• Title/Summary/Keyword: Nutritional intervention

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Nutritional Intervention for a Critically Ill Trauma Patient: A Case Report

  • Seong Hyeon Kim;Sun Jung Kim;Woojeong Kim
    • Clinical Nutrition Research
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    • v.11 no.3
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    • pp.153-158
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    • 2022
  • Critically ill trauma patients generally show good nutritional status upon initial hospitalization. However, they have a high risk of malnutrition due to hyper-metabolism during the acute phase. Hence, suitable nutritional support is essential for the optimal recovery of these patients; therefore, outcomes such as preservation of fat-free mass, maintenance of immune functions, reduction in infectious complications, and prevention of malnutrition can be expected. In this report, we present the experience of a patient subjected to 40 days of nutritional interventions during postoperative intensive care unit (ICU) care. Although the patient was no malnutrition at ICU admission, enteral nutrition (EN) was delayed for > 2 weeks because of several postoperative complications. Subsequently, while receiving parenteral nutrition (PN), the patient displayed persistent hypertriglyceridemia. As a result, his prescription of PN were converted to lipid-free PN. On postoperative day (POD) #19, the patient underwent jejunostomy and started standard EN. A week later, the patient was switched to a high-protein, immune-modulating formula for postoperative wound recovery. Thereafter, PN was stopped, while EN was increased. In addition, because of defecation issues, a fiber-containing formula was administered with previous formula alternately. Despite continuous nutritional intervention, the patient experienced a significant weight loss and muscle mass depletion and was diagnosed with severe malnutrition upon discharge from the ICU. To conclude, this case report highlights the importance of nutrition interventions in critically ill trauma patients with an increased risk of malnutrition, indicating the need to promptly secure an appropriate route of feeding access for active nutritional support of patients in the ICU.

The Effects of Oral Health Care Education for Nursing Staff on Halitosis and Nutrient Intake of the Elderly in a Long-term Care Facility (간호자 구강간호 교육프로그램이 요양시설 노인의 구취와 영양소 섭취량에 미치는 효과)

  • Park, Kyung-Ae;Choi-Kwon, Smi;Park, Myung-Sook
    • Journal of the Korean Dietetic Association
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    • v.17 no.3
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    • pp.243-258
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    • 2011
  • The purpose of this study was to investigate the effects of an oral health care education program for care providers on the nutritional status of the elderly in a long-term care facility. This study was conducted at a long-term care facility located in K metropolitan city using a nonequivalent control group non-synchronized design. Fifty-four nursing home residents aged 65 years or older were assigned either to the intervention group (n=27) or the control group (n=24). The intervention group received oral health care from the care providers' intervention group, who provided oral health care for 6 weeks after 6 weeks of oral health care education. Data were collected from the control group and intervention group at the baseline 6 and 12 weeks after oral care education and were analyzed using SPSS windows 16.0. The halitosis was lower in the intervention group than the control group at 12 weeks (P<0.01). Body mass index of the intervention group at 12 weeks was higher than that at 6 weeks. Iron intake of the intervention group at 12 weeks was lower than that at baseline. At baseline, the intakes of riboflavin, folate, and potassium were lower than 75% of dietary reference intakes. In conclusion, an oral care education program for care providers was effective in improving the oral hygiene of nursing home residents, and dietary plans are needed to improve the nutritional status of them.

Mediated Effects of Nutritional Status on the Relationship between Symptom Experience and Functional Status in Patients with Lung Cancer undergoing Chemotherapy (항암화학요법 폐암 환자의 증상경험과 기능상태간의 관계에 미치는 영양상태의 매개효과)

  • Jung, Kyoung-Sun;Min, Hye Sook;Yun, Mi-Jeong
    • Journal of muscle and joint health
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    • v.24 no.2
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    • pp.130-139
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    • 2017
  • Purpose: This study was conducted to explore the mediating effect of nutritional status in the relationship between symptom experience and functional status among in patients with lung cancer undergoing chemotherapy. Methods: Subject (N=139) were lung cancer patients visiting the D hospital in B city. Data collection was conducted from May 2016 to February 2017. Seven nutritional status measurement tools, 22 symptom experience tools, and 15 EORTC QLQ-C30 functional scales were used to measure nutritional, symptom, and functional levels. The collected data were analyzed by SPSS / WIN 21.0 using descriptive analysis, Pearson correlation, 3-step regression analysis of Baron and Kenny, and Sobel test. Results: There was a significant positive correlation between symptom experience and nutritional status, a significant negative correlation between symptom experience and functional status, and significant negative correlation between nutritional status and functional status. Symptom experience had direct effect and indirect effects on functional status through nutritional status. Conclusion: For enhancing functional status in lung cancer patients, it is necessary to develop nursing intervention programs to palliate symptoms and improve nutritional status.

Nutritional Assessment of the Older Population: Practical Application and Limitation

  • Yoon, Jin-Sook
    • Journal of Community Nutrition
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    • v.2 no.1
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    • pp.36-49
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    • 2000
  • Evaluation of nutritional status is an essential element in providing appropriate intervention strategies to achieve the highest level of health, Nutritional assessment of the older population is complicated by many factors which do not significantly affect the nutritional status in young adults, therefore, it should be considered in two ways; community-dwelling elders group and hospitalized or institutionalized elderly group. To sort out the individuals with nutritional problems in a community efficiently, nutrition screening tools must be simple, relatively inexpensive, and applicable to a large number of subjects. Combination of tools and indicators such as 24-hour food recall, body weight and height, and questionnaires on eating practices, and the presence of chronic diseases is practically applicable as basic tools of nutritional screening of older age group. However, the lack of validated screening techniques remains a barrier in improving nutrition. Validation is only limited to energy, BMI, protein intake of the older populations living in western countries. Further refinement of nutritional assessment tools is demanded to figure out whether those are practically applicable to community-living older adults in Asian Society. A careful and systematic evaluation of nutritional assessment tools should be carried out prior to implementation of stepwise nutrition service to the heterogeneous older population. For an in-depth nutritional assessment at the individual level, we need to extend research efforts to clarify the requirements of nutrients due to aging and diseases. More cost-effective method that will allow rapid analysis of survey results are needed so that information can be readily available to policymakers.

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The Mediating Effects of Nutritional Status on the Relationship between Symptom Experience and Functional Status in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 증상경험과 기능상태의 관계에 미치는 영양상태의 매개효과)

  • Jang, Jun Hee;Min, Hye Sook
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.112-121
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    • 2018
  • Purpose: This study was conducted to explore the mediating effect of nutritional status on the relationship between symptom experience and functional status of patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 141 COPD patients visiting D hospital and I hospital in B city were enrolled in this study. Data were collected from January 2017 to July 2017. Outcome variables were measured by Mini Nutritional Assessment Short-Form (MNA-SF) for nutritional status, The Memorial Symptom Assessment Scale (MSAS) for symptom experience, and The Functional Performance Inventory Short Form (FPI-SF) for functional status. The data were analyzed with descriptive statistics, Pearson's correlation, and path analysis using SPSS/WIN 21.0 and AMOS 25. Results: There was a significant negative correlation between symptom experience and nutritional status (r=-.61, p<.001), a significant negative correlation between symptom experience and functional status (r=-.40, p<.001), and significant positive correlation between nutritional status and functional status (r=.47, p<.001). Symptom experience had indirect effects on functional status through nutritional status. Conclusion: For enhancing functional status in COPD patients, it is necessary to develop nursing intervention programs to enhance symptom management as well as nutritional status.

Nutritional Support for Neurocritically Ill Patients (신경계 중환자의 영양 집중 치료)

  • Jeong, Hae-Bong;Park, Soo-Hyun;Ryu, Ho Geol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.71-80
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    • 2018
  • Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

Research for Developing Medical Nutrition Therapy on Korean Medicine : Literature Study and a Survey (한의학적 임상영양치료법 개발을 위한 연구)

  • Han, Eun Kyung;Hwang, Sang Moon;Seo, Soo Youn;Jung, Yun Im;Bae, Go Eun;Kim, Byung Joo;Lee, Sang Jae;Chae, Han;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.4
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    • pp.350-361
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    • 2013
  • aksun(藥饍), or 'Traditional oriental medicine nutrition therapy', is expected to be an effective nutritional intervention for the patients suffering from chronic diseases. However, there are no systemized protocol that utilize Yaksun as an effective nutrition therapy for Asian patients even though they are accustomed to traditional oriental diet. We investigated the possibility of using Yaksun for developing an effective Medical Nutrition Therapy for Asian patients and proposed factors that have to be considered. Articles published between 1995-2012 about MNT (Medical Nutrition Therapy) and Yaksun were reviewed. Male and female patients of two Korean Medicine Hospitals (n=93) and one Korean Medicine Clinic (n=20) answered a questionnaire asking about their thoughts on the effectiveness of nutritional intervention for their disease management and about their expectations toward Medical Nutrition Therapy on Korean Medicine. 92.9% of the patients have perceived that nutritional intervention is important in disease management. 79.6% of the patients have positively responded that they are willing to use the Medical Nutrition Therapy on Korean Medicine as a clinical nutrition therapy if developed. Female patients, aged in their forties and fifties, educated equivalent to high school graduates and more, and who visited Korean medicine clinic were most interested in the Medical Nutritional Therapy on Korean Medicine. The factors considered in developing the protocol are 1. effectiveness 2. safety 3. expense, in order of importance. Nutritional intervention protocol using Yacksun is necessary for the patients. Medical Nutrition Therapy on Korean Medicine is in need of development. Accumulated case-control studies, cost effectiveness studies, and studies about programming and systemizing the protocol are needed.

Comparison of Cognitive Levels, Nutritional Status, Depression in the Elderly according to Living Situations (동거유형에 따른 노인의 인지기능, 영양상태, 우울의 비교)

  • 정영미;김주희
    • Journal of Korean Academy of Nursing
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    • v.34 no.3
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    • pp.495-503
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    • 2004
  • Purpose: The purpose of this study was to compare the degree of cognitive level, nutritional status and depression in elderly according to living situations. Method: The subjects consisted of 173 elderly classifying three groups(living alone, living with spouse, living with children). Data was collected from March to June, 2003 by a structured questionnaire that included general characteristics, MMSE-K, nutritional status and depression scale. The collected data was analyzed by the SPSS program including descriptive statistics, $\chi$$^2$-test, ANCOVA, Scheffe test and Pearson Correlation Coefficient. Result: In MMSE-K, the living alone group showed suspicious dementia while the other groups were normal. The living alone group showed a high nutritional risk and all three groups showed depression. In MMSE-K, the nutritional status and depression were statistically significant by the living situation. In each group except living with spouse, MMSE-K indicated a significantly negative correlation to depression and nutritional status, while nutritional status showed a significantly positive correlation to depression. Conclusion: It is necessary to develop supportive programs for decreasing the risk of bad health in the elderly and an individual approach according to their living situation. Especially, more concern and intervention is necessary for the solitary elderly.

Effects of Copper Reduction on Angiogenesis-Related Factors in Recurrent Glioblastoma Cases

  • Jazayeri, Shima;Feli, Alireza;Bitaraf, Mohammad Ali;Dodaran, Masoud Solaymani;Alikhani, Mazdak;Hosseinzadeh-Attar, Mohammad Javad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4609-4614
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    • 2016
  • Purpose: To evaluate the therapeutic effects of copper reduction on angiogenesis-related factors in patients with glioblastoma multiforme treated by gamma knife radiosurgery. Materials and Methods: In the present block randomized, placebo-controlled trial, fifty eligible patients with a diagnosis of glioblastoma multiforme who were candidates for gamma knife radiosurgery were randomly assigned into two groups to receive daily either 1gr penicillamine and a low copper diet or placebo for three months. The intervention started on the same day as gamma knife radiosurgery. Serum interleukin-6 (IL-6), tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), vascular endothelial growth factor (VEGF) and copper levels were measured at baseline and after the intervention. The serum copper level was used as the final index of compliance with the diet. In order to control probable side effects of intervention, laboratory tests were conducted at the beginning, middle and end of the study. Results: The patients had a mean age and Karnofsky Performance Scale of 43.7 years and 75 respectively. Mean serum copper levels were significantly reduced in intervention group. Mean survival time was 18.5 months in intervention group vs. 14.9 in placebo group. VEGF and IL-6 levels in the intervention group were also significantly reduced compared to the placebo group and $TNF-{\alpha}$ increased less. Conclusions: It seems that reducing the level of copper in the diet and dosing with penicillamine leads to decline of angiogenesis-related factors such as VEGF, IL-6 and $TNF-{\alpha}$. Approaches targeting angiogenesis may improve survival and can be used as a future therapeutic strategy.

Effects of Multivitamin-Mineral Supplementation, at Nutritional Doses, on Plasma Antioxidant Status, Erythrocyte Antioxidant Enzyme Activities and Lipid Peroxidation during Pregnancy

  • Park, Eunju;Kang, Myung-Hee
    • Nutritional Sciences
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    • v.3 no.1
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    • pp.36-41
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    • 2000
  • The aim of this study was to evalute the effect of multivitamin-mineral supplementation during pregnancy on plasma levels of antioxidants, erythrocyte antioxidant enzyme activities, and lipid peroxidation. A controlled, semi-randomized, prospective trial was performed by comparing the supplement group, which received multivitamin-mineral tables once daily for 10 weeks, with the control group. Plasma levels of $\beta$-carotene, tocopherol, coenzyme Q10, ascorbate, folate, zinc, and selenium and malondialdehyde (MDA), as well as the activities of superocxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in erythrocytes were measured initially (20 wk gestation) and at the end of the intervention (34 wk gestation). In the control group, plasma ascorbate and selenium levels decreased and tocopherol levels increased. In the supplement group, a significant increase in plasma $\beta$-carotene(46%), conenzyme Q10 (42%), and zinc (24%) was observed after 10 weeks of supplementation. No changes were observed in the plasma levels of MDA, and erythrocyte GSH-Px activity, while SOD activity increased in both control group and the supplement group during the intervention. These data suggest that multivitamin-mineral supplementation during pregnancy produced moderate increases in plasma $\beta$-carotens, coenzyme Q10, and zinc concentrations but the enhancement of those plasma antioxidants had on direct on the plasma level of MDA, erythrocytes SOD or GSH-Px activities.

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