• Title/Summary/Keyword: Enteral nutrition

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A Study on Nutritional Status, Biochemical Parameters, Lipid and Electrolytes Concentrations According to the Duration of Enteral Nutrition Tube-feeding (경장영양 기간에 따른 영양상태, 생화학적 지표, 지질 및 전해질 농도에 관한 연구)

  • 이정화;조금호;이봉암;이선화;조여원
    • Journal of Nutrition and Health
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    • v.35 no.5
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    • pp.512-523
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    • 2002
  • The objective of this study was to investigate the nutritional status, biochemical parameters, lipid and electrolytes concentrations of the enteral nutrition patients according to the duration of enteral nutrition. Eighteen neurosurgery patients in the intensive care unit (ICU) at K University Hospital were subjected in this study. The duration of enteral nutrition was classified into under or over six month of period. Anthropometric, biochemical, clinical, and dietary assessments were performed. Patients' intakes of energy and protein were insufficient, from 82% to 95% of their requirements. Mid-arm muscle circumference (MAMC) and mid-am muscle area (MAMA) were significantly lower in patients over six months of enteral nutrition than those in patients under six months. The subjects were malnourished as indicated by nutrition-related parameters such as hemoglobin, albumin, total lymphocyte count (TLC), tricep skinfold thickness (TSF), mid-arm circumference (MAC), MAMC, and MAMA. Serum chloride level of the patients eve, six months of enteral nutrition was lower (94.7 $\pm$ 3.4 mmo1/1) significantly as compared to that of patients (99.3 $\pm$ 3.5 mmol/ 1) under six months. Urinary sodium and chloride levels were lower in the longer time of enteral nutrition patients than those of shorter period of enteral nutrition patients (p < .05). While serum phospholipid level was higher in the patients over six months of enteral nutrition, other blood biochemical parameters and electrolyte concentrations did not show any differences with the duration of enteral nutrition. Neurosurgery patients in the ICU undergoing long-term enteral nutrition tube-feeding were malnourished and had a variety of metabolic complications. The duration of enteral nutrition could affect the patients' nutritional status, biochemical parameters, and electrolytes balance. The patients who require nutritional support over an extended time need the continuous follow-up care and monitoring by the nutrition support team for laboratory, clinical, and nutritional assessments.

Nutritional Intake and Timing of Initial Enteral Nutrition in Intensive Care Patients: A Pilot Study (중환자실 환자의 경관영양 공급시기에 따른 영양섭취양상: 예비연구)

  • Kim, Hyunjung
    • Korean Journal of Adult Nursing
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    • v.25 no.4
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    • pp.444-453
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    • 2013
  • Purpose: The purpose of this study was to describe the differences between early and delayed enteral nutrition on nutritional intake. Methods: A pilot cohort study was conducted with 45 critically ill adult patients who had a primary medical diagnosis. Energy prescribed and received were collected during the four days after initiation of enteral nutrition. Adequate feeding was defined as the energy intake more than 90% of required energy. Results: A total of 23 patients (52%) were received early enteral nutrition (within 48 hours of admission). Energy intake of early enteral nutrition was less than intake of delayed enteral nutrition during the four days of the study. Although the difference on day one was significantly greater than the differences on day two, the differences on day two were not different from days three or four. No statistical differences in the adequacy of nutritional intake were found between patients in the early and the delayed group. Conclusion: In critically ill patients receiving early enteral nutrition, more aggressive administration from the beginning will improve the nutritional intake. Additional studies including a large multi-centre, randomized clinical trial are recommended.

Enteral nutrition for optimal growth in preterm infants

  • Kim, Myo-Jing
    • Clinical and Experimental Pediatrics
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    • v.59 no.12
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    • pp.466-470
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    • 2016
  • Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the clinical course of the infant. During hospitalization, enteral nutrition with preterm formula and fortified human milk represent the best feeding practices for facilitating growth. After discharge, the enteral nutrition strategy should be individualized according to the infant's weight at discharge. Infants with suboptimal weight for their postconceptional age at discharge should receive supplementation with human milk fortifiers or nutrient-enriched feeding, and the enteral nutrition strategy should be reviewed and modified continuously to achieve the target growth parameters.

Critical Care Nurses' Perception, Knowledge, and Practices of Enteral Nutrition (중환자간호사의 경관영양 공급에 대한 인식과 지식 및 수행)

  • Kim, Hyunjung;Soun, Eunjin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.4
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    • pp.383-392
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    • 2016
  • Purpose: The purpose of this study was to assess critical care nurses' perception, knowledge, and nursing practices regarding enteral nutrition. Methods: A descriptive study was conducted with 187 nurse participants who worked in one of the eight medical and surgical intensive care units (ICUs) from four hospitals in Korea. Data were collected using a self-administered questionnaire. Results: Although critical care nurses' perception toward enteral nutrition was high, knowledge was relatively low. The overall perception and knowledge of the nurses did not differ significantly between medical ICU and surgical ICU nurses. Perception of their own knowledge, in particular, 'nutritional goal' was lower for medical ICU nurses compared to surgical ICU nurses. Nurses also had limited knowledge about the significance of enteral nutrition, confirmation of feeding tube location, and nutritional requirements for ICU patients. They inadequately performed the following: changing the feeding tube every 24 hours, inspecting nostrils daily, and adjusting feeding schedule if feeding was stopped. Conclusion: Our results indicate that ICU nurses need up-to-date information about enteral nutrition. Based on the improved perception and knowledge, nursing practice activities with regard to enteral nutrition should be emphasized to enable nurses to provide optimal nutrition for ICU patients.

Two cases of Improved Diarrhea due to Enteral Nutrition in Oriental Medical Treatment (비위관 급식환자에서의 설사 치험 2례)

  • 임중화;유종민;장선영;한숙영;박석규;홍상선;김진성;윤상협;류봉하
    • The Journal of Korean Medicine
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    • v.24 no.3
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    • pp.192-198
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    • 2003
  • Diarrhea is defined as increased volume and frequency of stools, increased liquidity and decreased consistency of stools. Enteral nutrition is suited to the patient in a state of normal gastro-intestinal function but insufficient oral nutrition due to neurologic injury. Of many problems raised by enteral nutrition, diarrhea is the most common complication and raises severe clinical problems such as dehydration, disproportion of electrolytes, metabolic acidosis, bed sores, etc. We report two cases of diarrhea due to enteral nutrition treated with Dolichos lablab L. preparation added to herb-med prescription in stroke patients. After this treatment, the frequency of diarrhea decreased and general condition improved.

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Enteral Nutrition in Pediatric Patients

  • Yi, Dae Yong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.12-19
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    • 2018
  • Pediatric patients require specialized attention and have diverse demands for proper growth and development, and thus need a different approach and interest in nutritional assessment and supply. Enteral nutrition is the most basic and important method of nutritional intervention, and its indications should be identified. Also, the sites, modes, types, and timing of nutritional intervention according to the patient's condition should be determined. In addition, various complications associated with enteral nutrition supply should be identified, and prevention and treatment are required. This approach to enteral nutrition and proper administration can help in the proper growth and recovery of pediatric patients with nutritional imbalances or nutritional needs.

Comparison of Equipment Contamination Level according to Enteral Nutrition Bag Cleaning and Disinfection Methods (경장영양백 세척 및 소독방법에 따른 오염 정도 비교)

  • Park, Jin-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.4
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    • pp.472-479
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    • 2011
  • Purpose: The purpose of this study was to develop guidelines for cleaning of enteral nutrition bags by comparing the level of equipment contamination according to cleaning and disinfection methods. Method: This study was a true-experimental study, with 60 cases in total. Twenty cases each were randomly assigned to tepid water, detergent and brush, and disinfectant groups. The period of the experiment was March to April 2010, and enteral nutrition was given for 1 houre, 3 times a day at 7AM, noon, and 7PM for seven days. Enteral nutrition bags were cleaned after each feeding according to assigned cleaning and disinfection method followed by microbial cultures on 4th and 8th day before the 7AM feeding. Results: After 3 days of feeding and cleaning, the level of contamination of bags was not significantly different among the three groups. After seven days, the level of contamination was significantly lower when bags were cleaned with detergent and brush or with disinfectant compared to cleaning with tepid water. Conclusion: In cases where enteral nutrition bags are reused for example, in home care settings, studying findings indicate that cleaning bags using detergent and brush or disinfectant is an effective way to prevent contamination of bags.

Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas

  • Dong-Yeon Kim;Hee-Jae Suh
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.729-738
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    • 1998
  • In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritionally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group of heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.

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Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review (중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰)

  • Kim, Hyunjung;Chang, Sun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

Factors Influencing the Occurrence of Diarrhea in Patients Admitted to Intensive Care Units (중환자실 입원 환자의 설사 발생과 영향요인: 후향적 조사)

  • Lee, Hanna;Song, Rhayun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.4
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    • pp.221-230
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    • 2019
  • Purpose: This study was done to examine incidence of diarrhea and explore factors influencing occurrence of diarrhea in patients admitted to intensive care units (ICU). Methods: For this retrospective research, data based on inclusion criteria were collected from the electronic medical records for 142 patients admitted to a university hospital ICU from September 2014 to August 2015. Statistical analysis was conducted using SPSS/WIN 22.0 program. Results: Incidence of diarrhea was 53.5% during the 12-month study period. Diarrhea occurred at 4.54 days and continued for 1.79 days on average. Average total frequency of diarrhea was 5.56 times. Increased ICU stay, enteral nutrition, and infection state were significant predictors of the occurrence of diarrhea. Infection increased risk of diarrhea 3.4 times and enteral nutrition increased risk of diarrhea to 2.2 times greater than patients not receivng enteral nutrition. Conclusion: Diarrhea in ICU patients is associated with multiple factors that should be considered to implement preventive strategies. Infection control should be emphasized, and close monitoring of diarrhea should be provided for those with enteral nutrition. Further studies are warranted to determine standardized clinical definition of diarrhea and diarrhea risk factors in ICU patients with different levels of severity and comorbidity.