Enteral nutrition
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overview of enteral nutrition , i have seperate videos for ng tube and gastrostomy procedure and it can't be viewed here.
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Enteral nutrition method
1. The document discusses various enteral feeding methods including nasogastric tubes, nasojejunal tubes, percutaneous endoscopic gastrostomy (PEG) tubes, radiologically placed gastrostomy tubes, and jejunostomy tubes.
2. It describes the indications, contraindications, techniques, advantages, and complications of each method. PEG tubes are the most common method for long-term enteral access beyond 4-6 weeks while NG and NJ tubes are used for short-term feedings.
3. Access methods are chosen based on factors like the patient's condition, prognosis, ability to tolerate different sites of feeding, and risk of complications. Overall the document provides an overview
Enteral feeding
this presentation is about what is enteral feeding and how it is being carried out etc., it also gives information about classification based on duration of feeding. there is an information about infusion techniques and the time required for it.
Nutritional Support
This document discusses different types of nutritional support including enteral and parenteral feeding. Enteral feeding involves providing nutrients directly into the gastrointestinal tract via feeding tubes like nasogastric or gastrostomy tubes. Parenteral feeding provides nutrients intravenously when a patient cannot use their GI tract. The document describes the different tube types used for enteral feeding as well as indications, benefits, and potential complications of enteral and parenteral nutrition support.
Enteral nutrition
This document discusses enteral nutrition, which involves delivering nutrients directly into the gastrointestinal tract. It can be used when oral intake is not possible for 5-7 days or longer due to issues like inability to eat or impaired intestinal function. Enteral nutrition preserves gut integrity and function. It can be delivered via oral supplements, tubes like nasogastric or percutaneous endoscopic gastrostomy, or direct access methods like jejunostomy. Placement, administration methods, monitoring, and potential complications are outlined. The overall message is that enteral nutrition is generally better tolerated and less costly than total parenteral nutrition when the gastrointestinal tract is functional.
Enteral nutrition
1. Enteral nutrition is a way of providing nutrition to patients unable to consume an adequate oral intake but who have a partially functional GI tract. It can be delivered via nasogastric tubes, nasoduodenal/jejunal tubes, or gastrostomy/jejunostomy tubes placed surgically or endoscopically.
2. Parenteral nutrition provides nutrition directly into the bloodstream, bypassing the GI tract. It can be delivered peripherally via PPN or centrally via TPN, which requires central venous access.
3. Complications of enteral and parenteral nutrition include mechanical issues, gastrointestinal intolerance, metabolic abnormalities, and infections related to contamination of feeding solutions or
Enteral nutrition
Early Enteral Nutrition in Critically Ill Patients is the best for helping early recovery, decreasing hospital stay and decreasing malnutrition in ICU
How? When? Formulas used? Access forms?
Enteral nutrition
This document discusses the role of enteral nutrition therapy in treating pediatric Crohn's disease. It provides a history of enteral therapy and reviews studies showing its effectiveness in inducing remission and improving growth. Enteral therapy is recommended as a first-line induction treatment in other countries but not widely used in the US due to concerns about side effects, compliance and lack of experience. The document outlines the pros and cons of enteral therapy and compares it favorably to steroid treatment, noting its ability to induce remission, improve mucosal healing and linear growth with fewer adverse effects. Unanswered questions remain around optimal protocols and long-term outcomes compared to other medical therapies.
2009 inservice aspen guideline presentation
The document provides guidelines for enteral nutrition including criteria for use, access devices, initiation and advancement of feeding, administration methods, monitoring, and safety. It recommends starting enteral nutrition at 25% of goal rate and advancing slowly over 3-5 days to prevent refeeding syndrome in at-risk patients such as those with malnutrition. Guidelines are given for checking and interpreting gastric residual volumes to monitor for intolerance and reducing risks of aspiration.
Recommended
Enteral nutrition method
1. The document discusses various enteral feeding methods including nasogastric tubes, nasojejunal tubes, percutaneous endoscopic gastrostomy (PEG) tubes, radiologically placed gastrostomy tubes, and jejunostomy tubes.
2. It describes the indications, contraindications, techniques, advantages, and complications of each method. PEG tubes are the most common method for long-term enteral access beyond 4-6 weeks while NG and NJ tubes are used for short-term feedings.
3. Access methods are chosen based on factors like the patient's condition, prognosis, ability to tolerate different sites of feeding, and risk of complications. Overall the document provides an overview
Enteral feeding
this presentation is about what is enteral feeding and how it is being carried out etc., it also gives information about classification based on duration of feeding. there is an information about infusion techniques and the time required for it.
Nutritional Support
This document discusses different types of nutritional support including enteral and parenteral feeding. Enteral feeding involves providing nutrients directly into the gastrointestinal tract via feeding tubes like nasogastric or gastrostomy tubes. Parenteral feeding provides nutrients intravenously when a patient cannot use their GI tract. The document describes the different tube types used for enteral feeding as well as indications, benefits, and potential complications of enteral and parenteral nutrition support.
Enteral nutrition
This document discusses enteral nutrition, which involves delivering nutrients directly into the gastrointestinal tract. It can be used when oral intake is not possible for 5-7 days or longer due to issues like inability to eat or impaired intestinal function. Enteral nutrition preserves gut integrity and function. It can be delivered via oral supplements, tubes like nasogastric or percutaneous endoscopic gastrostomy, or direct access methods like jejunostomy. Placement, administration methods, monitoring, and potential complications are outlined. The overall message is that enteral nutrition is generally better tolerated and less costly than total parenteral nutrition when the gastrointestinal tract is functional.
Enteral nutrition
1. Enteral nutrition is a way of providing nutrition to patients unable to consume an adequate oral intake but who have a partially functional GI tract. It can be delivered via nasogastric tubes, nasoduodenal/jejunal tubes, or gastrostomy/jejunostomy tubes placed surgically or endoscopically.
2. Parenteral nutrition provides nutrition directly into the bloodstream, bypassing the GI tract. It can be delivered peripherally via PPN or centrally via TPN, which requires central venous access.
3. Complications of enteral and parenteral nutrition include mechanical issues, gastrointestinal intolerance, metabolic abnormalities, and infections related to contamination of feeding solutions or
Enteral nutrition
Early Enteral Nutrition in Critically Ill Patients is the best for helping early recovery, decreasing hospital stay and decreasing malnutrition in ICU
How? When? Formulas used? Access forms?
Enteral nutrition
This document discusses the role of enteral nutrition therapy in treating pediatric Crohn's disease. It provides a history of enteral therapy and reviews studies showing its effectiveness in inducing remission and improving growth. Enteral therapy is recommended as a first-line induction treatment in other countries but not widely used in the US due to concerns about side effects, compliance and lack of experience. The document outlines the pros and cons of enteral therapy and compares it favorably to steroid treatment, noting its ability to induce remission, improve mucosal healing and linear growth with fewer adverse effects. Unanswered questions remain around optimal protocols and long-term outcomes compared to other medical therapies.
2009 inservice aspen guideline presentation
The document provides guidelines for enteral nutrition including criteria for use, access devices, initiation and advancement of feeding, administration methods, monitoring, and safety. It recommends starting enteral nutrition at 25% of goal rate and advancing slowly over 3-5 days to prevent refeeding syndrome in at-risk patients such as those with malnutrition. Guidelines are given for checking and interpreting gastric residual volumes to monitor for intolerance and reducing risks of aspiration.
Surgical nutrition
enteral nutrition, nutrition, nutrition after surgery, nutrition of debilitated patient, nutrition of patient who cant take orally, post operative care, surgical nutrition, total parentral nutrition
Nutrition in surgical patients
- Enteral nutrition involves feeding through the gastrointestinal tract using tubes placed in the nose, stomach, or small intestine. It is preferred when the GI tract is functional. Parenteral nutrition is used when GI function is impaired or inadequate to meet nutritional needs.
- Factors to consider in enteral nutrition include the applicability, site of tube placement, formula selection based on patient needs, rate and method of delivery, and monitoring for tolerance. Complications can include infections, aspiration, and metabolic issues.
- Parenteral nutrition is indicated when GI function is severely impaired for over 5 days or nutrition cannot be met enterally. It involves intravenous delivery of nutrients and requires central line placement and monitoring for complications like infection, metabolic
Enteral nutrition - Modes, Indications, Complications
This document discusses enteral nutrition, including indications, contraindications, types, administration sites and tubes, feeding protocols, monitoring, and complications. The main points are:
- Enteral nutrition is indicated for inadequate oral intake of 5-7 days or inability to take oral feedings due to illnesses.
- Types of enteral nutrition include oral supplements, polymeric feeds, and disease-specific formulas.
- Administration sites are gastric or post-pyloric feeds via nasogastric, nasojejunal, or surgical tubes like PEG or jejunostomy.
- Feeding protocols depend on the tube type and location, starting at low rates and increasing gradually, with monitoring of tolerance and potential complications
Parenteral Nutrition
If you like to get the presentation as softcopy , please dont hesitate to contact me through email ((ahmad.thanin@outlook.com) , price 2.0 USA Dollar
Chapter 15 Enteral and Parenteral Nutrition Support
The document discusses enteral and parenteral nutrition support. Enteral nutrition involves tube feedings directly to the stomach or small intestine, while parenteral nutrition provides nutrients intravenously. Enteral is preferred when possible due to lower risks of infection and maintaining gut function. Tube feeding routes include nasogastric, nasoduodenal and gastrostomy tubes. Formulas are selected based on a patient's condition and needs. Administration involves gradually increasing delivery rates until goal is reached. Complications can be prevented by proper selection and delivery of feedings. Parenteral nutrition is considered when enteral is not possible due to conditions like short bowel syndrome.
Enteral
This document provides information on home enteral nutrition, including indications, enteral access methods, home care considerations, and insurance coverage. It discusses various patient populations that may benefit from home enteral nutrition due to inability to meet nutritional needs orally. Both short and long-term enteral access options are presented, as well as factors to consider when evaluating a patient's candidacy and managing their home enteral nutrition. Common challenges, resources, and guidelines related to home enteral nutrition are also summarized.
Intermittent bolus feeding versus continuous enteral feeding
Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favour of intermittent enteral nutrition administration, where volume is infused multiple times per day.
This presentation will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults.
Surgical Nutrition
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
role of nutrition in surgical critical care patients
The document discusses key points regarding surgical nutrition including:
- Enteral nutrition is preferred over parenteral nutrition when the GI tract is functional and should be initiated within 18 hours for burns and 24 hours for critically ill patients.
- Early enteral nutrition within 24 hours is associated with better outcomes than delayed feeding.
- Parenteral nutrition carries risks and should only be used when enteral is not possible or sufficient.
- Preoperative fasting from midnight is often unnecessary and clear fluids can be allowed until 2 hours before surgery.
Enteral Nutrition and Role of Milk
The document discusses enteral nutrition and the role of milk. It notes that enteral nutrition maintains gastrointestinal integrity and function while reducing complications compared to parenteral nutrition. Milk is an important source of protein for enteral feeds. However, diarrhea is a common complication when using milk-based feeds, often due to issues with milk quality and handling. Using UHT milk can help address these issues by providing a safer, bacteria-free option that does not require boiling and has less risk of contamination. This allows for easier preparation and administration of enteral feeds containing the important nutrients in milk.
Nutrition in surgery
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.
1. Nutritional Support In The Surgical Patient
The document discusses nutritional support in surgical patients. It covers 5 key issues: indications for nutritional support, determining nutritional status, the effectiveness of support for well-nourished vs malnourished patients, the route of nutrition (enteral vs parenteral), and appropriate composition of diets. Severely malnourished patients, those with short bowel syndrome, and those not expected to feed for 7+ days are good candidates. Markers like weight loss, transport proteins, and nutritional indices help determine status. Enteral nutrition is preferred but parenteral may be needed in some cases.
Short Bowel Syndrome
Short bowel syndrome (SBS) results from insufficient intestinal length to support nutrient absorption. It can be defined anatomically as less than 200cm of small bowel length in adults or less than 100-150cm without the colon. The main causes in developing countries are typhoid, intestinal atresias and complications of abdominal surgeries. Management involves nutritional support, medications to reduce diarrhea, and surgical procedures to increase bowel length or function. Advances include intestinal lengthening procedures and intestinal transplantation, but prevention through early management of conditions causing bowel loss remains important.
Discuss the Pathology and Management of Short Bowel Syndrome presentation
Short bowel syndrome (SBS) results from insufficient intestinal length to support nutritional needs. It can be defined anatomically as less than 200cm of small bowel length or functionally by the clinical manifestations of diarrhea, dehydration and malnutrition. Management involves medical therapy with nutritional supplementation, medications to reduce diarrhea, and surgical procedures to increase bowel length or function. Advances include serial transverse enteroplasty and intestinal transplantation. The goal is to improve patients' nutrition and quality of life through the safest and most effective treatment options. Prevention remains important to reducing the burden of this condition.
Perioperative nutrition
Dr. Asif Mian Ansari presented on nutritional requirements for surgical patients. Major points included:
1) Malnutrition can complicate surgical outcomes as nutritional needs are increased during stress and recovery requires an anabolic state.
2) Formulas to calculate basal metabolic rate and increased needs during stress or infection were provided.
3) Guidelines for caloric and protein intake for normal and surgical patients depending on stress level were outlined.
4) Enteral nutrition is preferred over parenteral nutrition when possible due to lower risk of complications.
Git nutrition1.
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.
Intestinal failure and Short bowel syndrome in children
Short bowel syndrome is defined as malabsorption resulting from the anatomical or functional loss of a significant length of the small intestine. It can be caused by conditions that remove portions of the small intestine like necrotizing enterocolitis or Crohn's disease. Management involves nutritional support through parenteral nutrition or specialized diets. Surgical interventions may also be used to taper or lengthen remaining intestine to promote adaptation. Complications include liver disease and infections resulting from long-term nutritional support needs.
Enteral Nutrition
Enteral nutrition is defined as providing nutrients directly to the gastrointestinal tract through a tube. It is indicated for patients who cannot meet their nutritional needs orally due to conditions like short bowel syndrome, inflammatory bowel disease, or neurological issues. Enteral nutrition can be administered through tubes in the nose, stomach, duodenum, jejunum, or by stoma. Initiation of enteral nutrition requires determining the appropriate feeding rate and regimen. Complications include gastrointestinal issues like vomiting or diarrhea, mechanical tube issues, and metabolic imbalances that require monitoring of electrolytes and fluids. Nursing management focuses on alleviating side effects and ensuring proper administration of enteral nutrition.
Enteral feeding
Enteral tube feeding is used to maintain or improve nutrition in patients unable to take food orally. Enteral nutrition is preferred over parenteral nutrition because it is safer for the patient and has less risk of infection. Ready to hang bottles are used with a pump set and flushed daily to maintain tube patency and hydration. Tubing and feeding sets are changed every 24 hours and residuals are checked every 4-6 hours during continuous feedings.
Short bowel syndrome in infants... Dr Sunil Deshmukh
Management of Short bowel syndrome in neonates & infants.........................by
Dr Sunil B Deshmukh, MBBS MD Paediatrics, Fellow in Neonatology(KEM Hospital ,Pune)
Enteral nutrition
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
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Chez SQUAD on prend le temps aussi de s'amuser et de se connaître ! En photos un aperçu de nos parties de poker riches en rebondissements ! C'est ça aussi une GreatPlaceToWork !
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Surgical nutrition
enteral nutrition, nutrition, nutrition after surgery, nutrition of debilitated patient, nutrition of patient who cant take orally, post operative care, surgical nutrition, total parentral nutrition
Nutrition in surgical patients
- Enteral nutrition involves feeding through the gastrointestinal tract using tubes placed in the nose, stomach, or small intestine. It is preferred when the GI tract is functional. Parenteral nutrition is used when GI function is impaired or inadequate to meet nutritional needs.
- Factors to consider in enteral nutrition include the applicability, site of tube placement, formula selection based on patient needs, rate and method of delivery, and monitoring for tolerance. Complications can include infections, aspiration, and metabolic issues.
- Parenteral nutrition is indicated when GI function is severely impaired for over 5 days or nutrition cannot be met enterally. It involves intravenous delivery of nutrients and requires central line placement and monitoring for complications like infection, metabolic
Enteral nutrition - Modes, Indications, Complications
This document discusses enteral nutrition, including indications, contraindications, types, administration sites and tubes, feeding protocols, monitoring, and complications. The main points are:
- Enteral nutrition is indicated for inadequate oral intake of 5-7 days or inability to take oral feedings due to illnesses.
- Types of enteral nutrition include oral supplements, polymeric feeds, and disease-specific formulas.
- Administration sites are gastric or post-pyloric feeds via nasogastric, nasojejunal, or surgical tubes like PEG or jejunostomy.
- Feeding protocols depend on the tube type and location, starting at low rates and increasing gradually, with monitoring of tolerance and potential complications
Parenteral Nutrition
If you like to get the presentation as softcopy , please dont hesitate to contact me through email ((ahmad.thanin@outlook.com) , price 2.0 USA Dollar
Chapter 15 Enteral and Parenteral Nutrition Support
The document discusses enteral and parenteral nutrition support. Enteral nutrition involves tube feedings directly to the stomach or small intestine, while parenteral nutrition provides nutrients intravenously. Enteral is preferred when possible due to lower risks of infection and maintaining gut function. Tube feeding routes include nasogastric, nasoduodenal and gastrostomy tubes. Formulas are selected based on a patient's condition and needs. Administration involves gradually increasing delivery rates until goal is reached. Complications can be prevented by proper selection and delivery of feedings. Parenteral nutrition is considered when enteral is not possible due to conditions like short bowel syndrome.
Enteral
This document provides information on home enteral nutrition, including indications, enteral access methods, home care considerations, and insurance coverage. It discusses various patient populations that may benefit from home enteral nutrition due to inability to meet nutritional needs orally. Both short and long-term enteral access options are presented, as well as factors to consider when evaluating a patient's candidacy and managing their home enteral nutrition. Common challenges, resources, and guidelines related to home enteral nutrition are also summarized.
Intermittent bolus feeding versus continuous enteral feeding
Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favour of intermittent enteral nutrition administration, where volume is infused multiple times per day.
This presentation will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults.
Surgical Nutrition
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
role of nutrition in surgical critical care patients
The document discusses key points regarding surgical nutrition including:
- Enteral nutrition is preferred over parenteral nutrition when the GI tract is functional and should be initiated within 18 hours for burns and 24 hours for critically ill patients.
- Early enteral nutrition within 24 hours is associated with better outcomes than delayed feeding.
- Parenteral nutrition carries risks and should only be used when enteral is not possible or sufficient.
- Preoperative fasting from midnight is often unnecessary and clear fluids can be allowed until 2 hours before surgery.
Enteral Nutrition and Role of Milk
The document discusses enteral nutrition and the role of milk. It notes that enteral nutrition maintains gastrointestinal integrity and function while reducing complications compared to parenteral nutrition. Milk is an important source of protein for enteral feeds. However, diarrhea is a common complication when using milk-based feeds, often due to issues with milk quality and handling. Using UHT milk can help address these issues by providing a safer, bacteria-free option that does not require boiling and has less risk of contamination. This allows for easier preparation and administration of enteral feeds containing the important nutrients in milk.
Nutrition in surgery
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.
1. Nutritional Support In The Surgical Patient
The document discusses nutritional support in surgical patients. It covers 5 key issues: indications for nutritional support, determining nutritional status, the effectiveness of support for well-nourished vs malnourished patients, the route of nutrition (enteral vs parenteral), and appropriate composition of diets. Severely malnourished patients, those with short bowel syndrome, and those not expected to feed for 7+ days are good candidates. Markers like weight loss, transport proteins, and nutritional indices help determine status. Enteral nutrition is preferred but parenteral may be needed in some cases.
Short Bowel Syndrome
Short bowel syndrome (SBS) results from insufficient intestinal length to support nutrient absorption. It can be defined anatomically as less than 200cm of small bowel length in adults or less than 100-150cm without the colon. The main causes in developing countries are typhoid, intestinal atresias and complications of abdominal surgeries. Management involves nutritional support, medications to reduce diarrhea, and surgical procedures to increase bowel length or function. Advances include intestinal lengthening procedures and intestinal transplantation, but prevention through early management of conditions causing bowel loss remains important.
Discuss the Pathology and Management of Short Bowel Syndrome presentation
Short bowel syndrome (SBS) results from insufficient intestinal length to support nutritional needs. It can be defined anatomically as less than 200cm of small bowel length or functionally by the clinical manifestations of diarrhea, dehydration and malnutrition. Management involves medical therapy with nutritional supplementation, medications to reduce diarrhea, and surgical procedures to increase bowel length or function. Advances include serial transverse enteroplasty and intestinal transplantation. The goal is to improve patients' nutrition and quality of life through the safest and most effective treatment options. Prevention remains important to reducing the burden of this condition.
Perioperative nutrition
Dr. Asif Mian Ansari presented on nutritional requirements for surgical patients. Major points included:
1) Malnutrition can complicate surgical outcomes as nutritional needs are increased during stress and recovery requires an anabolic state.
2) Formulas to calculate basal metabolic rate and increased needs during stress or infection were provided.
3) Guidelines for caloric and protein intake for normal and surgical patients depending on stress level were outlined.
4) Enteral nutrition is preferred over parenteral nutrition when possible due to lower risk of complications.
Git nutrition1.
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.
Intestinal failure and Short bowel syndrome in children
Short bowel syndrome is defined as malabsorption resulting from the anatomical or functional loss of a significant length of the small intestine. It can be caused by conditions that remove portions of the small intestine like necrotizing enterocolitis or Crohn's disease. Management involves nutritional support through parenteral nutrition or specialized diets. Surgical interventions may also be used to taper or lengthen remaining intestine to promote adaptation. Complications include liver disease and infections resulting from long-term nutritional support needs.
Enteral Nutrition
Enteral nutrition is defined as providing nutrients directly to the gastrointestinal tract through a tube. It is indicated for patients who cannot meet their nutritional needs orally due to conditions like short bowel syndrome, inflammatory bowel disease, or neurological issues. Enteral nutrition can be administered through tubes in the nose, stomach, duodenum, jejunum, or by stoma. Initiation of enteral nutrition requires determining the appropriate feeding rate and regimen. Complications include gastrointestinal issues like vomiting or diarrhea, mechanical tube issues, and metabolic imbalances that require monitoring of electrolytes and fluids. Nursing management focuses on alleviating side effects and ensuring proper administration of enteral nutrition.
Enteral feeding
Enteral tube feeding is used to maintain or improve nutrition in patients unable to take food orally. Enteral nutrition is preferred over parenteral nutrition because it is safer for the patient and has less risk of infection. Ready to hang bottles are used with a pump set and flushed daily to maintain tube patency and hydration. Tubing and feeding sets are changed every 24 hours and residuals are checked every 4-6 hours during continuous feedings.
Short bowel syndrome in infants... Dr Sunil Deshmukh
Management of Short bowel syndrome in neonates & infants.........................by
Dr Sunil B Deshmukh, MBBS MD Paediatrics, Fellow in Neonatology(KEM Hospital ,Pune)
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Enteral nutrition - Modes, Indications, Complications
Enteral nutrition - Modes, Indications, Complications
Chapter 15 Enteral and Parenteral Nutrition Support
Chapter 15 Enteral and Parenteral Nutrition Support
Intermittent bolus feeding versus continuous enteral feeding
Intermittent bolus feeding versus continuous enteral feeding
role of nutrition in surgical critical care patients
role of nutrition in surgical critical care patients
Discuss the Pathology and Management of Short Bowel Syndrome presentation
Discuss the Pathology and Management of Short Bowel Syndrome presentation
Intestinal failure and Short bowel syndrome in children
Intestinal failure and Short bowel syndrome in children
Short bowel syndrome in infants... Dr Sunil Deshmukh
Short bowel syndrome in infants... Dr Sunil Deshmukh
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Enteral nutrition
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Squad poker
Chez SQUAD on prend le temps aussi de s'amuser et de se connaître ! En photos un aperçu de nos parties de poker riches en rebondissements ! C'est ça aussi une GreatPlaceToWork !
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Parenteral Nutrition
The document discusses parenteral nutrition for critically ill patients. It begins by noting the high prevalence of malnutrition in ICUs and challenges in predicting metabolic needs. It then covers the indications for and types of parenteral nutrition, including total and peripheral parenteral nutrition. Practical considerations for intravenous site selection and formulations are discussed. The requirements and recommendations for energy, fluids, carbohydrates, proteins, fats, electrolytes, trace elements and vitamins are provided. Finally, preparations of single and multi-nutrient parenteral nutrition solutions are described.
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This document discusses enteral and parenteral nutrition. It begins by describing enteral nutrition, including types of enteral delivery such as oral diet or tube feeding. It then discusses indications, advantages, and effects of enteral nutrition on gut microbiota. Various techniques for enteral access like gastrostomy and jejunostomy are described. The document then discusses parenteral nutrition, including types like total or peripheral parenteral nutrition. Methods for calculating nutrient requirements and formulations for parenteral nutrition are provided. Complications of both enteral and parenteral nutrition are also summarized.
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Gastrostomy is a surgical opening made in the stomach to allow for placement of a feeding tube. It is indicated for patients who require prolonged tube feeding for over 4 weeks due to conditions such as neurological swallowing disorders, esophageal cancer, or gastric outlet obstruction. There are two main types - open gastrostomy involving surgical incision and percutaneous endoscopic gastrostomy (PEG) which is performed endoscopically. Complications can include infection, hemorrhage, leakage or displacement of the tube. Gastrostomy allows for safe enteral feeding in patients with poor oral intake who have a functional gastrointestinal system.
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Intestinal obstruction is a blockage of the bowel that prevents contents from passing through. There are two main types: mechanical obstruction from pressure on the bowel wall, and functional obstruction where the bowel muscles cannot propel contents. Causes of small bowel obstruction include adhesions, intussusception, volvulus, and tumors. Causes of large bowel obstruction include carcinoma, diverticulitis, and inflammatory bowel disorders. Treatment involves decompressing the bowel, fluid replacement, and usually surgery to relieve the obstruction.
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A 77-year-old female presented with progressive dysphagia and chest pain and was found to have a large paraesophageal hernia; she underwent a laparoscopic paraesophageal hernial repair with gastropexy and had an uneventful postoperative course with resolution of her symptoms. Paraesophageal hernias are rare types of hiatal hernias that can cause symptoms from GERD to obstruction and require surgical repair to prevent complications like strangulation.
Intestinal obstruction with Nursing Management
Introduction, definition, types, etiology, pathophysiology, clinical manifestations, diagnostic tests, medical management, surgical mangement, nursing management with nursing diagnoses, health education of intestinal obstruction.
Gasrtointestinal bleeding & obstruction
Gastrointestinal bleeding and obstruction with diagnostic finding and the medical ,surgical and nursing management
nutrition in surgical patients
This document discusses nutrition support for surgical patients, including enteral and parenteral nutrition. It outlines the goals of nutritional support as preventing catabolism, meeting energy requirements, and aiding tissue repair. Methods for estimating caloric and protein requirements are provided. The advantages of enteral over parenteral nutrition are described. Complications and their management for both enteral and parenteral nutrition are covered. Specific nutrients important for immune function, such as arginine, glutamine, and omega-3 fatty acids, are also discussed.
PSEUDOPANCREATIC CYST
Case Presentation acts as a demo for Abdominal Cases.
Outline of Management of Pseudopancreatic cysts
Recent Advances
small intestinal obstruction
This document provides an overview of small bowel obstruction, including classification, common causes, clinical features, investigation, and treatment. It discusses how to determine if a patient has bowel obstruction or ileus, and how to investigate and manage the patient. The main causes of small bowel obstruction are discussed, including adhesions, hernias, volvulus, and intussusception. Indications for surgery include generalized peritonitis, failure to improve with conservative treatment, and unclear diagnosis. Initial management focuses on resuscitation, decompression, and monitoring for signs of strangulation or perforation that would require surgery.
Small intestine
The document provides an overview of the anatomy, physiology, and pathologies of the small intestine. It discusses the following key points:
- The small intestine is responsible for digestion and absorption. It starts at the pylorus and ends at the ileocecal valve, measuring around 7 meters long.
- Common pathologies include small bowel obstruction, which can be diagnosed using imaging like CT scans, and ileus, which results in impaired motility.
- Infectious diseases like typhoid fever and tuberculosis can also affect the small intestine. Typhoid is caused by Salmonella and can lead to perforation of the ileum if untreated.
Chronic epigastric pain
1. The document discusses chronic epigastric pain, its causes, symptoms, and methods of investigation and treatment. Common causes mentioned include gallstones, peptic ulcers, pancreatitis, and gastric carcinoma.
2. Diagnosis involves history, physical exam, and endoscopy to identify the specific cause. Treatment depends on the underlying condition but may include lifestyle changes, medications like PPIs, and eradication of H. pylori infection.
3. Surgery was previously used more often to treat peptic ulcers but has become less common with the availability of effective medical therapies. Surgical options described include various vagotomy procedures and gastrojejunostomy.
MGB (Mini-Gastric Bypass) v Sleeve Gastrectomy
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Short bowel syndrome
Short Bowel Syndrome (SBS) results from the resection of over half of the small intestine, usually due to disease or injury. It leads to malabsorption, diarrhea, and nutritional deficiencies requiring lifelong specialized medical and nutritional management. Treatment focuses on aggressive enteral nutrition to promote intestinal adaptation, parenteral nutrition, micronutrient supplementation, and management of complications like bacterial overgrowth. With sufficient residual small bowel and colon, patients may achieve independence from parenteral nutrition over time. Intestinal transplantation is considered for those with permanent intestinal failure.
Ulcerative colitis
Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon. It involves diffuse inflammation and ulceration of the colonic mucosa. The cause is unknown but likely related to genetic and immune factors. Symptoms include bloody diarrhea. Diagnosis involves colonoscopy and biopsy. Treatment involves medications to induce and maintain remission such as mesalamine, corticosteroids, immunomodulators, and biologics. Surgery may be required for severe cases or cancer prevention. Long-term monitoring is needed due to cancer risk.
Short Bowel syndrome Dr Habibur Rahim
Short bowel syndrome (SBS) occurs when extensive segments of the small intestine are resected, severely compromising absorptive capacity. It is a leading cause of intestinal failure in infants, with an incidence of 0.1-0.5% among live births and ICU admissions. The minimal length of small intestine needed to survive is 15-38 cm, though adaptation allows survival with even shorter lengths. Management involves total parenteral nutrition, optimizing enteral nutrition, and treating complications until the remnant intestine sufficiently adapts through processes like increased blood flow and growth. With current treatment, 80% of infants with SBS achieve full enteral nutrition within a year.
Peptic ulcer
Peptic Ulcer Disease is caused by stomach acid and pepsin damaging the stomach or duodenal lining. Risk factors include H. pylori infection, smoking, NSAIDs, and age. The two main types are gastric and duodenal ulcers. Patients may experience abdominal pain or bleeding. Diagnosis involves endoscopy, biopsy, and breath testing. Treatment focuses on eradicating H. pylori, reducing acid with PPIs or H2 blockers, and surgery for complications. Lifestyle changes and multi-drug antibiotic regimens are effective at curing ulcers and preventing recurrence.
pepticulcer-160130225146.pdf
Peptic Ulcer Disease is caused by stomach acid and pepsin damaging the stomach or duodenal lining. Risk factors include H. pylori infection, smoking, NSAIDs, and age. The two main types are gastric and duodenal ulcers. Patients may experience abdominal pain or bleeding. Diagnosis involves endoscopy, biopsy, and breath testing. Treatment focuses on eradicating H. pylori, reducing acid with PPIs or H2 blockers, and surgery for complications. Lifestyle changes and multi-drug antibiotic regimens are effective at curing ulcers and preventing recurrence.
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anatomy , clinical correlation , approach to mediastinal tumors, overview of different mediastinal tumors . slides are made very simple and easy .
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Fungal infections prenav
This document discusses different types of fungal infections, including superficial, subcutaneous, and systemic mycoses. Superficial mycoses include pityriasis versicolor, pityrosporum folliculitis, tinea nigra palmaris, black piedra, white piedra, dermatophytosis, and candidiasis. Dermatophytosis is caused by dermatophyte fungi and can affect different body sites like the scalp, beard, trunk and nails. Candidiasis is caused by Candida species and can cause infections in the mouth, skin folds, and genital area. Subcutaneous mycoses include mycetoma, chromoblastomycosis, sporotrich
Hypolipidemic pharmacology outline
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epidemiology of cholera
This document discusses cholera, including its epidemiology and control. It provides statistics on cholera cases and deaths in India from 1950 to 2011. It describes the agent (Vibrio cholerae bacteria), host (humans of any age and sex but particularly the poor), and transmission (contaminated food/water and overcrowding). The pathogenesis, clinical features (stages of evacuation, collapse, recovery), carriers, and laboratory diagnosis are examined. The aim is to study cholera to control its spread.
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The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Physiology of Chemical Sensation of smell.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Physiology of Special Chemical Sensation of Taste
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Enteral nutrition
- 2. DELIVERY OF NUTRITION THROUGH THE GASTRO INTESTINAL TRACT .
- 3. “USE GI TRACT FOR FEEDING WHENEVER POSSIBLE”
- 4. CONTRAINDICATIONS OF ENTERAL FEEDING • BOWEL OBSTRUCTION • BOWEL ISCHAEMIA • ILEUS • SEVERE CIRCULATORY SHOCK
- 5. TUBE FEEDING NASO GASTRIC TUBE SIP FEEDING GASTROSTOMY JEJUNOSTOMY METHODS OF DELIVERING ENTERAL NUTRTION INDICATION : PATIENT HAVING DIFFICULTY IN EATING DUE TO SOME CAUSE BUT GI TRACT IS NORMALLY FUNCTIONING . Eg – stroke , oesophageal ca , alzheimer’s , prematurity and so on . INDICATION : PATIENTS WHO CAN CONSUME FOOD ORALLY AND GI TRACT IS NORMAL BUT APPETITE IS IMPAIRED .
- 6. NASOGASTRIC TUBE Indications • Short term requirement i.e. Less than 8 weeks • Terminally ill Patients who can’t undergo invasive procedure
- 7. GASTROSTOMY Indication: • Long term requirement i.e. more than 8 weeks • Oesophageal ca , severe stoke , motor neuron disease , maxillo-facial injury Percutaneous endoscopic gastrostomy pull technique push technique
- 8. JEJUNOSTOMY Indication: • Long term requirement of more than 8 weeks. • Surgery - Gastrectomy , surgery related to oesophagus , pancreas , defects in gastric emptying
- 9. NUTRITIONAL FEEDS DIFFERENT TYPES OF NUTRITIONAL FEEDS ARE AVAILABLE BASED ON CALORIES PROTEIN CONTENT – POLYMERIC , OLIGOMERIC CARBOHYDRATE CONTENT FIBER CONTENT LIPID CONTENT
- 10. Creating a feeding regimen • Find out daily energy requirement and protein requirement • Select a feeding formula • Calculate the desired infusion rate
- 11. COMPLICATIONS • TUBE RELATED MALPOSITION DISPLACEMENT BLOCKAGE EROSION OF MUCOSA • GI RELATED DIARRHOEA VOMITING ASPIRATION
- 12. REFEEDING SYNDROME • Complication that occurs when a malnourished person begins to receive nutrition . • There will be hypophosphatemia , hypokalemia , hypomagnesemia . • There will be decrease in thiamine levels as well . • cardiac arrythmia , confusion , convulsions , coma , death .