Guidelines for covid-19 nutrition for both non critically ill and critically ill patients based upon ESPEN Guidelines 2022. For health care team and dietitians and nutrition specialists
ESPEN provides expert guidance on nutritional management for individuals with SARS-CoV-2 infection. Key recommendations include screening patients for malnutrition risk and optimizing nutritional status. Supplementation with vitamins and minerals is advised, along with encouraging regular physical activity. Oral nutrition supplements should be used if dietary intake is insufficient, and enteral nutrition is preferred over parenteral nutrition for patients who cannot meet needs orally. Nutritional support is also advised for ICU patients, whether intubated or not, to help support recovery and prevent complications like muscle loss. A comprehensive, individualized approach combining nutrition and medical care can help improve outcomes for COVID patients.
This document discusses nutrition in critical care patients. It recommends that critically ill patients who are at high nutritional risk based on a NUTRIC or NRS 2002 score of 5 or higher should receive specialized nutrition support, preferably through enteral feeding. Enteral feeding is preferred over parenteral nutrition when possible. The goals of nutrition support are to provide 1.2-2.0 g/kg/day of protein and aim for 25 kcal/kg/day of calories. Achieving adequate protein provision may improve outcomes over providing only trophic or permissive underfeeding. Monitoring of nutrition support is important to help meet goals and avoid overfeeding complications.
This document discusses solutions for undernutrition in elderly patients in healthcare settings. It presents a new food concept that aims to:
1) Allow patients to choose foods they enjoy to improve intake and adherence.
2) Provide foods enriched with protein to meet nutritional needs.
3) Distribute protein intake throughout the day with protein-rich options for meals and snacks.
Research showed the new concept successfully increased protein intake compared to standard diets. Interviews found patients were unaware of undernutrition risks and importance of protein. Enriched familiar foods that fit preferences were better accepted than nutritional supplements.
This document discusses nutrition in surgical patients. It begins by outlining the goals of nutritional support, which include identifying patients at risk of malnutrition, preventing or reversing catabolism, and meeting energy requirements. It then covers topics like malnutrition, nutritional assessment tools, estimating energy needs, and administration of enteral and parenteral nutrition. The key points are that nutritional support should begin preoperatively for high-risk patients or if oral intake won't resume within 7 days post-op, and the enteral route is preferred over parenteral nutrition when possible.
Nutritional support is important for surgical patients to prevent complications. Three key aspects of nutritional support discussed are:
1) Enteral nutrition is preferred over parenteral nutrition when possible, with a hierarchy of feeding methods from oral to tube feeding to be followed.
2) Malnutrition increases surgical risk, so nutritional screening and optimization of intake, including supplementation, is important pre-and post-operatively.
3) Close monitoring of caloric and protein intake as well as electrolytes and glucose is needed for patients receiving enteral or parenteral nutrition support.
This document provides an overview of nutrition in surgical patients. It discusses the basics of nutrition including caloric and protein requirements. The importance of nutrition for surgical patients is described along with the complications of malnutrition like infection and poor wound healing. Methods of nutritional assessment involving history, exams, and labs are outlined. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The take home messages emphasize the importance of meeting caloric needs to avoid complications, using enteral nutrition when possible, and closely monitoring patients on nutrition support.
This document discusses nutritional support in critical illness. It defines nutritional support as the provision of nutrients to patients who cannot meet their nutritional needs through standard diets. Malnutrition occurs in approximately 40% of hospitalized patients and can lead to increased morbidity and mortality by impairing organ function and healing. The document outlines the history of nutritional support, from overfeeding in the 1970s to more targeted support today. It discusses screening patients for nutritional risk and assessing nutritional status. The key questions of who needs support, when to start, how much to provide, and how to provide it are addressed. Enteral nutrition is generally preferred over parenteral nutrition. The document describes different enteral feeding methods and formulas for meeting various nutritional needs.
This document provides guidelines on nutrition in the intensive care unit (ICU). It defines patients at risk of malnutrition in the ICU, how to assess nutritional status, determine energy needs, choose feeding routes, and adapt nutrition based on clinical conditions. It discusses initiating and progressing nutrition administration, determining macronutrient needs, and paying special attention to glutamine and omega-3 fatty acids. The guidelines also address nutrition for patients with conditions like dysphagia, trauma, surgery, sepsis, and obesity that are common in the ICU.
ESPEN provides expert guidance on nutritional management for individuals with SARS-CoV-2 infection. Key recommendations include screening patients for malnutrition risk and optimizing nutritional status. Supplementation with vitamins and minerals is advised, along with encouraging regular physical activity. Oral nutrition supplements should be used if dietary intake is insufficient, and enteral nutrition is preferred over parenteral nutrition for patients who cannot meet needs orally. Nutritional support is also advised for ICU patients, whether intubated or not, to help support recovery and prevent complications like muscle loss. A comprehensive, individualized approach combining nutrition and medical care can help improve outcomes for COVID patients.
This document discusses nutrition in critical care patients. It recommends that critically ill patients who are at high nutritional risk based on a NUTRIC or NRS 2002 score of 5 or higher should receive specialized nutrition support, preferably through enteral feeding. Enteral feeding is preferred over parenteral nutrition when possible. The goals of nutrition support are to provide 1.2-2.0 g/kg/day of protein and aim for 25 kcal/kg/day of calories. Achieving adequate protein provision may improve outcomes over providing only trophic or permissive underfeeding. Monitoring of nutrition support is important to help meet goals and avoid overfeeding complications.
This document discusses solutions for undernutrition in elderly patients in healthcare settings. It presents a new food concept that aims to:
1) Allow patients to choose foods they enjoy to improve intake and adherence.
2) Provide foods enriched with protein to meet nutritional needs.
3) Distribute protein intake throughout the day with protein-rich options for meals and snacks.
Research showed the new concept successfully increased protein intake compared to standard diets. Interviews found patients were unaware of undernutrition risks and importance of protein. Enriched familiar foods that fit preferences were better accepted than nutritional supplements.
This document discusses nutrition in surgical patients. It begins by outlining the goals of nutritional support, which include identifying patients at risk of malnutrition, preventing or reversing catabolism, and meeting energy requirements. It then covers topics like malnutrition, nutritional assessment tools, estimating energy needs, and administration of enteral and parenteral nutrition. The key points are that nutritional support should begin preoperatively for high-risk patients or if oral intake won't resume within 7 days post-op, and the enteral route is preferred over parenteral nutrition when possible.
Nutritional support is important for surgical patients to prevent complications. Three key aspects of nutritional support discussed are:
1) Enteral nutrition is preferred over parenteral nutrition when possible, with a hierarchy of feeding methods from oral to tube feeding to be followed.
2) Malnutrition increases surgical risk, so nutritional screening and optimization of intake, including supplementation, is important pre-and post-operatively.
3) Close monitoring of caloric and protein intake as well as electrolytes and glucose is needed for patients receiving enteral or parenteral nutrition support.
This document provides an overview of nutrition in surgical patients. It discusses the basics of nutrition including caloric and protein requirements. The importance of nutrition for surgical patients is described along with the complications of malnutrition like infection and poor wound healing. Methods of nutritional assessment involving history, exams, and labs are outlined. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The take home messages emphasize the importance of meeting caloric needs to avoid complications, using enteral nutrition when possible, and closely monitoring patients on nutrition support.
This document discusses nutritional support in critical illness. It defines nutritional support as the provision of nutrients to patients who cannot meet their nutritional needs through standard diets. Malnutrition occurs in approximately 40% of hospitalized patients and can lead to increased morbidity and mortality by impairing organ function and healing. The document outlines the history of nutritional support, from overfeeding in the 1970s to more targeted support today. It discusses screening patients for nutritional risk and assessing nutritional status. The key questions of who needs support, when to start, how much to provide, and how to provide it are addressed. Enteral nutrition is generally preferred over parenteral nutrition. The document describes different enteral feeding methods and formulas for meeting various nutritional needs.
This document provides guidelines on nutrition in the intensive care unit (ICU). It defines patients at risk of malnutrition in the ICU, how to assess nutritional status, determine energy needs, choose feeding routes, and adapt nutrition based on clinical conditions. It discusses initiating and progressing nutrition administration, determining macronutrient needs, and paying special attention to glutamine and omega-3 fatty acids. The guidelines also address nutrition for patients with conditions like dysphagia, trauma, surgery, sepsis, and obesity that are common in the ICU.
This document discusses nutrition and nutritional support for patients. It notes that malnutrition is common in hospitalized patients, especially those with gastrointestinal diseases or postoperative complications, and that malnourished patients have higher risks of complications and death. The aim of nutritional support is to identify at-risk patients and meet their nutritional needs through the most appropriate route to minimize complications. Methods of assessment and artificial nutritional support through enteral or parenteral means are described, along with their potential complications.
Admission Criteria in PICU for Children having COVID 19 & general care of a ...Vivek Maheshwari
The document discusses criteria for admission to the pediatric intensive care unit (PICU) for children with COVID-19 and the general care of children in the PICU. Children may be admitted to the PICU if they require mechanical ventilation, have shock requiring vasopressors, worsening mental status, or multi-organ dysfunction. Once admitted, the focus is on supportive care including feeding, analgesia, sedation, glucose control, and pressure sore prevention to restore the child's health and provide family support.
1. Nutrition is now recognized as an important subspecialty, as proper nutrition can improve patient outcomes like muscle strength, immune function, and wound healing.
2. Malnutrition is common in hospitalized patients, with 1/3 at risk, and even small amounts of weight loss are associated with worse outcomes. Nutritional support teams provide care for complex cases requiring enteral or parenteral nutrition.
3. Indications for nutritional support include a BMI <19, unintentional weight loss, and inability to meet nutritional needs enterally. Tube feeding is used when oral intake is inadequate, and parenteral nutrition is for intestinal failure when the gut cannot be used.
The low FODMAP diet for irritable bowel syndrome: from evidence to practice Robin Allen
At the end of this session, participants will
be able to:
– Describe the mechanisms of action and
evidence for the use of the low FODMAP diet
in patients with irritable bowel syndrome
– Be familiar with the concepts of the 3 phases
for implementing the low FODMAP diet
– Discuss ways in which the diet could be
modified to suit the needs of the individual
التغذية لمرضي الجراحة
للزملاء المتقدمين لامتحانات اجنبية زي MRCS
و للزملاء اللي منتقلين حديثا للعمل بالمملكة المتحدة او بينوو العمل فيها
تابعونا علي الصفحة الجراح
https://www.facebook.com/algarra7/
عنوان الفيديوعلى اليوتيوب
https://youtu.be/PNe2e41pv_w
Prevention and follow up of malnutritionShaan Ahmed
Malnutrition requires prevention, treatment, and long-term follow up. Children should be followed up to 2-5 years after discharge to monitor growth, development, and prevent long term issues. Treatment may fail if feed is improperly prepared, inadequate, or not taken properly. Multilevel actions are needed including nutrition education, breastfeeding promotion, improved family diets, and coordinated programs at family, community, national, and international levels.
Malnutrition - The Public Health Issue Overshadowed by Obesity - Joanne Casey
IPH, Open, Conference, Belfast, Northern, Ireland, Dublin, Titanic, October, 2014, Health Public
1) The document provides guidelines for nutritional aspects of Enhanced Recovery After Surgery (ERAS) and special nutritional needs of patients undergoing major surgery, especially for cancer.
2) It aims to integrate nutrition into overall patient management, avoid long preoperative fasting, establish early oral feeding after surgery, and minimize factors that exacerbate stress and impaired gastrointestinal function.
3) The guidelines include 37 recommendations covering preoperative, perioperative and postoperative nutritional care, including the use of preoperative carbohydrates, early resumption of oral intake, indications for nutritional support and specific supplements, and timing of enteral versus parenteral nutrition.
feeding of newborn presentation ppt for Children's diseasesDanaYrzabek
The document discusses optimal infant and young child feeding recommendations including exclusive breastfeeding for the first six months, continued breastfeeding for up to two years or beyond, and introducing safe and appropriate complementary foods between six to twenty-four months. It also discusses assessing nutritional status through growth monitoring and evaluating factors like weight, length, head circumference using growth charts. The document provides information on breastfeeding benefits, contraindications, supplementation, complementary feeding recommendations including avoiding potentially allergenic foods and meeting iron requirements through foods rather than cow's milk. It also discusses energy and nutrient needs at different ages.
This document discusses nutrition in surgery and provides an overview of key topics including nutritional assessment, requirements, interventions, and complications. Nutritional assessment involves taking a history, physical exam including anthropometric measures, and lab tests to evaluate a patient's nutritional status. Enteral and parenteral nutrition routes are described. Enteral nutrition is preferred when possible as it supports gut health while parenteral nutrition is for cases of total gut failure. Complications of both enteral and parenteral nutrition are outlined. The goal of nutritional intervention is to identify and support patients at risk of malnutrition.
This document discusses nutrition considerations for patients undergoing surgery. It notes that proper pre-operative nutrition can help reduce surgical risks and complications by promoting wound healing and immune function. The document recommends a high-protein, high-calorie diet in the week or two before surgery to prepare the body. It also discusses ensuring fluid and electrolyte balance and an empty stomach before anesthesia. During recovery, nutrition aims to aid repair of damaged tissues through adequate intake of proteins, carbohydrates, fats, vitamins and minerals.
Nutrition and fluid therapy are important aspects of surgical care. There are different metabolic phases following injury or surgery including an ebb phase and flow phase. Nutritional status should be assessed using measurements like weight, BMI, serum proteins, and nitrogen balance. Enteral nutrition via tubes is preferred over parenteral nutrition when possible due to benefits like maintaining gut integrity. Criteria for initiating nutritional support include severe preexisting malnutrition or anticipated inability to meet needs enterally.
This document discusses nutrition in surgical patients. It begins with the basics of nutrition including definitions of malnutrition and nutritional requirements. The importance of proper nutrition for surgical patients is described along with methods for nutritional assessment. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The document emphasizes the importance of a multidisciplinary approach and initiating nutrition support early to optimize surgical outcomes.
Sudeshna Paul presented on the nutritional management of long-stay patients admitted to the intensive care unit (ICU). The objectives were to identify malnourished critically ill patients, determine calorie and protein requirements, and measure the efficacy of nutritional support within the first 3 days of ICU admission. Materials and methods included using a nutritional risk screening tool to identify malnourished patients and calculating energy and protein needs based on guidelines. Results found many patients had calorie and protein deficits on days 1-3 due to reasons like intubation, which common supplements were used to help meet nutritional needs. The conclusion was that critically ill ICU patients generally need high-protein, high-calorie diets and supplements to help manage
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
Enteral and Parenteral Nutrition Dr Zahid Soomro.pptxzahid aziz
This document discusses enteral and parenteral nutrition for critically ill patients. It notes that nutritional support may be needed if a patient cannot eat or digest food properly due to illness. Nutrition can be provided enterally through oral or tube feeding directly into the stomach or intestines, or parenterally through intravenous delivery bypassing the gastrointestinal tract. Enteral nutrition is generally preferred over parenteral nutrition. The document outlines factors to consider for both enteral and parenteral nutrition such as calorie requirements, specific formulas, administration methods, monitoring, and potential complications.
Nutritional support and fluid therapy in surgeryAjai Sasidhar
The document discusses nutrition and fluid therapy in surgery. It covers metabolic responses to injury and starvation, including ebb and flow phases. It discusses nutritional assessment, monitoring nutritional status, and criteria for initiating nutritional support. The document outlines principles of enteral and parenteral nutrition. It also discusses fluid therapy in surgery, including body fluid composition and maintenance of fluid balance.
This document provides guidelines for nutrition in critical care patients. It recommends early enteral nutrition within 24-48 hours for eligible patients and identifies patients at high risk of malnutrition. Enteral nutrition is preferred over parenteral nutrition when possible. For patients who cannot tolerate enteral nutrition, parenteral nutrition may be considered after 5-7 days. The document also outlines principles for assessing nutritional needs, providing adequate calories and protein, monitoring for complications, and preventing refeeding syndrome in at-risk patients.
- Critically ill patients are at high risk of malnutrition due to poor nutrient intake and increased metabolic demands.
- Early enteral nutrition within 48 hours is recommended to improve outcomes when possible. Parenteral nutrition may be considered after 1 week if enteral nutrition is not feasible.
- Nutrition support aims to meet caloric and protein goals to reduce catabolism and support anabolism while avoiding overfeeding. Standard enteral formulas are preferred over specialty formulas.
- Careful monitoring is needed to optimize delivery of nutrition and minimize risks like aspiration while the patient's condition and ability to tolerate feeds is changing.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
This document discusses nutrition and nutritional support for patients. It notes that malnutrition is common in hospitalized patients, especially those with gastrointestinal diseases or postoperative complications, and that malnourished patients have higher risks of complications and death. The aim of nutritional support is to identify at-risk patients and meet their nutritional needs through the most appropriate route to minimize complications. Methods of assessment and artificial nutritional support through enteral or parenteral means are described, along with their potential complications.
Admission Criteria in PICU for Children having COVID 19 & general care of a ...Vivek Maheshwari
The document discusses criteria for admission to the pediatric intensive care unit (PICU) for children with COVID-19 and the general care of children in the PICU. Children may be admitted to the PICU if they require mechanical ventilation, have shock requiring vasopressors, worsening mental status, or multi-organ dysfunction. Once admitted, the focus is on supportive care including feeding, analgesia, sedation, glucose control, and pressure sore prevention to restore the child's health and provide family support.
1. Nutrition is now recognized as an important subspecialty, as proper nutrition can improve patient outcomes like muscle strength, immune function, and wound healing.
2. Malnutrition is common in hospitalized patients, with 1/3 at risk, and even small amounts of weight loss are associated with worse outcomes. Nutritional support teams provide care for complex cases requiring enteral or parenteral nutrition.
3. Indications for nutritional support include a BMI <19, unintentional weight loss, and inability to meet nutritional needs enterally. Tube feeding is used when oral intake is inadequate, and parenteral nutrition is for intestinal failure when the gut cannot be used.
The low FODMAP diet for irritable bowel syndrome: from evidence to practice Robin Allen
At the end of this session, participants will
be able to:
– Describe the mechanisms of action and
evidence for the use of the low FODMAP diet
in patients with irritable bowel syndrome
– Be familiar with the concepts of the 3 phases
for implementing the low FODMAP diet
– Discuss ways in which the diet could be
modified to suit the needs of the individual
التغذية لمرضي الجراحة
للزملاء المتقدمين لامتحانات اجنبية زي MRCS
و للزملاء اللي منتقلين حديثا للعمل بالمملكة المتحدة او بينوو العمل فيها
تابعونا علي الصفحة الجراح
https://www.facebook.com/algarra7/
عنوان الفيديوعلى اليوتيوب
https://youtu.be/PNe2e41pv_w
Prevention and follow up of malnutritionShaan Ahmed
Malnutrition requires prevention, treatment, and long-term follow up. Children should be followed up to 2-5 years after discharge to monitor growth, development, and prevent long term issues. Treatment may fail if feed is improperly prepared, inadequate, or not taken properly. Multilevel actions are needed including nutrition education, breastfeeding promotion, improved family diets, and coordinated programs at family, community, national, and international levels.
Malnutrition - The Public Health Issue Overshadowed by Obesity - Joanne Casey
IPH, Open, Conference, Belfast, Northern, Ireland, Dublin, Titanic, October, 2014, Health Public
1) The document provides guidelines for nutritional aspects of Enhanced Recovery After Surgery (ERAS) and special nutritional needs of patients undergoing major surgery, especially for cancer.
2) It aims to integrate nutrition into overall patient management, avoid long preoperative fasting, establish early oral feeding after surgery, and minimize factors that exacerbate stress and impaired gastrointestinal function.
3) The guidelines include 37 recommendations covering preoperative, perioperative and postoperative nutritional care, including the use of preoperative carbohydrates, early resumption of oral intake, indications for nutritional support and specific supplements, and timing of enteral versus parenteral nutrition.
feeding of newborn presentation ppt for Children's diseasesDanaYrzabek
The document discusses optimal infant and young child feeding recommendations including exclusive breastfeeding for the first six months, continued breastfeeding for up to two years or beyond, and introducing safe and appropriate complementary foods between six to twenty-four months. It also discusses assessing nutritional status through growth monitoring and evaluating factors like weight, length, head circumference using growth charts. The document provides information on breastfeeding benefits, contraindications, supplementation, complementary feeding recommendations including avoiding potentially allergenic foods and meeting iron requirements through foods rather than cow's milk. It also discusses energy and nutrient needs at different ages.
This document discusses nutrition in surgery and provides an overview of key topics including nutritional assessment, requirements, interventions, and complications. Nutritional assessment involves taking a history, physical exam including anthropometric measures, and lab tests to evaluate a patient's nutritional status. Enteral and parenteral nutrition routes are described. Enteral nutrition is preferred when possible as it supports gut health while parenteral nutrition is for cases of total gut failure. Complications of both enteral and parenteral nutrition are outlined. The goal of nutritional intervention is to identify and support patients at risk of malnutrition.
This document discusses nutrition considerations for patients undergoing surgery. It notes that proper pre-operative nutrition can help reduce surgical risks and complications by promoting wound healing and immune function. The document recommends a high-protein, high-calorie diet in the week or two before surgery to prepare the body. It also discusses ensuring fluid and electrolyte balance and an empty stomach before anesthesia. During recovery, nutrition aims to aid repair of damaged tissues through adequate intake of proteins, carbohydrates, fats, vitamins and minerals.
Nutrition and fluid therapy are important aspects of surgical care. There are different metabolic phases following injury or surgery including an ebb phase and flow phase. Nutritional status should be assessed using measurements like weight, BMI, serum proteins, and nitrogen balance. Enteral nutrition via tubes is preferred over parenteral nutrition when possible due to benefits like maintaining gut integrity. Criteria for initiating nutritional support include severe preexisting malnutrition or anticipated inability to meet needs enterally.
This document discusses nutrition in surgical patients. It begins with the basics of nutrition including definitions of malnutrition and nutritional requirements. The importance of proper nutrition for surgical patients is described along with methods for nutritional assessment. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The document emphasizes the importance of a multidisciplinary approach and initiating nutrition support early to optimize surgical outcomes.
Sudeshna Paul presented on the nutritional management of long-stay patients admitted to the intensive care unit (ICU). The objectives were to identify malnourished critically ill patients, determine calorie and protein requirements, and measure the efficacy of nutritional support within the first 3 days of ICU admission. Materials and methods included using a nutritional risk screening tool to identify malnourished patients and calculating energy and protein needs based on guidelines. Results found many patients had calorie and protein deficits on days 1-3 due to reasons like intubation, which common supplements were used to help meet nutritional needs. The conclusion was that critically ill ICU patients generally need high-protein, high-calorie diets and supplements to help manage
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
Enteral and Parenteral Nutrition Dr Zahid Soomro.pptxzahid aziz
This document discusses enteral and parenteral nutrition for critically ill patients. It notes that nutritional support may be needed if a patient cannot eat or digest food properly due to illness. Nutrition can be provided enterally through oral or tube feeding directly into the stomach or intestines, or parenterally through intravenous delivery bypassing the gastrointestinal tract. Enteral nutrition is generally preferred over parenteral nutrition. The document outlines factors to consider for both enteral and parenteral nutrition such as calorie requirements, specific formulas, administration methods, monitoring, and potential complications.
Nutritional support and fluid therapy in surgeryAjai Sasidhar
The document discusses nutrition and fluid therapy in surgery. It covers metabolic responses to injury and starvation, including ebb and flow phases. It discusses nutritional assessment, monitoring nutritional status, and criteria for initiating nutritional support. The document outlines principles of enteral and parenteral nutrition. It also discusses fluid therapy in surgery, including body fluid composition and maintenance of fluid balance.
This document provides guidelines for nutrition in critical care patients. It recommends early enteral nutrition within 24-48 hours for eligible patients and identifies patients at high risk of malnutrition. Enteral nutrition is preferred over parenteral nutrition when possible. For patients who cannot tolerate enteral nutrition, parenteral nutrition may be considered after 5-7 days. The document also outlines principles for assessing nutritional needs, providing adequate calories and protein, monitoring for complications, and preventing refeeding syndrome in at-risk patients.
- Critically ill patients are at high risk of malnutrition due to poor nutrient intake and increased metabolic demands.
- Early enteral nutrition within 48 hours is recommended to improve outcomes when possible. Parenteral nutrition may be considered after 1 week if enteral nutrition is not feasible.
- Nutrition support aims to meet caloric and protein goals to reduce catabolism and support anabolism while avoiding overfeeding. Standard enteral formulas are preferred over specialty formulas.
- Careful monitoring is needed to optimize delivery of nutrition and minimize risks like aspiration while the patient's condition and ability to tolerate feeds is changing.
Similar to covide-19 nutrition dr.Zahra Motawei.pdf (20)
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
1. Key Aspects Of Nutrition In
Patients With Covid-19
Dr. Alzahraa M. Motawei
Lecturer Of Food Sciences And Nutrition
Faculty Of Agriculture
Mansoura University
2. The Speaker
• Lecturer Of Food Sciences and Dietetics - Faculty Of Agriculture - Mansoura University
• B.Sc. in Agric. Sci. “Food Industries” (2001). Mansoura University, Egypt.
• M.Sc. Degree in Food Technology (2004 - 2009) Suez Canal University Egypt.
• Biotechnology Training - Aachen university of applied science (Germany) April –
October, 2011.
• PhD Degree Nutrition Sci. (Food industries) (2011- 2014). Mansoura University, Egypt
• Visiting researcher, Post Doc In Preventive And Clinical Nutrition Department,
Nutrition, Exercise And Sports Institute, faculty of Sciences, Copenhagen university -
2015 till 2016. Denmark
• Visiting researcher , Preventive And Clinical Nutrition department, Nutrition, Exercise
and Sports institute, Faculty Of Sciences, Copenhagen University - 2016 till 2018.
Denmark
• Specialist Dietitian in Renal And Kidney Diseases Unit – Children Hospital- Mansoura
University
• NUTRITION DIPLOMA – NNI- Cairo , 2021
• Member of The Danish Diabetes Academy
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3. Background
• COVID-19 is a hypercatabolic disease with possible pulmonary and
gastrointestinal symptoms, and consequent deterioration of the nutritional
status and the worst clinical prognosis.
• We will present a guide to the nutritional care of adult and elderly people
non-critically and critically ill with COVID-19. based on ESPEN Clinical
Nutrition guidelines for 2022
Reference: Clinical Nutrition ESPEN 49 (2022) 544-550
https://doi.org/10.1016/j.clnesp.2022.03.002
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4. Why are patients with COVID-19 at risk of
Malnutrition?
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5. Process Of Nutritional Management
Assessment • Screening
Counselling
• Nutritional
Education
Application
• Normal oral
• Parenteral
• Enteral
Outcome
• Discharge
management
5
Find
Feed
Follow
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6. 1. Assessing The Nutritional Status
2. Calculating Nutritional Needs
3. Initiating Nutritional Therapy
4. Monitoring during hospitalization
5. Follow up after hospital discharge.
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Process Of Nutritional Management
9. Nutritional Approach
A. Complete Nutritional Assessment Considering
1. COVID-19
2. Comorbidities and injuries (medical history)
3. Number of hospitalization days before ICU (clinical diagnosis)
4. Energy balance since hospital admission (diet intake history)
5. Risk for refeeding syndrome
6. Frequent monitoring of serum Ph, Mg, K levels
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10. B. Nutritional Needs
• Caloric and protein needs should be adjusted per age, nutritional
status, disease severity, gastrointestinal tolerance
• use predictive equations is recommended
• If re-feeding syndrome risk is present Start at 25% of caloric goal with
slow increase
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11. Energy Needs
• Estimated needs 15-20 kcal/kg AW ,1.2 gm protein/kg AW/d
• For Elderly People (> 65 years) with comorbidities 27 kcal/kg /day.
• Patients With Severely Malnourishment Comorbidities 30 kcal/kg of body
weight per day, with the gradual progression
• Obese patients of up to 30 kcal/kg adjusted weight.
• After discharged from the ICU(30-35 kcal/kg /day) and high protein diet
(2g/kg/d)
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12. Patients at Home
• For malnourished or at risk patients, nutritional treatment should
continue after hospital discharge with oral nutritional supplements
and individualized nutritional plans.
• In case of swallowing difficulties, texture modified food and
thickened fluids should be considered.
• Some patients may also need home enteral or parenteral nutrition.
• Nutritional care plans should be regularly monitored
• Patients should be adhered with nutritional treatment, on tools for
self-screening of nutritional risk, and when to contact health care
providers.
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13. Macronutrients
• ESPEN recommends
• protein supply above 1 g/kg of body weight (>20% calories)
• lipids and carbohydrates of 30:70 for patients without respiratory
failure and 50:50 for those ventilated
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14. Feeding Routes: 1- Oral
• The oral feeding route should be preferred in patients able to consume 70% of
their needs between the third and the seventh day of hospitalization, considering
the nutritional needs without risk of vomiting or aspiration.
• If meeting the nutritional needs is not possible, or the patient presents
nutritional risk through screening, oral supplements should be used .
• The meals provided by the hospital must consist of unprocessed or minimally
processed foods, including all food groups, so as to ensure an appropriate supply
of macronutrients and micronutrients.
• Appropriate nutritional support in terms of micronutrients, vitamins (mainly A, C,
E, D, and the B complex), omega-3, and trace elements (such as selenium, zinc,
and iron), helps the immune system's general functioning, control of
inflammatory processes, oxidative stress, and nutritional status.
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15. Eat Vitamin-D Rich Foods
• In the last two and a half years, the experts have stated that eating
foods that are rich in Vitamin-D is beneficial for the management of
COVID-19 infection. Some of the foods which are rich in Vitamin D are
• Cod liver
• Egg yolk
• Sardines, Salmon fish
• Fortified orange juice
• Canned tuna
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16. Including Vitamin-A
• Vitamin A is a fat-soluble antioxidant. It has anti-inflammatory
properties, and studies have shown that it may be beneficial for
managing pneumonia and respiratory infections. Since COVID is a
respiratory disease, one
• who is infected with coronavirus must include this in their diet.
• Chicken liver
• Leafy greens
• Carrots
• Sweet potato
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17. Add Zinc To Your Plate
• Also, zinc is very important for patients who are recovering from
COVID-19. Add these
• foods which are rich in zinc content.
• Dark chocolate
• Hemp seeds
• Seafood oyster
• Pumpkin seeds
• Lentils
• Cashew nuts
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18. OMEGA -3
Food rich in omega-3
• Olive oil
• Canola oil
• Cod liver oil
• Seeds
• Nuts
• Fish
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19. Tips for Increasing Calories
• Aim to eat around 6 times a day (or every 2–3 hours).
• Eat small amounts frequently if larger amounts during mealtimes are
challenging.
• Choose nutrient-dense foods (including whole grains, fruits, and
vegetables) at each meal and snack.
• Increase the amounts of fats and oils added to foods, focusing on the
heathy ones (olive oil, avocado, etc).
• Add some non-salt seasonings to dishes if taste is affected.
• Use high-calorie liquid nutrition supplement
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21. Importance of Nutrition
• During the acute phase hyper catabolism leads to energy depletion
• Amino acids are mobilized from muscles leading to negative nitrogen
balance and sarcopenia
• Crucial illness leads to gut dysfunction which accentuate the
inflammatory response and lead to an increased MORE organ
dysfunction
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22. Key recommendation #1
• Initiate early enteral nutrition
• Within 2-3 days of ICU admission
• Within 12 hr of incubation
• EN is safely preferred over PN
If can be successfully fed via gastric route
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23. Key recommendation #2
• Start a standard EN isotonic (1 kcal/ml)
high protein formula
• EN-Gastric feeding preferred over post-
pyloric
• 1- need minimal expertise
• 2- allows use of NGT/OGT placed at
incubation
• 3- Continuous
• 4- less diahrea optimizesBG control
• 5- less staff interaction needed
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24. Key recommendation #3
• Switch to PN when EN is not as an
option
• If there are persistent diarrhea, ileus,
nausea, GI intolerance
• Limit soybean lipids the first week
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25. ESPEN 10 recommendations "Nutritional management in
individuals at risk for severe COVID-19, in subjects suffering of
COVID-19, and in COVID-19 ICU
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26. • Check for Malnutrition: Patients at risk for worst outcomes and
higher mortality following infection with SARS-Cov-2, namely older
adults and polymorbid individuals, should be checked using the MUST
criteria or, for hospitilized patients, the NRS-2002 criteria.
• Optimization of the nutritional status: Subjects with malnutrition
should undergo diet counselling from experienced professionals.
• Supplementation with vitamins and minerals: ensure
supplementation with vitamin A, vitamin D and other micronutrients.
• Regular physical activity: Patients in quarantine should continue
regular physical activity while taking precautions.
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ESPEN 10 recommendations "Nutritional management in
individuals at risk for severe COVID-19, in subjects suffering of
COVID-19, and in COVID-19 ICU
27. • Oral nutritional supplements (ONS): ONS should be used whenever
possible to meet patient's needs, when dietary counselling and food
fortification are not sufficient to increased dietary intake and reach
nutritional goals.
• Enteral nutrition (EN): In patients, whose nutritional requirements
cannot be met orally, EN should be administered. Parenteral nutrition
(PN) should be considered when EN is not indicated or insufficient.
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ESPEN 10 recommendations "Nutritional management in
individuals at risk for severe COVID-19, in subjects suffering of
COVID-19, and in COVID-19 ICU
29. Medical nutrition in ICU patients
• Medical nutrition in non-intubated ICU patients: If the energy target
is not reached with an oral diet, ONS should be considered first and
then EN treatment. If there are limitations for the enteral route, it
could be advised to prescribe peripheral PN in the population not
reaching energy-protein target by oral or enteral nutrition.
• Medical nutrition in intubated ICU patients I: EN should be started
through a nasogastric tube; post-pyloric feeding should be performed
in patients with gastric intolerance after pro kinetic treatment or in
patients at high)risk for aspiration.
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30. Medical NUTRITION in intubated ICU patients II
• In ICU patients who do not tolerate full dose EN during the first week
in the ICU, initiating parenteral nutrition (PN) should be weighed on a
case-by-case basis.
• Patients who need mechanical ventilatory support and orotracheal
intubation require specific nutritional care after extubation. About
10-67% of these patients present swallowing disorders.
• Nutrition in ICU patients with dysphagia: Texture-adapted food can
be considered. If swallowing is proven unsafe, EN should be
administered.
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32. Nutritional recommendations according to the type
of respiratory support in patients with COVID-19
Oxygen support Nutritional support
Ambient air/binasal catheter Oral diet: free, mild consistency, or according to the patient's preference; High-calorie
and/or high-protein oral supplement in nutritional risk or food intake <60% of caloric needs
for 2 days;
Enteral or parenteral nutrition, if necessary.
Non-rebreather mask NRB Oral diet: homogeneous creamy or pasty consistency, or thin pasty for consumption with
the aid of a straw, in order to facilitate the intake, avoid effort, and desaturation; High-
calorie and/or high-protein oral supplementation;
Enteral or parenteral nutrition, if necessary.
Mechanical ventilation Early enteral nutrition;
Parenteral nutrition, if necessary.
Extubation Assess dysphagia and if possible, oral diet; Enteral nutrition in case of risk of
bronchoaspiration.
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34. Main Targets Of Recommended Dietary
Compounds In Patients With Post-covid-19
Syndrome
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Nutrients 2022, 14, 1305.
https://doi.org/10.3390/nu14061305
https://www.mdpi.com/journal/nutrients
35. Dietary recommendations for patients with
post-COVID-19 syndrome
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Nutrients 2022, 14, 1305.
https://doi.org/10.3390/nu14061305
https://www.mdpi.com/journal/nutrients
36. TAKE HOME MESSAGE
• Patients with COVID-19 are at nutritional risk. A complete
nutritional assessment (anthropometric, dietary, and laboratory
assessment) enables the establishment of an individualized
nutritional approach in order to contribute to better clinical and
nutritional prognoses.
• Natural minimal processed foods are preferred
• Best drink is plain water.
• Limit saturated fat and increase unsaturated omega3 rich fats
• Choose white meats and salty fish
• Reduce salt and sugars
• Avoid eating outdoor
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37. References
• National Schedule of NHS costs2019/20 Yu, Y., et al 2020.
MalnutritionProlongs the Hospitalization of Patients with COVID-19
Infection: A Clinical Epidemiological Analysis. The journal of nutrition,
health & aging, 25(3),pp.369-373.
• Nutrients 2022, 14, 1305. https://doi.org/10.3390/nu14061305
https://www.mdpi.com/journal/nutrients
• Clinical Nutrition ESPEN 49 (2022) 544-550
https://doi.org/10.1016/j.clnesp.2022.03.002
• MNI__Covid-19_Factsheet_Poster.pdf
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