU的时间、住院费用、死亡患者的生存时间方面与肠外营养组比较,差异均有统计学意义(P<0.05).治疗后肠内营养组的清蛋白水平明显增高,丙氨酸氨基转移酶及血糖水平明显降低,与肠外营养组比较差异均有统计学意义(P<0.05).结论 早期肠内营养支持可改善重症脑卒中患者机体的营养指标,降低并发症的发生率,缩短入住ICU时间,延长死亡患者的生存时间,降低住院费用.

  12. 不同鼻饲法在高龄重型脑出血患者肠内营养中的应用%Application of different nasal feedings in enteral nutrition for elderly patients with severe brain hemorrhage

    Institute of Scientific and Technical Information of China (English)

    何惠美; 刘文青; 刘景端; 温春霞; 郭苑秋; 郭苑芳

    2015-01-01

    Objective To explore the effect of different nasal feedings in enteral nutrition for elderly patients with severe brain hemorrhage. Methods Eighty elderly patients with severe brain hemorrhage were assigned into the observation group and control group according to the odd and even numbers at admission with 40 in each group. The control group was treated with graded injection nasal feeding, and the observation group was treated with continuous infusion nasal feeding. The nutrition indicators and enteral nutrition complications were compared between the two groups. Result The nutrition indicators in the observation group were better than those in the control group and the rate of enteral nutrition complications in the observation group was lower than that in the control group (P<0.05). Conclusion Continuous infusion nasal feeding can improve the nutritional status of elderly patients with severe cerebral hemorrhage and effectively reduce the incidence of complications of enteral nutrition. So it is worthy of clinical application.%目的:探讨持续滴注鼻饲法和分次注入鼻饲法在高龄重型脑出血患者肠内营养中的应用效果。方法将80例高龄重型脑出血住院患者,按入院先后顺序分为观察组和对照组,每组各40例。对照组采用分次注入鼻饲法,观察组采用持续滴注鼻饲法。观察两组患者营养指标和并发症发生情况。结果观察组患者各项营养指标均优于对照组;并发症发生率均低于对照组,两组比较,差异均有统计学意(P<0.05)。结论持续滴注鼻饲法可改善高龄重度脑出血患者的营养状况,有效降低肠内营养并发症的发生,值得临床推广应用。

  13. Influence of Early Enteral Nutrition on the Intestinal Function Recovery of Postoperative Gastric Cancer%早期肠内营养对胃癌术后肠功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    黄俊勇

    2013-01-01

    Objective:To investigate the effects of early enteral nutrition on intestinal function recovery of patients with postoperative gastric cancer. Methods:80 patients were divided into observation group and control group according to the postoperative trophic modes, observation group adopted early enteral nutrition, while the control group received parenteral nutrition, to compare the influence of intestinal function recovery with two kinds of trophic modes. Results:Recovery time of intestinal function, protein level and body weight of observation group were all superior to those of con-trol group (P<0.05). Conclusion:Early enteral nutrition on patients with postoperative gastric cancer is safe and effective, which can shorten recov-ery time of intestinal function, improve the nutritional status and enhance patients' immunity.%  目的:探讨早期肠内营养对胃癌术后患者肠功能恢复的影响。方法:将80例患者根据术后营养方式分为观察组及对照组,观察组采用早期肠内营养,对照组行肠外营养,比较两种营养方式对患者肠功能恢复的影响。结果:观察组患者肠功能恢复时间、蛋白水平及体重均优于对照组(P<0.05)。结论:胃癌术后患者行早期肠内营养安全有效,能缩短患者肠功能恢复时间,改善营养状况,提高机体免疫力。

  14. 胃癌患者术后个体化早期肠内营养支持的效果观察%Observation effect of early individualized enteral nutrition support in patients with gastric cancer after operation

    Institute of Scientific and Technical Information of China (English)

    孙莹; 季烨; 马燕君

    2016-01-01

    Objective To investigate the clinical effect of early individualized enteral nutrition support in patients with gastric cancer after operation.Method According to the admission time a total of 90 cases of patients with gastric cancer after operation were selected.Patients in the control group(44 cases)received conventional enteral nutrition support nursing,the experimental group(46 cases)on the basis of the individual enteral nutritional support program,including preoperative NRS -2002 nutrition risk screening,the establishment of the nutritional support group,monitoring of weight calculation adjustment of heat,individual-ized composition and concentration.Evaluation of nutritional index and recovery time after two weeks of enteral nutrition in two groups of patients.Results The experimental group after nutritional support serum nutrition indicators were better than the control group,the control group was earlier in the recovery time after surgery,compared two groups of data,the difference was statistically significant (P <0.05).Conclusion Individualized enteral nutrition can improve the nutritional status of patients with early gas-tric cancer after operation,promote the rehabilitation of patients.%目的:探讨胃癌患者术后给予个体化早期肠内营养支持的临床效果。方法:根据入院时间先后选取胃癌术后患者共90例,对照组44例给予常规肠内营养支持护理,试验组46例在此基础上采用个体化肠内营养支持方案,包括术前 NRS -2002营养风险筛查、成立营养支持小组、监测体重计算热量、个体化配方及浓度的调整。评价两组患者肠内营养支持两周后血清营养学指标及术后恢复时间。结果:试验组营养支持后血清营养学指标均优于对照组,术后恢复时间均早于对照组,两组数据比较,差异有统计学意义(P <0.05)。结论:胃癌术后早期给予个体化肠内营养支持方案有利于改善患者营养

  15. 混合肠内营养支持对老年脑卒中患者的疗效观察%Curative observation of different enteral nutrition support in elderly stroke patients

    Institute of Scientific and Technical Information of China (English)

    梁倩芳

    2013-01-01

      目的探讨混合肠内营养(EN)支持对老年脑卒中患者营养状况的影响。方法将69例老年脑卒中患者随机分为观察组35例和对照组34例。观察组采用传统推注普通匀浆膳+持续输注能全力肠内营养混悬液,对照组采用传统推注普通匀浆膳。观察两组患者营养支持前后各项营养指标的变化并比较疗效。结果观察组营养支持后第7、14d总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、血红蛋白(HGb)水平均明显高于对照组,差异有统计学意义(P <0.05)。结论采取传统推注匀浆膳加持续输注肠内营养混悬液的混合肠内营养支持方式,能增加老年脑卒中患者摄入量,提高血清蛋白水平,改善机体的营养状况。%  Objective To investigate the Curative observation of different enteral nutrition support in elderly stroke patients. Methods 69 cases with elderly stroke patients were randomly divided into observation group(n=35) and control group(n=34). Cases in observation group were treated enteral nutrition support with Nutrison Fibre and homogenate die, while cases in control group were treated with homogenate diet. Indicators of nutrition status were detected in two groups both before and after nutrition support, changes of all nutrition indicators of the two groups have been detected. Results Levels of TP, ALB, PA and HGb were significantly higher after receiving nutrition on the 7th and 14th day in observation group than those in control group(P <0.05). Conclusion Enteral nutrition support with Nutrison Fibre and homogenate diet can take in more protein and caloric, can improve nutritional status of elderly stroke patients.

  16. Analysis of the Effect of Early Enteral Nutrition on Postoperative Patients With Gastric Cancer%早期肠内营养对胃癌术后患者影响分析

    Institute of Scientific and Technical Information of China (English)

    于洪玥

    2015-01-01

    Objective To investigate the effect of early enteral nutrition in patients after radical gastric cancer.Methods 90 patients in our hospital with gastric cancer surgery were devided 50 patients into observation group, and 40 patients in the control group.Compared in patients with bowel function recovery time and postoperative nutritional status. Results The postoperative intestinal function recovery time was significantly shorter than the control group, the nutritional situation was significantly better than the control group.ConclusionsEarly enteral nutrition is conducive to the prognosis of gastric cancer patients .%目的:探讨早期肠内营养对胃癌根治术后患者的影响。方法选取我院收治并行根治术的胃癌患者90例,观察组40例,对照组50例,比较两组患者肠功能恢复时间及术后营养状况。结果观察组术后肠功能恢复时间比对照组短,营养状况优于对照组。结论早期肠内营养有利于胃癌根治术后患者的预后。

  17. Effect of enteral feeding ELENTAL on nutritional status of burned patients%要素营养制剂ELENTAL对烧伤患者营养状况的维护效应

    Institute of Scientific and Technical Information of China (English)

    颜洪; 汪仕良; 彭朝阳; 李江

    2003-01-01

    AIM:To investigate the maitainance effect of enteral feeding ELENTAL on intestine,liver and nutritional status of burned patients.METHODS:30 cases of burned patients were randomly devided into ELENTAL feeding group(E group) and intravenous nutrition group(control, D).The whole calorie in group E were supplied by feeding elemental diet ELENTAL and those in group D were supplied by intravenous nutrition from the third day after burning.the supplemented calorie and nitrogen were equal in two groups. Before the experiment and on the 5th day and 10th day,blood were drawn to examine the levels of and serum transferring.RESULTS:There were no significant difference of serum lipid and serum transferring levels on the 7th day and 10th day in burned patients.CONCLUSION:ELENTAL diet can protect intestine effectively and improve nutritious status of the burned patients.

  18. Effectiveness of a voluntary nutrition education workshop in a state prison.

    Science.gov (United States)

    Curd, Philip; Ohlmann, Kathleen; Bush, Heather

    2013-04-01

    Improved nutrition has implications for both prisoners and the penal system. This study evaluated a pilot intervention to improve nutrition in prisoners. Residents of a correctional substance abuse program (SAP) completed a health risk appraisal (HRA) upon entering the SAP and at completion. Nineteen participants in a pilot nutrition workshop were matched with 37 nonparticipant controls. Analysis of changes in HRA responses relating to nutrition, general health, and social ties found that a significantly greater proportion of participants than controls reported improved nutrition practices (23.5% vs. 3.2%, p = .047). Participants were 4 times more likely to report improved general health than controls (52.6% vs. 13.9%, p = .002). A smaller proportion of participants than controls reported improved social ties (10.5% vs. 30.6%, p = .18). This study suggests that inmate participants and the penal system may benefit from nutrition workshops. Further investigation should involve a larger study population.

  19. 胃癌术后早期肠内营养对改善营养状况及降低并发症的价值%Effect of Early Postoperative Enteral Nutrition on Gastric Cancer Patients’ Nutritional Status and Complications

    Institute of Scientific and Technical Information of China (English)

    叶培军

    2014-01-01

    目的:分析胃癌术后早期肠内营养对改善营养状况及降低并发症的价值。方法选择在本院接受手术治疗的胃癌患者作为研究对象,随机分为术后常规营养的对照组及术后早期肠内营养的观察组,比较其术后营养指标及并发症发生率等差异。结果观察组患者术后早期营养指标值明显优于对照组患者(P<0.05);各项并发症发生率明显低于对照组患者(P<0.05)。结论胃癌术后患者早期行肠内营养可提高患者的术后营养指标,且降低各项并发症的发生率,具有积极的临床意义。%Objective To analyze the Effect of early postoperative enteral nutrition on gastric cancer patients’ nutritional status and complications. Methods Choosed patients with gastric cancer underwent surgery in our hospital as study object, randomly divided into control group with routine postoperative nutritional and observation group with early postoperative enteral nutrition, compared postoperative nutritional indicators and complications incidence. Results Observation group patients postoperative nutritional value index was higher than control group patients (P<0.05); complication rate was significantly lower than control group patients(P<0.05). Conclusions Early postoperative enteral nutrition in patients can improve nutrition indicators, reduce incidence of various complications, had positive clinical significance.

  20. 胃癌全胃切除术后早期肠内营养的临床应用%Clinical application of early enteral nutrition after total gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    栾炯地

    2014-01-01

    目的:观察胃癌全胃切除术后早期肠内营养的应用效果。方法:将胃癌全胃切除术患者82例随机分为肠内营养组42例和全肠外营养组40例,比较两组术后7天营养指标、免疫指标、血糖、肝功指标等变化,以及术后肠道功能恢复时间、不良反应。结果:两组营养指标和免疫指标均较术前改善,其中肠内营养组改善情况较全肠外营养组明显(P<0.05)。全肠外营养组经营养支持后空腹血糖、肝功指标均高于术前水平(P<0.05),而肠内营养组该指标变化较平稳(P>0.05)。肠内营养组术后肠道功能恢复明显,较全肠外营养组快(P<0.05)。结论:胃癌全胃切除术后在严密监护下实施早期肠内营养,有助于患者的康复,安全可靠,值得应用。%Objective:To observe the application effect of early enteral nutrition after total gastrectomy for gastric cancer.Methods:82 cases with total gastrectomy for gastric cancer were randomly divided into the enteral nutrition group in 42 cases and the total parenteral nutrition group in 40 cases.7 days after the operation,the changs of nutritive index,immune index,blood glucose,hepatic function index of patients in two groups were compared.The postoperative intestinal function recovery time,adverse reaction were compared.Results:Compared with pre-operation,the nutritive index and immune index of two groups were improved,and the improvement situation of the enteral nutrition group was significant than that of the total parenteral nutrition group(P0.05). Postoperative intestinal function recovery of the enteral nutrition group was much faster than that of the total parenteral nutrition group(P<0.05).Conclusion:The implement of early enteral nutrition after total gastrectomy for gastric cancer under the close guardianship can help the rehabilitation of patients.It is safe and reliable.So it is worth of application.

  1. Perioperative clinical care of parenteral and enteral nutrition supports in post-hepatectomy patients%肝切除患者围手术期营养支持的护理作用

    Institute of Scientific and Technical Information of China (English)

    门吉芳; 李磊; 付申凌; 张丹静; 金向晖; 崔红元; 朱明炜; 韦军民

    2009-01-01

    目的 评述肝切除患者围手术期营养支持的护理作用.方法 146例接受肝切除手术的患者人院后进行营养风险筛查,术前给予肠内营养,术后进行肠外和肠内营养支持,围绕术后营养指标变化、临床部分结局指标,就诊治过程中的各种护理方法进行总结.结果 146例患者营养风险筛查评分≥3分者91例,<3分者55例;接受肠外肠内营养支持者118例,平均肠内营养支持时间9.6 d,平均肠外营养支持时间5.4d;术后平均肛门排气时间(70.7±17.1)h;死亡3例,术后感染15例次,其他并发症13例,中位住院习25.5 d.结论 肝切除患者人院后应进行营养风险筛查,围手术期营养支持以肠内营养为主,术后需要联合肠外营养,强化护理作用是实施营养支持的保障.%Objective To summarize the perioperative clinical care experience of parenteral and enteral nutrition supports in post-hepatectomy patients.Methods The clinical data of 146 consecutive post-hepatectomy patients in Beijing Hospital were collected and analyzed.For these patients,nutritional risk screening (NRS) 2002 was performed after admission,enteral nutrition support was provided before operation,and enteral and parenteral nutrition supports were provided after operation.Nutritional parameters,clinical outcomes,and nursing methods were evaluated.Results Among these 146 patients,91 patients had≥3 NRS2000 scores,and the remaining 55 patients scored < 3.A total of 118 patients were administrated with enteral and pareteral nutrition;the average enferal nutrition time was 9.6 days,and the average pareteral nutrition time was 5.4 days.The average onset time of passage of gas by anus afar operation was (70.7±17.1) hours.Three patients died,15 patients suffered from infections after operation,and 13 patients experienced other complications.The median hospital stay was 25.5 days.Conclusions Post-hepatectomy patients need take nutritional risk screening after admission and

  2. Factores pronósticos de morbi-mortalidad en nutrición enteral hospitalaria: estudio prospectivo Prognostic morbidity and mortality factors in hospital enteral nutrition: prospective study

    OpenAIRE

    O. Moreno Pérez; A. Meoro Avilés; A. Martínez; Boix, E.; S.; Aznar; M.ª D. Martín; A. M. Picó

    2005-01-01

    Objetivos: Determinar aquellos factores pronósticos que mejor puedan prever el resultado de una intervención nutricional vía enteral y evaluar la calidad asistencial de una unidad de nutrición. Ámbito y sujetos: Pacientes que precisaron nutrición enteral en régimen de ingreso hospitalario, en un centro de 3.er nivel. Intervenciones: Estudio observacional, prospectivo, en el que se incluyeron 160 pacientes mediante muestreo consecutivo, durante un período de seguimiento de 6 meses. Se determin...

  3. Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake Evaluación nutricional a largo plazo de pacientes con grave síndrome de intestino corto controlada con nutrición enteral e ingestión oral

    Directory of Open Access Journals (Sweden)

    V. Chaer Borges

    2011-08-01

    Full Text Available Background: Parenteral nutrition (PN is used to control the nutritional state after severe intestinal resections. Whenever possible, enteral nutrition (EN is used to promote intestinal rehabilitation and reduce PN dependency. Our aim is to verify whether EN + oral intake (OI in severe short bowel syndrome (SBS surgical adult patients can maintain adequate nutritional status in the long term. Methods: This longitudinal retrospective study included 10 patients followed for 7 post-operative years. Body mass index (BMI, percentage of involuntary loss of usual body weight (UWL, free fat mass (FFM, and fat mass (FM composition assessed by bioelectric impedance, and laboratory tests were evaluated at 6, 12, 24, 36, 48, 60, 72, and 84 months after surgery. Energy and protein offered in HPN and at long term by HEN+ oral intake (OI, was evaluated at the same periods. The statistical model of generalized estimating equations with p Antecedentes: La nutrición parenteral (NP se emplea para controlar el estado nutricional después de resecciones intestinales extensas. Siempre que sea posible, se empleará la nutrición enteral (NE para favorecer la rehabilitación intestinal y reducir la dependencia de la NP. Nuestro propósito fue verificar si la NE + ingesta oral (IO en el síndrome del intestino corto (SIC grave en pacientes adultos quirúrgicos puede mantener un estado nutricional adecuado a largo plazo. Métodos: Este estudio longitudinal retrospectivo incluyó 10 pacientes seguidos durante 7 años tras la intervención quirúrgica. Se evaluaron el índice de masa corporal (IMC, el porcentaje de pérdida involuntaria del peso corporal habitual (PCH, la masa grasa libre (MGL y la composición de la masa grasa (MG mediante impedancia bioeléctrica, así como los datos de laboratorio a los 6, 12, 24, 36, 48, 60, 72 y 84 meses tras la cirugía. Se evaluaron en los mismos periodos la energía y las proteínas aportadas con la NPD y a largo plazo con la NED

  4. A comparative analysis of curative effect of Prebiotics enhanced enteral nutrition and conventional enteral nutrition on patients with severe acute pancreatitis%益生元强化肠内营养与常规肠内营养对重症急性胰腺炎治疗作用的对比分析

    Institute of Scientific and Technical Information of China (English)

    黄成良

    2016-01-01

    目的 探讨益生元强化肠内营养(prebiotic fiber enriched enteral nutrition,PEN)与常规肠内营养(enteral nutrition,EN)对重症急性胰腺炎(severe acute pancreatitis,SAP)疗效的差异.方法 自2013年8月至2015年6月按照连续采样的方法,收集确诊为SAP住院治疗的46例患者的临床资料.随机数字表法将患者随机分为PEN、EN两组,EN组接受常规早期肠内营养,PEN组在EN组营养配方的基础上添加益生元.比较两组患者总体住院时间、ICU入住时间、肠内营养支持时间、血淀粉酶/CRP/APACHEⅡ评分/CTSI评分恢复正常时间、并发症发生率、病死率及住院费用的差异.结果 患者分组结果为PEN组25例,EN组21例.患者年龄分布,性别/病因构成,平均BMI,平均发病至入院时间,入院血淀粉酶、CRP、前白蛋白(prealbumin,PA)、入院APACHEⅡ/CTSI评分比较,组间无显著性差异(P>0,05).患者临床经过及结局相比,PEN组患者住院时间、肠内营养支持治疗时间、APACHEⅡ评分恢复正常时间、CTSI评分恢复正常时间相对较短,并发症发生率相对较低,住院费用相对较少,组间差异有统计学意义(P均<0.05).结论 与传统肠内营养相比,益生元强化的肠内营养更有助于降低SAP患者的感染性并发症发生率和死亡率,加速患者康复,值得临床进一步研究探索.

  5. 严重烧伤后不同时机实施肠内营养的对比研究%A Comparative Study on Enteral Nutrition in Different Times for Patients with Severe Burns

    Institute of Scientific and Technical Information of China (English)

    徐风瑞; 乔亮; 姚忠军; 杨帆; 何明武

    2016-01-01

    目的:通过观察严重烧伤患者不同时机实施肠内营养的临床效果,探讨严重烧伤后实施肠内营养的最佳时机。方法收集2012年6月-2015年10月烧伤面积≥30%的烧伤患者合计86例,根据实施肠道复苏时机不同分为A组(29例,伤后6 h内实施)、B组(27例,伤后24~48 h实施)及C组(30例,伤后48 h后实施)。肠道复苏应用肠内营养乳剂瑞高。对比观察3组胃肠动力状况,入院第1、3、7、14天营养状况指标,以及血清降钙素原( PCT),血浆革兰阴性菌脂多糖( LPS),C-反应蛋白( CRP)变化。结果 A组便秘发生率少于B、C组,首次排便时间早于B、C组(P<0.05);A组住院第3、7天白蛋白、前白蛋白水平均优于B、C组,同时B组优于C组(P<0.05);A组住院第3、7、14天CRP水平和第3、7天PCT及LPS水平均低于B、C组(P<0.05)。结论以6 h以内起始的早期肠内营养是可行的,与24及48 h后延期肠内营养比较,具有更好的改善营养及降低机体炎性反应的效果。%Objective To observe the clinical effect of enteral nutrition at different times on patients with severe burn in order to study the best time for the implementation of enteral nutrition after severe burns. Methods A total of 86 severely burnt patients with burn area equal or greater than 30% of total body surface area ( TBSA) during June 2012 and October 2015 were divided into group A (treated with enteral nutrition within 6 h after injury, n=29), group B (treated with enteral nutrition within 24-48 h after injury, n=27) and group C ( treated with enteral nutrition 48 h after injury, n=30 ) . The conditions of gastrointestinal motility and the changes of nutritional status indexes, serum procalcitonin (PCT), plasma gram negative bacterial lipopolysaccharide (LPS) and C-reactive protein (CRP) the1st, 3rd, 7th and 14th d after admission were compared and observed in the three groups. Results Compared with those in group B and C, in group A, the

  6. Ⅱ型糖尿病的营养治疗与肠内营养支持%Medical nutrition therapy(MNT) and enteral nutrition(EN)for type Ⅱ diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    于良; 蒋朱明; 等

    2001-01-01

    营养治疗是Ⅱ型糖尿病综合治疗的基本组成部分。本文介绍了美国糠尿病协会(ADA)2000年提出的营养治疗的目标,以及基于现有的临床经验和普遍认识而提出的热量及营养素推荐存量标准。对于难以经口摄取自然膳食的糖尿病患者,应首选肠内营养。密切监测血糖、糖化血红蛋白、血脂、血压、体重及肾功能的代谢指标以及生活方式等,是保证治疗成功的关键。%Medical nutrition therapy (MNT) is an essential component oftotal 2 type diabetes mellitus (DM) care and management.This review reflects the overall goal of MNT from American Diabetes Association (ADA) in 2000,and the dietary reference recommendations based on current clinical experiences and consensus.For the DM patients who could hardly take normal diet,enteral nutrition(EN) should be the first of choice.Monitoring metabolic paramenters,including blood glucose levels,glycated hemoglobin,lipids,blood pressure,body weight,and renal function,as well as quality of life,is crucial to ensure successful outcomes.作者单位:于康(中国医学科学院中国协和医科大学北京协和医院北京 100730,中国) 王女亘(中国医学科学院中国协和医科大学北京协和医院北京 100730,中国) 蒋朱明(中国医学科学院中国协和医科大学北京协和医院北京 100730,中国)

  7. Nursing observation early postoperative gastrointestinal surgery in elderly patients with jejunal enteral nutrition infusion%胃肠外科老人术后早期空肠输注肠内营养护理

    Institute of Scientific and Technical Information of China (English)

    罗美珍

    2015-01-01

    目的: 对应用综合护理干预模式对接受胃肠外科手术治疗的老年患者在术后早期空肠输注肠内营养支持过程中实施护理的临床效果进行研究.方法:选择接受胃肠外科手术治疗的老年患者86例,随机分为对照组和观察组,每组43例,在术后均实施早期空肠输注肠内营养支持.采用综合护理干预模式对观察组患者在营养支持期间实施护理;采用常规护理模式对对照组患者在营养支持期间实施护理.结果:观察组患者对术后营养支持期间的护理服务满意度明显高于对照组;术后营养支持计划实施时间和住院时间明显短于对照组.结论:应用综合护理干预模式对接受胃肠外科手术治疗的老年患者在术后早期空肠输注肠内营养支持过程中实施护理的临床效果非常明显.%Objective:The clinical effect of comprehensive nursing intervention model for application acceptance of gastrointestinal surgical treatment of elderly patients in the early postoperative jejunal enteral nutrition infusion during the implementation of nursing research. Methods:In our hospital receiving treatment in elderly gastrointestinal surgery 86 patients were randomly divided into control group and observation group, 43 cases on average each group, in implementation of early postoperative jejunal infusion of enteral nutrition. Integrated nursing intervention model to observe patients during nutritional support of nursing; conventional nursing model for the control group of patients nutritional support during the implementation of care. Results:The patient satisfaction with care during the postoperative nutritional support significantly higher; postoperative nutritional support program implementation time and total time in hospital receiving treatment was significantly shorter than the control group. Conclusion:Comprehensive nursing intervention model for accepting gastrointestinal surgery in elderly patients in the early

  8. Observation of the effect of early enteral nutrition in patients with gastric cancer after operation%胃肿瘤术后早期应用肠内营养护理的效果观察

    Institute of Scientific and Technical Information of China (English)

    华美琳

    2016-01-01

    Objective:To observe and analyze the effect of early enteral nutrition in patients with gastric cancer after operation. Methods:70 patients with gastric cancer were selected.They were divided into two groups.The two groups of patients were treated with subtotal gastrectomy.The control group were treated with parenteral nutrition,and the observation group were treated with enteral nutrition.The clinical effect was compared.Results:The recovery time, body weight and length of stay of the patients in the observation group were higher than those in the control group(P<0.05).Conclusion:Enteral nutrition can promote the recovery of patients with gastric cancer after operation.%目的:观察并分析胃肿瘤患者术后早期应用肠内营养护理的效果。方法:收治胃肿瘤患者70例,分两组。两组患者均采取胃大部切除术进行治疗,对照组实施肠外营养护理,观察组采取肠内营养护理,对比临床效果。结果:观察组的肠蠕动恢复时间、体重差值以及住院时间指标等均优于对照组(P<0.05)。结论:对胃肿瘤术后早期患者实施肠内营养护理,能促进患者康复。

  9. Pediatric Enteral Access Device Management.

    Science.gov (United States)

    Abdelhadi, Ruba A; Rahe, Katina; Lyman, Beth

    2016-10-13

    Enteral nutrition (EN) support has proven to be a nutrition intervention that can provide full or partial calories to promote growth and development in infants and children. To supply these nutrients, an enteral access device is required, and the use of these devices is growing. Placement of the proper device for the patient need, along with appropriate care and monitoring, is required for individualized patient management. When complications arise, early identification and management can prevent more serious morbidity. Complication management requires a tiered approach starting with staff nurses and ending with a physician expert. In addition to this, each institution needs to have an approach that is coordinated among disciplines and departments to promote consistency of practice. The formation of an enteral access team is a conduit for clinical experts to provide education to families, patients, and healthcare professionals while serving as a platform to address product and practice issues. © 2016 American Society for Parenteral and Enteral Nutrition.

  10. Effect of minimal enteral feeding on recovery in a methotrexate-induced gastrointestinal mucositis rat model

    NARCIS (Netherlands)

    N.S.S. Kuiken (Nicoline S. S.); E.H.H.M. Rings (Edmond); R. Havinga (Rick); A. Groen (Albert); W.J.E. Tissing (Wim)

    2016-01-01

    textabstractPurpose: Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administratio

  11. 危重病人达到肠内营养支持营养目标的短期疗效%The short term effect of enteral nutrition support which achieve the nutritional goal on criticalpatients

    Institute of Scientific and Technical Information of China (English)

    吕利; 刘庆春; 李瑛; 杜金赞

    2000-01-01

    目的对1998年以来临床28例危重病人,实施达到营养目标的肠内营养支持,并做了短期疗效观察.方法1.依病情需要分TEN管饲匀浆膳、要素膳组(一组)9例,外科6例,内科3例,支持时间平均25.8天.EN+PN组(二组)9例,外科7例,内科2例,支持时间平均22.1天.口服营养补充剂组(三组)10例,外科7例,内科3例,支持时间平均16.1天.每日摄人热能以BEE×活动系数×应激系数公式计算,蛋白质平均1.2g/kg,脂肪平均占25%,碳水化物平均占55%.维生素、矿物质、微量元素以RDA计算. 2.营养目标:①恢复或保持血浆白蛋白正常水平.②降低异常或保持血糖正常水平.③纠正电解质平衡紊乱.结果短期内血浆白蛋白达标率分别为:89%、78%、80%,血糖达标率为:89%、86%、80%,离子达标率为:K78%、100%、80%,Na89%、88%、90%,Cl100%、88%、100%,Ca89%、100%、100%,P100%、100%、100%o 结论虽然三组各自的应用范围不同,但只要有明确的营养目标,各组血浆白蛋白、血糖、血清离子在短期内都会取得显著改善,有效地提高疾病临床治愈率.应注意的是在临床实际应用时,为防止正常血糖、离子等的异常变化,营养医师应及时了解病情动态,随时调整个体化的营养素配方.%Objeetvie Enteral nutrition support which achieve the nutritional goal was applied in 28 clinical critical patients Imm 1998 in our hospital and the short term effect was observed. Methods 1. The patients were divided into three groups according to the paTIENT' S condition, A group of 9 eases of intubation feeding with homogenate meal and elemental diet (the first group), 6 are surgical patients and 3 are internaldept patients, average duration is 26 days. A group of 10 cases with oral nutrition supplement (the third group), 7 are surgical patients and 3 are medical patients,average duration is 16 days. Daily energy intake is calculated with the formula: BEE x coefficient of activity x

  12. Enteral nutrients potentiate glucagon-like peptide-2 action and reduce dependence on parenteral nutrition in a rat model of human intestinal failure

    DEFF Research Database (Denmark)

    Brinkman, Adam S; Murali, Sangita G; Hitt, Stacy

    2012-01-01

    human SBS and requires parenteral nutrition (PN). Male Sprague-Dawley rats were assigned to one of five groups and maintained with PN for 18 days: total parenteral nutrition (TPN) alone, TPN + GLP-2 (100 μg·kg(-1)·day(-1)), PN + EN + GLP-2(7 days), PN + EN + GLP-2(18 days), and a nonsurgical oral...

  13. Meta-Analysis of Early Nutrition: The Benefits of Enteral Feeding Compared to a Nil Per Os Diet Not Only in Severe, but Also in Mild and Moderate Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Katalin Márta

    2016-10-01

    Full Text Available The recently published guidelines for acute pancreatitis (AP suggest that enteral nutrition (EN should be the primary therapy in patients suffering from severe acute pancreatitis (SAP; however, none of the guidelines have recommendations on mild and moderate AP (MAP. A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P. The following PICO (problem, intervention, comparison, outcome was applied: P: nutrition in AP; I: enteral nutrition (EN; C: nil per os diet (NPO; and O: outcome. There were 717 articles found in Embase, 831 in PubMed, and 10 in the Cochrane database. Altogether, seven SAP and six MAP articles were suitable for analyses. In SAP, forest plots were used to illustrate three primary endpoints (mortality, multiorgan failure, and intervention. In MAP, 14 additional secondary endpoints were analyzed (such as CRP (C-reactive protein, WCC (white cell count, complications, etc.. After pooling the data, the Mann–Whitney U test was used to detect significant differences. Funnel plots were created for testing heterogeneity. All of the primary endpoints investigated showed that EN is beneficial vs. NPO in SAP. In MAP, all of the six articles found merit in EN. Analyses of the primary endpoints did not show significant differences between the groups; however, analyzing the 17 endpoints together showed a significant difference in favor of EN vs. NPO. EN is beneficial compared to a nil per os diet not only in severe, but also in mild and moderate AP.

  14. Meta-Analysis of Early Nutrition: The Benefits of Enteral Feeding Compared to a Nil Per Os Diet Not Only in Severe, but Also in Mild and Moderate Acute Pancreatitis

    Science.gov (United States)

    Márta, Katalin; Farkas, Nelli; Szabó, Imre; Illés, Anita; Vincze, Áron; Pár, Gabriella; Sarlós, Patrícia; Bajor, Judit; Szűcs, Ákos; Czimmer, József; Mosztbacher, Dóra; Párniczky, Andrea; Szemes, Kata; Pécsi, Dániel; Hegyi, Péter

    2016-01-01

    The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome. There were 717 articles found in Embase, 831 in PubMed, and 10 in the Cochrane database. Altogether, seven SAP and six MAP articles were suitable for analyses. In SAP, forest plots were used to illustrate three primary endpoints (mortality, multiorgan failure, and intervention). In MAP, 14 additional secondary endpoints were analyzed (such as CRP (C-reactive protein), WCC (white cell count), complications, etc.). After pooling the data, the Mann–Whitney U test was used to detect significant differences. Funnel plots were created for testing heterogeneity. All of the primary endpoints investigated showed that EN is beneficial vs. NPO in SAP. In MAP, all of the six articles found merit in EN. Analyses of the primary endpoints did not show significant differences between the groups; however, analyzing the 17 endpoints together showed a significant difference in favor of EN vs. NPO. EN is beneficial compared to a nil per os diet not only in severe, but also in mild and moderate AP. PMID:27775609

  15. Effectiveness of Enteral Nutritional Therapy in Children with Crohn′s Disease%肠内营养疗法在儿童克罗恩病治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    彭晓康; 詹学

    2011-01-01

    至少25%的克罗恩病(CD)患者在儿童期发病,且大多患者伴体质量减轻,身高增长不良,甚至严重影响成年期最终身高,导致心理精神疾病发生.长期激素治疗可能导致显著的不良反应,这使肠内营养疗法在儿童CD(特别是活动性CD)的治疗中显得尤为重要.在欧美(尤其欧洲)国家,肠内营养被作为一线疗法.%At least 25% of individuals diagnosed patient with Crohn’s disease(CD) have onset of disease in childhood,and almost every patient with CD has nutritional impairment, such as weight loss,growth failure, even the final adult height may be impaired, sometimes psychological status of the patient may be caused.Long - term corticosteroids therapy may result in significant side effects, so the enteral nutritio-nal therapy seems to be much more suitable for pediatric CD(especially active CD).In the west,particularly in European countries,enteral nutrition is considered as the first - line of treatment for pediatric CD.

  16. 急性重症脑卒中患者早期肠内营养支持的临床研究%Clinical Efifcancy of Enteral Nutritional Support in the Treatment of Patients with Severe Acute Stoke

    Institute of Scientific and Technical Information of China (English)

    郭莺

    2015-01-01

    目的:探讨急性重症脑卒中患者接受不同营养支持治疗的临床疗效。方法随机选取本院2011年2月至2013年2月急性重症脑卒中伴吞咽困难者100例,随机分为两组,肠内营养组50例,肠外营养组50例,进行对照研究,共治疗3周,比较两组患者治疗前后的营养指标和并发症情况。结果治疗后肠内营养组血清白蛋白、血色素均高于肠外营养组,差异有统计学意义(p<0.05);肠内营养组并发症发生率低于肠外营养组,差异有统计学意义(p<0.05)。结论早期肠内营养支持可提高急性重症脑卒中患者生存率,降低致残率及死亡率。%Objective To compare the effects of enteral nutrition and parenteral nutrition for the early support of patients with severe acute stroke and dysphagia.Methods A total of 100 patients with dysphagia and severe acute stroke were selected from February 2011 to February 2013,who were randomly divided into two groups.50 patients were given enteral nutrition support treatment as the observation group, and the other 50 patients were given parenteral nutrition support treatment as the control group.The course of treatment was 3 weeks. Nutrition index and complications were compared between two groups before and after treatment.Results After treatment ,serum albumin and hemoglobin in the observation group were signiifcantly higher than those in the control group,the differences were statistically signiifcant (P<0.05); Complication rate in the observation group was signiifcantly lower than that in the control group. The difference was statistically signiifcant(p<0.05).Conclusion Early enteral nutrition support therapy for patients with serve acute stroke combined with dysphagia can signiifcantly improve survival rate and decrease the incidence of physical-disability and decease.

  17. Observation of the clinical effects of early application of enteral nutrition nursing for gastric cancer after operation%胃肿瘤术后早期应用肠内营养护理的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    李玉红

    2015-01-01

    Objective:To explore the clinical effects of early application of enteral nutrition nursing for gastric cancer after operation.Methods:56 patients with gastric cancer were selected.They were randomly divided into the observation group and the control group.The observation group was given enteral nutrition nursing,and the control group was given parenteral nutrition nursing.We observed the nutritional index,weight,gastrointestinal function recovery and adverse reaction before and after opeation of the two groups.Results:In the observation group,nursing effect was better than that of the control group(P<0.05);nutritional status of the observation group was stable.Conclusion:The clinical effects of early application of enteral nutrition nursing for gastric cancer after operation was significant,there was no serious adverse reaction,and it was worth the clinical promotion.%目的:分析胃肿瘤术后早期应用肠内营养护理的临床效果。方法:收治胃肿瘤患者56例,随机分为观察组和对照组,观察组给予肠内营养护理,对照组给予肠外营养护理,观察两组患者护理前后的营养指标、体重、肠胃功能恢复情况及不良反应情况。结果:观察组护理效果优于对照组(P<0.05);且观察组营养状况保持平稳。结论:在胃肿瘤患者术后早期应用肠内营养护理的效果显著,无严重不良反应,值得临床应用推广。

  18. Effect of personalized enteral nutrition support in post-operative patients with laryngeal carcinoma%个性化肠内营养支持应用于喉癌术后患者的效果观察

    Institute of Scientific and Technical Information of China (English)

    谢小红; 吴兰笛; 王瑞娴; 周铨梅

    2014-01-01

    Objective To study the effect of personalized enteral nutrition support in patients with laryngeal carcinoma after operation .Methods From June 2010 to April 2013 , 62 cases of laryngeal cancer patients received individualized enteral nutrition support as A group , and others 42 cases of laryngeal carcinoma after operation received commodity nutrition from January 2008 to May 2010 as B group.Then, nutrition index such as weight, prealbumin, albumin, total protein and so on, and complications, average hospitalization days, nutrition related costs , and time of wound stitches out between the two groups were detected and recorded respectively before operation , 7 th day and 14 th day after operation .Results Nutritional indexes in A group were significantly improved than those in B group , as well as the average hospitalization days , nutrition related costs , stitches out of the wound time between A group and B group , and the difference was statistically significant ( t=-12.900,-36.011,-13.762,respectively;P<0.05).Conclusions Personalized enteral nutrition support is one of the important means to promote the rehabilitation of postoperative patients with laryngeal carcinoma of nasal feeding homogenate , and self-made enteral nutrition is safe and effective , economic and simple , fewer complications , more in line with human physiological needs , and it is worthy of clinical application .%目的:探讨个性化肠内营养支持在喉癌患者手术后的应用效果。方法选择2010年6月-2013年4月住院的62例喉癌手术患者作为营养 A 餐组,实施个性化肠内营养支持;2008年1月-2010年5月手术后使用商品营养制剂的42例喉癌患者作为营养B餐组,检测与记录两组患者术前、术后7 d和14 d的体质量、前白蛋白、清蛋白、总蛋白等指标,观察有无并发症发生,比较两组平均住院时间、营养相关费用、伤口拆线时间。结果营养A餐组术后各项营养相关指标比营

  19. Modulation by enteral nutrition of the acute phase response and immune functions Regulación de la respuesta de fase aguda y de las funciones inmunitarias mediante nutrición enteral

    OpenAIRE

    2003-01-01

    To use nutrition in order to limit the negative consequences of physical and mental stress is not new. Recent advances in immunology and particularly in the understanding of the chemical language used to communicate both by eukarytic and prokarotic cells has made it easier to objectively evaluate effects of various immunomodulating efforts including the use of nutrients, vitamins and antioxidants in preventing or limiting the development of disease and its late consequences.El empleo de la nu...

  20. 术后早期肠外联合肠内营养支持治疗对老年胃癌病人临床预后的影响%The effect of early postoperative parenteral nutrition combined with enteral nutrition support on the prognosis of gastric cancer in old patients

    Institute of Scientific and Technical Information of China (English)

    谢小平; 揭志刚; 李正荣; 唐城; 端木尽忠

    2012-01-01

    目的:观察术后早期肠外联合肠内营养支持治疗对老年胃癌病人临床预后的影响. 方法:96例老年胃癌病人随机分为观察组和对照组,每组48例.术后分别行肠外营养(PN)+肠内营养(EN)和PN支持,持续7d.测定两组病人手术前后血清C反应蛋白(CRP)、清蛋白(ALB)、转铁蛋白(TF)水平和术后疲劳指数,并观察两组病人术后肛门排气、并发症和住院时间的变化. 结果:与对照组比,观察组老年胃癌病人术后第7天血清CRP水平和疲劳指数均明显下降(P<0.05),血清TF水平显著增加(P<0.05),并且术后肛门排气和术后住院时间缩短(P<0.05),术后感染发生率降低(P<0.05). 结论:PN联合EN治疗有助于调节老年胃癌病人术后机体的创伤应激,促进病人康复.%Objective:To investigate the effects of early postoperative parenteral and enteral nutrition on the prognosis of gastric cancer in old patients. Methods: Ninty six cases of old patients with gastric cancer were randomly divided into treatment group (n=48) and control group (n=48). Parenteral nutrition or enteral nutrition combined with parenteral nutrition were given respectively. The treatment lasted 7day posteroperatively. Serum CRP levels, postoperative fatigue index and serum albumin ( ALB) levels and transferrin ( TF) levels were measured before and after operation. The prognosis of the disease were compared between these two groups. Results: Compared with the control group, the serum CRP levels( P <0. 05 ) and fatigue index ( P < 0. 05 ) on 7 d after operation were significantly lower in treatment group. The enteral nutrition combined with parenteral nutrition increased serum transferrin lev-els(P<0. 05) , reduced the incidence of postoperative infections (P <0. 05), shortered postoperative hospital stay(F<0.05). Conclusion: Parenteral nutrition combined with enteral nutrition can reduce surgical trauma stress and improve surgical prognosis of gastric cancer in old

  1. Evaluación biológica de la calidad de una mezcla de proteínas para uso en nutrición enteral Biological evaluation of a protein mixture intended for enteral nutrition

    OpenAIRE

    J. Olza Meneses; J. Porres Foulquie; G. Urbano Valero; E. Martínez de Victoria; A. Gil Hernández

    2008-01-01

    La nutrición enteral (NE) es el mejor recurso para complementar la alimentación de los pacientes, siempre que el tracto gastrointestinal este funcional. Cuando se indica NE total, ésta representa la fuente exclusiva de alimento, por lo que es importante asegurar un alto valor biológico de la proteína incluida. Objetivo: Valorar la calidad biológica de una mezcla proteica constituida por 50% de caseinato potásico, 25% de proteínas de suero lácteo y 25% de proteína de guisante para ser utilizad...

  2. Research on application prospects of marine active substances in the diabetes mellitus enteral nutrition support%海洋活性物质在糖尿病肠内营养支持中的应用前景研究

    Institute of Scientific and Technical Information of China (English)

    万鹏

    2013-01-01

    With the development of molecular nutrition and personalized clinical enteral nutrition ( EN) support,marine active substances have become an ideal nutritional substrate of EN preparation. The combination of EN preparation research with marine active substances research has become a new direction of modern clinical EN support. For the special pathogenesis and nutritional needs of diabetes mellitus ( DM), the application prospects of marine polysaccharides, polyunsaturated fatty acids (PUFA) , taurine,and trace elements has been discussed in the diabetes mellitus EN support. It presents a new development trend for personalized diabetes mellitus EN preparation.%随着分子营养学和个性化临床肠内营养(EN)支持的发展,海洋活性物质逐渐成为EN制剂理想的营养基质.EN制剂研究与海洋活性物质研究相结合,成为现代临床EN支持的新方向.我们针对糖尿病(DM)特殊的患病机制和营养需求,探讨海洋多糖、多不饱和脂肪酸(PUFA)、牛磺酸(Tau)、微量元素在糖尿病病人EN支持中的应用前景,为糖尿病个性化EN制剂的开发提供新的思路.

  3. Clinical analysis of enteral nutrition in 47 children%儿童肠内营养47例临床分析

    Institute of Scientific and Technical Information of China (English)

    庄睿丹; 唐鲁静; 方优红; 彭克荣; 陈洁

    2016-01-01

    用,实施家庭肠内营养具有可行性.%Objective To explore the efficacy and safety of the application of enteral nutrition (EN) in gastrointestinal disease in children,and to explore the possibility of the implementation of family EN.Method Retrospective analysis of disease spectrum,EN approach,preparation,speed and time as we