Pn algorithm
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1) The document provides guidelines for administering parenteral nutrition (PN) to critically ill patients in the ICU. 2) It outlines strategies to maximize enteral nutrition (EN) before using PN, such as implementing a feeding protocol and using prokinetics to increase EN tolerance. 3) If EN is not possible, it recommends providing hypocaloric PN without IV lipids, or low dose EN with IV glutamine to improve outcomes.
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1) Low-dose enteral nutrition can be started within 48 hours of admission, even during treatment with small or moderate doses of vasopressor agents.
2) A percutaneous enteral access should be used when enteral nutrition is anticipated for 4 weeks or longer.
3) Energy delivery should not be calculated to match energy expenditure before day 4-7, and use of energy-dense formulas can be restricted to cases where full-volume isocaloric enteral nutrition is not tolerated or fluid restriction is needed.
4) The occurrence of refeeding syndrome should be assessedNutrition in Intensive Care
This document summarizes key considerations for nutrition in intensive care patients. It addresses questions like which patients should be fed, when feeding should start, what route is best, how much to feed, and what the feed should contain. The document discusses evidence that early enteral feeding within 48 hours is preferable to delaying feeding. It also notes that enteral feeding is generally better than parenteral feeding when possible due to lower risks, though parenteral may be necessary in some cases. The optimal amount of feeding is also addressed.
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This document discusses various topics related to nutrition support for critically ill patients. It covers causes of injury and metabolic stress, phases of the stress response, differences between starvation and stress-induced metabolic changes, major causes of death, and considerations for providing nutrition support to critically ill patients with conditions like infection, trauma, burns, and obesity or undergoing surgery. Key points emphasized include the importance of early initiation of nutrition support to minimize complications, meeting calorie and protein needs while avoiding overfeeding, and managing fluid, electrolytes and glycemic control.
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Dr. Dominic D'Agostino, an assistant professor at the University of South Florida, introduces the ketogenic diet as a potential treatment for epilepsy. The ketogenic diet focuses on minimizing glucose and insulin production while promoting the liver's production of ketones to be used as energy. It is a modified version of the Atkins diet that may help epilepsy patients who do not qualify for surgery. Individuals should always consult their physician before starting the ketogenic diet.
Importance of nutritional management during hospitalization
The document discusses the importance of nutritional management for hospitalized patients. It notes that up to 50% of hospitalized patients experience some degree of malnutrition. Providing adequate nutrition support through enteral or parenteral nutrition can improve patient outcomes, reduce recovery time, and lower healthcare costs. The document provides guidelines for estimating caloric and protein needs for critically ill patients and recommends early enteral nutrition within 24-48 hours when possible to support gut health and integrity.
Optimzing nutrition delivery in icu
This document discusses optimal nutrition strategies for critically ill patients. It emphasizes the importance of early enteral nutrition within 48 hours of admission, and achieving adequate calorie and protein intake levels. Higher calorie and protein intake levels are associated with better outcomes like reduced infections, shorter hospital stays and lower mortality. The development of the NUTRIC risk score is summarized, which can help identify patients most likely to benefit from aggressive nutrition therapy based on factors like age, illness severity and comorbidities. Validation studies showed higher risk patients based on NUTRIC score had worse outcomes with low nutrition adequacy levels. Nurse-directed feeding protocols are recommended to help optimize enteral nutrition delivery.
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This document discusses nutritional assessment and management in surgical patients. It begins with an outline of the topics to be covered, including nutritional assessment, requirements, interventions, and disease-specific nutrition. Various methods of nutritional assessment are described, such as clinical history, physical exam, laboratory tests, and calculations of energy expenditure. Enteral and parenteral nutrition are presented as interventions, with details on their indications, delivery methods, and complications. The goal of nutritional support is to meet metabolic needs in patients who cannot maintain adequate intake orally.
Benefits of a Ketogenic Diet
A longtime assistant professor at the University of South Florida, Dr. Dominic D'Agostino has conducted extensive research on areas relating to mitigating muscle wasting associated with cancer and the health consequences of a ketogenic diet. Nutrition researchers such as Dr. Dominic D'Agostino have long investigated the benefits of a ketogenic diet, which involves minimizing sugar and carbohydrate intake in favor of foods with a relatively high fat content. In the absence of sugar as a primary energy source, the body begins to utilize fatty acid metabolism, which relies on the body’s fat stores.
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Ketogenic Diet
A ketogenic diet is a low-carb, high-fat diet that shifts the body's metabolism away from glucose and towards ketone bodies. It has been used to treat epilepsy, cancer, Alzheimer's, and other diseases. The diet forces the body to burn fats rather than carbohydrates. This makes it an effective treatment for cancer since cancer cells cannot use ketones for energy. In addition to weight loss, the ketogenic diet provides more energy and fewer side effects than chemotherapy or radiation. It is becoming a popular alternative treatment option.
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This document provides guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN) on clinical nutrition for patients in the intensive care unit (ICU). It defines who is at nutritional risk, how to assess a patient's nutritional status, how to determine energy needs, and the appropriate route (enteral vs parenteral) and progression of nutrition support. Recommendations are given for the amount and composition of macronutrients (carbohydrates, fat, protein) to provide. Special clinical situations like dysphagia, trauma, sepsis, and obesity are also addressed. The guidelines aim to guide practitioners in providing optimal evidence-based medical nutrition therapy to critically ill patients.
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The document provides 10 tips for enteral nutrition in intensive care units based on recent American and European guidelines and expert consensus:
1) Low-dose enteral nutrition can be started within 48 hours of admission, even during treatment with small or moderate doses of vasopressor agents.
2) A percutaneous enteral access should be used when enteral nutrition is anticipated for 4 weeks or longer.
3) Energy delivery should not be calculated to match energy expenditure before day 4-7, and use of energy-dense formulas can be restricted to cases where full-volume isocaloric enteral nutrition is not tolerated or fluid restriction is needed.
4) The occurrence of refeeding syndrome should be assessedNutrition in Intensive Care
This document summarizes key considerations for nutrition in intensive care patients. It addresses questions like which patients should be fed, when feeding should start, what route is best, how much to feed, and what the feed should contain. The document discusses evidence that early enteral feeding within 48 hours is preferable to delaying feeding. It also notes that enteral feeding is generally better than parenteral feeding when possible due to lower risks, though parenteral may be necessary in some cases. The optimal amount of feeding is also addressed.
Ketogenic Diet
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that has been used since the 1920s to treat intractable childhood epilepsy. It works by increasing ketone body production which is thought to have anti-seizure effects. A randomized controlled trial in 2008 found that 38% of children on the ketogenic diet experienced at least a 50% reduction in seizures, compared to only 6% of children in the control group. Common side effects include kidney stones and slowed growth in young children on the diet long-term.
Immunonutrition
This document discusses the role of arginine-supplemented diets in critically ill patients. It summarizes the largest randomized controlled trial of an immunonutrition formula enriched with arginine, glutamine, antioxidants, and omega-3 fatty acids, which found no differences in outcomes. Subsequent analyses found no effect on mortality or infectious complications. However, some smaller studies found increased mortality in septic patients receiving arginine. Guidelines now recommend against the use of arginine-supplemented diets for critically ill patients based on the current evidence.
091110 Kondrup IHF Rio
Lecture at 36th World Hospital Congress of International Hospital Federation in Rio de Janiero, November 2009
Nutrition
Enteral and parenteral nutrition are important for critically ill children to prevent further deterioration. Enteral nutrition is preferred when possible due to gut trophic effects. Nutritional requirements vary based on factors like age, illness severity, and metabolic stress. Careful monitoring is needed to avoid overfeeding and associated complications while meeting caloric and protein goals tailored for each patient.
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Arginine metabolism by aslam matania
Arginine is a semiessential amino acid that is synthesized endogenously in the liver and kidney cortex. It plays an important role in the urea cycle, where it is both synthesized and hydrolyzed. Arginine is also involved in the citrulline-nitric oxide cycle, where it is converted by nitric oxide synthase enzymes into nitric oxide, an important signaling molecule. Disruptions to arginine metabolism can occur due to deficiencies in its synthesizing or metabolizing enzymes and can result in medical conditions like hyperargininemia or hypoargininemia.
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Wound healing
Primary intention healing occurs when a wound is closed within hours of injury through surgical or mechanical approximation of wound edges. Delayed primary healing allows time for wound debridement before closure to prevent infection. Secondary intention healing involves closure of full thickness wounds through wound contraction and epithelialization without surgical closure. Wound healing progresses through inflammatory, proliferative, and remodeling phases regardless of closure method and can move between phases based on intrinsic and extrinsic patient factors.
Skin, Wounds, and Nutrition Part 4
This document discusses nutritional needs and interventions to promote wound healing. It covers increased energy, protein, and micronutrient requirements for wound healing. Carbohydrate intake should be 55-60% of the diet to provide glucose for cellular function. Protein intake should be increased to 20-25% of calories to support new cell growth. Fat intake should be limited to 20-25% of calories or less than 2 grams/kg daily. Several vitamins and minerals like vitamins A, C, zinc, and arginine are important for collagen synthesis and wound healing. Nutrition support through oral or enteral intake can help optimize healing when needed. Non-pharmacological and pharmacological interventions may also be used to further support the nutritional
Diet and tissue healing
This is a presentation I done with 3 days in a rush for a presentation in a workshop. I hope it brings certain information to my blog users. From www.littlediet.info.
ARGININE METABOLISM
Arginine is a semi-essential amino acid that is cleaved by the enzyme arginase to produce urea and ornithine. It is also the substrate for the production of nitric oxide (NO) by nitric oxide synthase (NOS). There are three isoforms of NOS - neuronal NOS, macrophage NOS, and endothelial NOS. NO functions as a vasodilator, regulates blood flow and pressure, inhibits platelet aggregation, and is involved in other physiological processes like the erection of the penis. Dysfunction of arginine metabolism or NO production can lead to conditions like hyperargininemia or pulmonary hypertension.
Arginine and Glutamine in Wound Healing
This document summarizes research on the roles of the amino acids glutamine and arginine in wound healing. It discusses how both are conditionally essential and have been shown to improve wound healing in studies of pressure ulcers, burns, and skin grafts through their effects on immune function, protein synthesis, and nitric oxide production. However, the results have been mixed, and more research is still needed to better understand how to individualize amino acid supplementation for different types of wounds and patients.
Wounds, Wound Healing And Complications
The document discusses wound classification and the normal sequence of wound healing. It defines a wound and classifies wounds based on exposure to the external environment and risk of sepsis. There are two main types of wound healing: primary intention and secondary intention. Primary intention involves clean wounds where the edges are closed, leading to rapid healing. Secondary intention occurs when the edges are separated, requiring slower healing from the bottom up. The normal sequence of wound healing involves three phases - inflammation, proliferation, and remodeling - occurring over days to months.
Wound healing
This document provides an overview of wound healing. It begins with definitions of regeneration, repair, and the two types of wound healing: primary intention and secondary intention. For regeneration and repair, it describes the molecular events of cell growth, proliferation, and extracellular matrix formation. It then covers the stages of primary and secondary wound healing in more detail. Specialized tissue healing like fractures is also summarized. Factors influencing wound healing and complications are listed. The document contains detailed information on the cellular and molecular processes involved in wound healing.
Chemistry of amino acids
The document provides information about amino acids and their classification. It discusses that amino acids are the monomer units that make up protein polymers. They can be classified based on their structure, side chains, nutritional requirements, and metabolic fate. The 20 standard amino acids are discussed in detail, including their physical and chemical properties. Key reactions of amino acids involving their amino, carboxyl, and side chain groups are also summarized.
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This document discusses nutrition in the ICU, including nutritional assessment and requirements for critically ill patients. It recommends initiating enteral nutrition within 24-48 hours for patients unable to maintain oral intake. Parenteral nutrition should only be used if enteral nutrition is not feasible or possible after 7 days of hospitalization. The goals of nutrition support are to provide adequate calories, protein, vitamins and minerals to meet metabolic demands and support organ function while avoiding complications.
Liver Disease and GERD
A 57-year-old male was admitted with nausea, vomiting and abdominal pain due to cirrhosis and bleeding esophageal varices. He has a history of alcoholism. Initial labs showed hyponatremia and low albumin. A jejunostomy tube was placed for nutrition but caused intolerance. He was started on TPN with Hepatamine which was later tapered as he transitioned to an oral soft diet.
Total parental nutrition
description about the Total Parentral Nutrition. where it is indicated and contraindicated and others
5-6-(TPN).ppt
Total Parenteral Nutrition (TPN), also known as hyperalimentation, is the intravenous infusion of a nutritionally complete formula including amino acids, dextrose, fat emulsions, vitamins, electrolytes, minerals, and trace elements. TPN provides nutrition when the gastrointestinal tract cannot be used due to conditions such as severe burns, sepsis, liver failure, or gastrointestinal diseases impairing absorption. Candidates for TPN are patients unable to take in nutrition orally or enterally who are at risk of malnutrition due to an inability to ingest, digest, or absorb nutrients. TPN must be carefully monitored to ensure patients maintain ideal body weight, fluid and electrolyte balance, normal blood glucose levels, and remain free
Nutrition in critically ill 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.
TOTAL PARETERAL NUTRITION and Enteral Nutrition.pptx
Total Pareteral and Enteral nutrion ,indications .Advantages and Disadvantages .when to use Gut and whe to use Pereteral route for nutrition.
sick day managment CAN SAFE LIFE FOR DM1
This document discusses the importance of sick day management for diabetic patients and provides guidance on managing common illness scenarios. It emphasizes that failure to properly manage illness can lead to dangerous complications like DKA, cerebral edema, and death. The document outlines criteria for diagnosing DKA and provides a 5-step approach to prevent DKA during illness. It also discusses guidelines for different scenarios involving hypoglycemia, ketosis, and hyperglycemia during sickness. Overall, the document stresses that educating patients and caregivers on sick day management is critical for safely managing illness and avoiding life-threatening outcomes.
vdocument.in_nutritional-support-55849fd534680.ppt
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.
Glycemic Control - Diabetes Mellitus
This document discusses glycemic control in ICU patients. It defines hyperglycemia as blood glucose above 140 mg/dL and recommends treating levels above 180 mg/dL, with a target range of 140-180 mg/dL. For patients on insulin infusions, it recommends hourly blood glucose monitoring initially, extending to every 2 hours once stable, and potentially every 4 hours if two consecutive readings are in target range. It also provides guidance on transitioning patients from intravenous to subcutaneous insulin and treating hypoglycemia.
Inpatient Diabetes
This document provides clinical practice guidelines for inpatient management of diabetes and hyperglycemia in adults. It recommends intensive insulin therapy to maintain blood glucose at or below 110 mg/dL to reduce morbidity and mortality. It establishes a multidisciplinary team at each hospital to develop protocols focused on glycemic control. It also encourages diabetes patient self-management when appropriate and provides discharge planning guidelines.
ueda2012 -incretin based therapy of type 2 diabetes mellitus_d.adel
(1) Sitagliptin is an oral dipeptidyl peptidase-IV (DPP-IV) inhibitor that works by inhibiting the breakdown of glucagon-like peptide-1 (GLP-1), allowing endogenous GLP-1 to remain active for longer and improve glycemic control. (2) In clinical trials comparing sitagliptin to sulfonylurea as an add-on to metformin, sitagliptin provided comparable reductions in HbA1c levels over 52 weeks and two years with a lower risk of hypoglycemia and weight gain. (3) The efficacy of sitagliptin in reducing HbA1c was associated with higher
Diet intessar 2012 final ppt
INTESSAR SULTAN
MD, MRCP
PROF. OF MEDICINE
@ TAIBAH UNIVERSITY
Consultant endocrinologist, diabetologist @ KFH
Total parenteral nutrition
Total Parenteral Nutrition (TPN) involves delivering nutrients, vitamins, electrolytes, and medications via intravenous route for patients unable to tolerate enteral nutrition. The key goals of TPN are to maintain nutritional status, limit protein wasting, boost immune function, and improve wound healing. Indications for TPN include inadequate oral/enteral intake for over 7-10 days, pre-existing malnutrition, and conditions impairing nutrient absorption. TPN aims to balance fluid, carbohydrates, fats, proteins, and micronutrients based on individual patient needs and includes monitoring for risks of over/under feeding.
DIABETIC_KETO_ACIDOSIS.pptx
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus caused by a lack of insulin. It is characterized by hyperglycemia, acidosis, and ketosis. The key precipitating factor is severe insulin deficiency. Diagnosis is based on hyperglycemia, presence of ketones, acidosis, and other metabolic disturbances. Treatment involves fluid resuscitation, insulin therapy to lower blood glucose levels, electrolyte replacement, and treating any underlying infections. Careful monitoring is needed to gradually correct metabolic abnormalities and avoid complications like cerebral edema.
Nutrition
This document discusses malnutrition in hospital patients and nutritional support. It provides information on screening patients for malnutrition, who needs nutritional support, the benefits of support, and enteral and parenteral nutrition routes and guidelines. Key points include that many hospital patients are malnourished due to increased needs, losses, or decreased intake; screening involves history, exam, and labs; and enteral nutrition is preferred over parenteral when possible due to fewer complications.
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TOTAL PARETERAL NUTRITION and Enteral Nutrition.pptx
TOTAL PARETERAL NUTRITION and Enteral Nutrition.pptx
vdocument.in_nutritional-support-55849fd534680.ppt
vdocument.in_nutritional-support-55849fd534680.ppt
ueda2012 -incretin based therapy of type 2 diabetes mellitus_d.adel
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Nut screening assess felanpe 2012
- Underfeeding occurs commonly in ICUs according to studies, with mean caloric intake around 56% of targets.
- Several nutrition screening tools are available but may not be optimal for the ICU given limitations like unavailable nutritional history.
- The NUTRIC score was developed to quantify a patient's nutritional risk in the ICU based on factors like age, illness severity, comorbidities, inflammation.
- A higher NUTRIC score is associated with worse outcomes like higher mortality and longer ventilation, and these high-risk patients may benefit most from aggressive nutrition therapy.
Impactof en feeding protocols
This multicenter observational study evaluated the impact of enteral feeding protocols on nutrition delivery in critically ill patients. The study found that sites using a feeding protocol had better enteral nutrition adequacy, started enteral nutrition earlier, and had higher overall nutritional adequacy compared to sites without a protocol. Specifically, sites with a protocol achieved 45.4% enteral nutrition adequacy compared to 34.7% for sites without. The presence of a protocol was associated with a 4.1% increase in enteral nutrition adequacy after adjusting for patient and site characteristics. However, overall nutritional adequacy remained below targets, indicating need for further refinement of feeding protocols.
IX Congreso Internacional Nutrición, Alimentación y Dietética
El documento presenta información sobre la revista Nutrición Clínica y Dietética Hospitalaria, incluyendo su objetivo y ámbito, comités editoriales, índices de impacto, y detalles de publicación. La revista cubre temas de nutrición clínica, dietética, salud pública y nuevos alimentos/ingredientes funcionales. Se publica trimestralmente y está indexada en varias bases de datos.
Gastric feeding
This guideline provides recommendations for safely delivering enteral nutrition to ICU patients, including:
1) Initiating enteral nutrition within 24-48 hours of admission, starting at 25 mL/hr with the head of bed elevated over 45 degrees and providing metoclopramide.
2) If gastric residual volumes exceed 250 mL, refeeding a maximum of 400 mL and continuing feeds at the same rate, or lowering narcotics as tolerated.
3) If gastric residual volumes remain high, using prokinetics like erythromycin or placing a post-pyloric feeding tube if prokinetics fail.
Critical nutrition
This document summarizes new randomized controlled trials in critical care nutrition published between 2009-2011 and their impact on existing clinical practice guidelines. It discusses several new RCTs on probiotics, fish oils, arginine, glutamine, and lipid emulsions. For probiotics and fish oils, the new evidence strengthens recommendations for their use. However, for arginine and glutamine, the new RCTs did not clearly support benefits. Overall, the new data impacts some recommendations and highlights areas requiring further research.
Diarrhea
This ICU guideline provides recommendations for managing diarrhea in patients. It involves first determining if the patient's medical history is consistent with diarrhea and assessing their risk of stool impaction. It then recommends stopping oral medications that could be causing diarrhea and manually disimpacting the patient if needed. Based on ongoing assessment of the patient's symptoms and stool output, the guideline provides steps for medical intervention which may include initiating antidiarrheal agents or considering fiber-containing formulas if investigations rule out other potential causes.
A
Trauma causes physical damage and metabolic stress. Early enteral nutrition within 72 hours of injury decreases sepsis risk, while total enteral nutrition preserves gut function and immunity. For severe trauma, an immune-enhancing diet with higher protein of 2.2-2.5 g/kg daily for a week may reduce infections. Severe head trauma increases energy expenditure and protein breakdown while impairing immunity. Early enteral nutrition can improve outcomes if given after intracranial pressure is controlled, while overfeeding must be avoided to prevent increased intracranial pressure from excess nutrient processing.
Redox
This document summarizes the findings of the REDOXS study, a randomized controlled trial that investigated the effects of high-dose glutamine and antioxidant supplementation in critically ill patients with multi-organ failure. The study found that glutamine supplementation was not beneficial and may have been harmful, increasing mortality. Subgroup analyses found the highest risk of harm with glutamine in patients who had renal dysfunction at enrollment. An updated meta-analysis of intravenous glutamine trials did not find an overall increase in mortality, though the REDOXS study results suggest glutamine could be harmful in certain critically ill populations such as those with renal failure.
Weight management popular approaches
This document summarizes and compares several popular weight loss approaches, including formula diets, Atkins, South Beach, and high carbohydrate low fat diets. It finds that meal replacements and very low calorie diets can promote significant short-term weight loss but have high dropout rates and weight regain. The Atkins and South Beach diets emphasize limiting carbohydrates, especially refined carbs, while high carb low fat diets focus on high fiber whole foods and calorie density. Research shows the Atkins and South Beach diets can produce similar initial weight loss to low fat diets but long term outcomes are unclear.
Soporte nutricional
Este documento presenta información sobre el soporte nutricional. Define la malnutrición y describe cómo evaluar el estado nutricional de un paciente mediante antropometría, análisis de laboratorio y cálculo de necesidades calóricas y proteicas. Además, explica el algoritmo para decidir el tipo de soporte nutricional basado en la situación del paciente y los posibles riesgos y beneficios. Finalmente, detalla opciones para la alimentación oral como formulaciones especiales y apoyo farmacológico con agentes orexígenos.
Servicio de alimentación
El documento describe la importancia de la nutrición hospitalaria y los objetivos de un servicio de nutrición. La desnutrición afecta entre el 30-60% de pacientes hospitalizados y aumenta la estadía y mortalidad. El servicio busca identificar pacientes en riesgo, mantener su estado nutricional, desarrollar protocolos multidisciplinarios y fomentar la capacitación continua del personal. Un equipo de nutrición es fundamental para optimizar el tratamiento y evolución de los pacientes.
Screening nutrition care process
The document describes the Nutrition Care Process, which is a standardized process for providing nutrition care. It involves 5 steps: nutrition screening, assessment, diagnosis, intervention, and monitoring and evaluation. Nutrition screening is used to quickly identify patients at nutritional risk and determine if a full assessment is needed. Hospitals are required to conduct nutrition screening within 24 hours of admission according to Joint Commission standards. Nutrition assessments gather comprehensive dietary, medical, and social data on patients to identify nutrition problems. This leads to developing a nutrition diagnosis, then creating and implementing a nutrition intervention plan to address the problem. Progress is monitored and outcomes are evaluated.
Optimal provision of en nutrition in the icu
The document discusses factors related to nutrition therapy outcomes in critically ill patients. It finds that increased calorie and protein intake from early enteral nutrition is associated with better outcomes like decreased mortality and shorter hospital stays. However, the optimal amounts may depend on the individual patient characteristics and analysis methods used. Higher calorie intake showed benefit except in young, healthy, overweight patients with short ICU stays. The document develops the NUTRIC risk assessment score to identify patients most likely to benefit from aggressive nutrition therapy based on age, comorbidities, inflammation markers, time in hospital and ICU before admission.
Probioticos
El documento describe los beneficios de los probióticos y prebióticos para la salud. Explica que los probióticos son microorganismos vivos que al ser ingeridos producen un efecto beneficioso al equilibrar la flora intestinal y fortalecer el sistema inmunológico, mientras que los prebióticos son ingredientes alimenticios que fomentan el crecimiento de bacterias benéficas. Los probióticos y prebióticos pueden ayudar a reducir el riesgo de efectos gastrointestinales y tratar en
Perioperative nutrition support
Nutrition is important for surgical patients. Malnutrition can compound complications, while well-nourished patients tolerate surgery better. Several factors are used to assess a patient's nutritional status prior to surgery, including weight loss, serum albumin levels, and medical history. For patients who cannot eat adequately after surgery, enteral or parenteral nutrition may be needed to meet nutrient demands and support healing. Enteral nutrition involves feeding through a stomach or intestinal tube, while parenteral nutrition is administered intravenously.
Nutrition screening and assessment in critically ill patients
- Underfeeding occurs commonly in ICUs according to studies, with mean caloric intake around 56% of targets.
- Several nutrition screening tools are available but may not be optimal for the ICU given limitations like unavailable nutritional history.
- The NUTRIC score was developed to quantify a patient's nutritional risk in the ICU based on factors like age, illness severity, comorbidities, inflammation.
- Higher NUTRIC scores are associated with worse outcomes like mortality and longer ventilation. Patients with higher scores may benefit most from aggressive nutrition interventions while low scores could see potential harm from such interventions.
Indicaciones de soporte nutricional
Este documento proporciona indicaciones sobre el soporte nutricional. Explica que la malnutrición contribuye a aumentar la morbilidad y mortalidad de los pacientes. Detalla los diferentes tipos de soporte nutricional como la nutrición enteral y parenteral, y ofrece consideraciones sobre su uso en diferentes situaciones clínicas como en pacientes críticos o con enfermedades como la diabetes. Finalmente, concluye que el soporte nutricional está indicado en pacientes desnutridos o con riesgo de desnutrición para cubrir sus requerimientos nut
Guía de nutrición en enfermedad renal crónica avanzada (erca)
- La guía recomienda proporcionar alrededor de 0,75 g de proteínas por kg de peso al día para pacientes con ERC en estadios 1-3, y alrededor de 0,6 g por kg en estadios 4-5, para frenar la progresión y minimizar toxinas urémicas.
- Es esencial mantener una adecuada ingesta energética en todos los estadios de la ERC.
- La valoración del estado nutricional requiere múltiples marcadores como la albúmina, peso seco,
Filtro de desnutrición en paciente hospitalizado
Este documento presenta información sobre la detección y prevalencia de la desnutrición hospitalaria. En particular, discute varios métodos de detección de la desnutrición como MUST, NRS-2002 y VGS. También analiza la prevalencia de la desnutrición en diferentes poblaciones de pacientes hospitalizados y en residencias, así como marcadores bioquímicos comunes.
Eating disorders lecture
This document discusses eating disorders and provides information about anorexia nervosa and bulimia nervosa. It defines the diagnostic criteria for these disorders according to the DSM and describes their prevalence, risk factors, psychological and physical symptoms, and pathophysiology. Anorexia is characterized by restricted food intake and fear of gaining weight, while bulimia involves binge eating followed by purging behaviors. Both disorders predominantly affect adolescent and young adult females and can have serious long-term health consequences if not properly treated.
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IX Congreso Internacional Nutrición, Alimentación y Dietética
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Pn algorithm
- 1. PN to be delivered <10 days and patient well-nourished? 1) Provide hypocaloric PN♦ . 2) Withhold IV lipids♦ . 1) Provide required energy level. 2) Provide IV lipids. All strategies to maximize EN implemented? (e.g. protocol outlining acceptable gastric residual volume of 250 ml; prokinetic(s)* provided; small bowel feeding tube placed). 1) Implement strategies as noted above. 2) Increase EN to goal rate as tolerated. 1) Provide low dose EN*. 2) Provide IV glutamine♦ . If IV N/A consider enteral glutamine (0.25 gm/kg/day - 0.5 gm/kg/day mixed in 50 ml saline; delivered in divided doses). ICU GUIDELINE: PARENTERAL NUTRITION (PN) Yes No Formatted by: J. Greenwood, RD. for CCN. Update 7/4/2010 www.criticalcarenutrition.com NoYes ♦In critically ill patients hyperglycemia should be avoided (blood sugar > 10 mmol/L). Target blood glucose 8.0 mmol/L (7.0 – 9.0 mmol/L) * Unless contraindicated ♦ Evidence-based recommendation; all other information opinion-based.