• Title/Summary/Keyword: nutritional support

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Nutritional Support, Gastric Residual Volume and Nutritional Status during Enteral Nutrition in Intensive Care Unit Patients (중환자실 경장영양 환자의 영양지원, 위 잔여량 및 영양상태)

  • Lee, Minju;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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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.

Degree of Nutritional Support and Nutritional Status in MICU Patients (내과계 중환자의 영양공급 현황 및 영양상태 변화)

  • Chi, Soo-Na;Ko, Jea-Young;Lee, Su-Ha;Lim, Eun-Hwa;Kown, Kuk-Hwan;Yoon, Mi-Seon;Kim, Eun-Sook
    • Journal of Nutrition and Health
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    • v.44 no.5
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    • pp.384-393
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    • 2011
  • The objective of this study was to determine the nutritional support in patients treated in medical intensive care units (MICUs) by evaluating the extent of current nutritional support using the patient care plan and considering the association between nutritional status and the amount of nutrition supplied. From April to December 2010, 114 patients (age ${\qeq}$ 18 years) admitted to the MICU and who underwent nutritional support for > 5 days were included. Descriptive statistics showed that the 114 patients received nutritional support within 1.2 ${\pm}$ 0.7 days and for 16.2 ${\pm}$ 11.7 days in the MICUs. The total delivered/required caloric ratio was 81.08 ${\pm}$ 27.31%, and the protein ratio was 80.32 ${\pm}$ 28.93%. Patients who received > 80% of required calories and protein showed improved nutritional status (p < 0.05). The results showed that adequate nutritional support is crucial to critically ill patients. We suggest early nutritional screening using simple tools such as periodic monitoring and management to recalculate nutritional status and nutritional requirements and nutritional support using a multidisciplinary method. Systematic nutritional support teams are needed to provide adequate nutritional support for patients in the MICU.

A study on Nutritional status and Support in Critically ill patients (서울시내 1 개병원 중환자의 영양상태와 영양지원 실태에 관한 연구)

  • Choe, Mi-Suk;Kim, Jeong-Nam
    • Journal of the Korean Dietetic Association
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    • v.1 no.1
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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.

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How to Manage the Pediatric Nutritional Support Team: Updates

  • Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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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.

The Effect of Enteral Nutritional Support in Cancer Patients (암 환자에서의 경구 영양 보충 효과에 관한 연구)

  • 문수재
    • Journal of Nutrition and Health
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    • v.27 no.3
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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.

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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.

Nutritional Status among Elderly Korean Women and Related Factors (간이영양상태조사지(Mini Nutritional Assessment)로 조사한 일개 복지관 여성노인의 영양상태 평가와 관련요인 분석)

  • Kim, So-Hyun;ChoiKwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.14 no.1
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    • pp.16-24
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    • 2012
  • Purpose: The purpose of this study was to evaluate the nutritional status of elderly Korean women and to investigate related factors. Methods: A total of 100 elderly women attending a local elderly welfare center were recruited for study. Evaluation criteria included demographics, clinical status, nutritional status (using a mini-nutritional assessment), food intake, and nutritional bioparameters, including homocysteine, transferrin, prealbumin and lymphocyte levels, and their antioxidant power status. Results: Among the test group, 83% of the subjects were classified as undernourished, and they often had hyperlipidemia and a lower intake of fiber ($p$ <.05, respectively) and vegetables than normal subjects. In a correlation analysis, their nutritional status was associated with abdominal circumference, the Korean Geriatric Depression Scale score and the Enriched Social Support Inventory score. Nutritional bioparameters and antioxidant power were associated with age among undernourished subjects. Old age, the prevalence of hyperlipidemia, and poor social support significantly increased the risk of undernutrition. Poor social support, the prevalence of diabetes mellitus and depression significantly increased the risk of nutritional deficiency after controlling for age, educational and economic variables. Conclusion: More strategies to increase social support in the Korean female elderly population may improve their nutritional status.

Assessment and Methods of Nutritional Support during Atropinization in Organophosphate and Carbamate Poisoning Cases (아트로핀으로 치료하는 유기인계와 카바메이트 중독 환자의 영양지원 평가와 방법)

  • Park, Jong-uk;Min, Young-gi;Choi, Sangcheon;Ko, Dong-wan;Park, Eun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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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.

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

  • Kim, Seung;Lee, Eun Hye;Yang, Hye Ran
    • Nutrition Research and Practice
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    • v.12 no.3
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    • pp.215-221
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    • 2018
  • BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

Chylomicron Retention Disease: a Description of a New Mutation in a Very Rare Disease

  • Ferreira, Helena;Ramos, Raquel Nunez;Quan, Cinthia Flores;Ferreiro, Susana Redecillas;Ruiz, Vanessa Cabello;Goni, Javi Juamperez;Bernabeu, Jesus Quintero;Canton, Oscar Segarra;Beltran, Marina Alvarez
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.134-140
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    • 2018
  • Chylomicron retention disease, also known as Anderson's disease, is a rare hereditary hypocholesterolemic disorder, recessive inherited, characterized by nonspecific symptoms as abdominal distension, steatorrhea, and vomiting associated with failure to thrive. We describe a patient with failure to thrive, chronic diarrhea and steatorrhea who the diagnosis of chylomicron retention disease was established after several months of disease progression. The genetic study confirmed a homozygosity mutation in SAR1B gene, identifying a mutation never previous described [c.83_84delTG(p.Leu28Argfs*7)]. With this case report the authors aim to highlight for this very rare cause of failure to thrive and for the importance of an attempting diagnosis, in order to start adequate management with low fat diet supplemented with fat-soluble vitamins, reverting the state of malnutrition and avoiding possible irreversible and desvantating complications.