• 성인간호학회지
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• 제26권6호
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• pp.621-629
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• 2014

Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.

• Journal of Nutrition and Health
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• 제27권3호
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• pp.281-291
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• 1994

The purpose of this study was to investigate the effectiveness of enteral nutritional support to cancer patients who were clinically malnourished and receiving chemotherapy after surgery. To estimate the effect of nutritional support using Greenbia(Dr. Chung's Food Cooperation, LTD., Seoul, Korea) for patients with cancer, 41 patients were participated between January 1991 to November 1991. All patients were randomized into 2 groups and 18 patients were evaluated(experimental group : 12, control group : 6). The counseling was carried out once a week for 2 months. To compare the nutrient intake before and after administration of nutritional beverage and to identify the potential effectiveness of nutritional support in this group, a record of this diet on all patients during the test period was carried out for 3 days. To evaluate the patients nutritional status, the anthropometric parameters and serum protein were checked at the begining as baseline, week 3, week 6, and at the end of the test(week 8). In the case of energy balance, no patients appeared to be positive before administration of nutritional beverage, while 2 patients among 12 were observed to be more than 100% positive after administration. There were some differences among the experimental group which had administration of nutritional beverage but most of the results of anthropometric parameters were improved. When comparing the experimental and control group, there was significant increase in body weight, body fat, arm circumference and tricep skinfold. This study suggests that enteral nutritional support can help improving the nutritional status of patients received chemotherapy.

• Journal of Nutrition and Health
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• 제35권5호
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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.

• Nutrition Research and Practice
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• 제4권5호
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• pp.393-399
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• 2010

Enteral nutritional support has been used via tube feeding for dysphagic stroke patients. We performed long and short term trials to evaluate the effects of commercial enteral nutritional supports on nutrition and health in stroke patients (mRS = 3~5) and quality of life in their caregivers. For a long term study, we recruited chronic (${\geq}$ 1 yrs) stroke patients (n = 6) and administered them 6 cans/day (1,200 kcal) of the commercial enteral formula N for 6 months according to IRB-approved protocol. We collected peripheral blood at 0, 2, 4 and 6 months. For a short term study, we recruited acute (${\leq}$ 3 months) stroke patients (n = 12) and randomly administered them two different commercial enteral formulas, N or J, for 2 weeks. We collected their blood at 0, 4, 7 and 14 day of the administration. Blood samples were analyzed to quantify 19 health and nutritional biomarkers and an oxidative stress biomarker, malondialdehyde (MDA). In order to evaluate quality of life, we also obtained the sense of competence questionnaire (SCQ) from all caregivers at 'before' and 'after trials'. As results, the enteral formula, N, improved hemoglobin and hematocrit levels in the long term trial and maintained most of biomarkers within normal ranges. The SCQ levels of caregivers were improved in the long term treatment (P < 0.05). In a case of the short term study, both of enteral formulas were helpful to maintain nutritional status of the patients. In addition, MDA levels were decreased in the acute patients following formula consumption (0.05 < P < 0.1). Most of health and nutrition outcomes were not different, even though there is a big difference in price of the two products. Thus, we evaluate the formula N has equal nutritional efficacy compared to the formula J. In addition, long term use of enteral formula N can be useful to health and nutrition of stroke patients, and the quality of life for their caregivers.

• Clinical and Experimental Pediatrics
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• 제53권1호
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• pp.7-13
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• 2010

Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

• 대한임상독성학회지
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• 제18권2호
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• pp.123-129
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• 2020

Purpose: Atropine is an antidote used to relieve muscarinic symptoms in patients with organophosphate and carbamate poisoning. Nutritional support via the enteral nutrition (EN) route might be associated with improved clinical outcomes in critically ill patients. This study examined the administration of nutritional support in patients undergoing atropinization, including methods of supply, outcomes, and complications. Methods: A retrospective observational study was conducted in a tertiary care teaching hospital from 2010 to 2018. Forty-five patients, who were administered with atropine and on mechanical ventilation (MV) due to organophosphate or carbamate poisoning, were enrolled. Results: Nutritional support was initiated on the third day of hospitalization. Thirty-three patients (73.3%) were initially supported using parenteral nutrition (PN). During atropinization, 32 patients (71.1%) received nutritional support via EN (9) or PN (23). There was no obvious reason for not starting EN during atropinization (61.1%). Pneumonia was observed in both patient groups on EN and PN (p=0.049). Patients without nutritional support had a shorter MV duration (p=0.034) than patients with nutritional support. The methods of nutritional support during atropinization did not show differences in the number of hospital days (p=0.711), MV duration (p=0.933), duration of ICU stay (p=0.850), or recovery at discharge (p=0.197). Conclusion: Most patients undergoing atropinization were administered PN without obvious reasons to preclude EN. Nutritional support was not correlated with the treatment outcomes or pneumonia. From these results, it might be possible to choose EN in patients undergoing atropinization, but further studies will be necessary.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권2호
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• pp.79-84
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• 2012

Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.

• 대한임상독성학회지
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• 제19권2호
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• pp.93-99
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• 2021

Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

• 대한영양사협회학술지
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• 제1권1호
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• pp.21-30
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• 1995

Critically ill patients admitted in ICU and NCU were studied with respect to their nutritional status and support to them at initial period, and the effect of nutritional support after 3 weeks. The nutritional support was supplied to these patients with the enteral and parenteral nutrition. The results of biochemical test and status of nutritional support on 52(29 males, 23 females) critically ill patients were based on medical records and the anthropometry was measured on 28 patients. The subjects were in mild malnutrition. Their initial calorie intakes were 85% of BEE, 57% of total energy requirements and 49% of protein requirement were provided. Two groups, one group of serum albumin level more than 3.5g/dl and the other group of serum albumin level less than 3.5g/dl, were significant different in total calorie and protein intakes. After 3 weeks, inappropriate nutritional support in the group of normal nutrition results in significant decreasing of serum albumin level but, there were no changes in the group of malnutrition. Nutritional support is one of the mainstays in the management of these critically ill patients and is aimed at preventing malnutrition. Therefore, timely nutritional support is heavily required in cases of critically ill patients whether their initial nutritional status is normal or not.

• 중환자간호학회지
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• 제3권1호
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• pp.79-88
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• 2010

Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.