RESUMO
PURPOSE: To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. METHODS: Several experienced board-certified clinical pharmacists in nutrition support compiled a list of publications published in 2013 that they considered to be important to their practice. The citation list was compiled into a Web-based survey whereby pharmacist members of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), GI-Liver-Nutrition Practice Research Network of the American College of Clinical Pharmacy, and the Pharmacy and Pharmacology Section of the Society of Critical Care Medicine were asked to rank each article according to level of importance in their practice. RESULTS: A total of 30 articles were identified by the author group. Thirty-six participants responded to the survey. The top-ranked papers by participants from the Web-based survey were reviewed by the authors. Due to its high level of importance, the parenteral nutrition safety consensus recommendations article, to be published in 2014 by A.S.P.E.N., was also reviewed. CONCLUSION: It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these publications.
RESUMO
Pulmonary aspiration of gastric contents is common in enterally fed patients. Tinting enteral feedings with blue dye is thought to aid the early detection of aspiration in hospitalized patients. The blue-dye method is popular despite evidence that it is not sensitive. Reports of absorption of blue dye from enteral feedings in patients with sepsis and other critical illnesses are increasing. The presence of blue and green skin and urine, and serum discoloration has been linked with death. FD&C Blue No.1 and related dyes have toxic effects on mitochondria, suggesting that dye absorption is harmful. This study reviews the literature on the dye method and dye pharmacology, reports the results of a survey of current dye use, and describes 2 recent deaths associated with blue-dye absorption. We concluded that the use of blue dye in enteral feedings should be abandoned and replaced by evidence-based methods for the prevention of aspiration.
Assuntos
Currículo , Dietética/educação , Ética Profissional , Medicina Baseada em Evidências , Apoio Nutricional , Dietética/ética , Dietética/normas , Dietética/tendências , Ética Profissional/educação , Humanos , Comunicação Interdisciplinar , Apoio Nutricional/ética , Apoio Nutricional/normas , Apoio Nutricional/tendências , Nutricionistas/educação , Nutricionistas/ética , Nutricionistas/normas , Cuidados Paliativos/ética , Cuidados Paliativos/normas , Cuidados Paliativos/tendências , Guias de Prática Clínica como Assunto , Papel Profissional , Sociedades Científicas , Estados Unidos , Recursos HumanosAssuntos
Cromo/administração & dosagem , Insulina/administração & dosagem , Nutrição Parenteral Total , Adulto , Idoso , Glicemia/análise , Cromo/deficiência , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Feminino , Humanos , Insulina/metabolismo , Masculino , Pessoa de Meia-Idade , Necessidades Nutricionais , Nutrição Parenteral Total/efeitos adversos , Nutrição Parenteral Total/normasRESUMO
Obstruction of enteral tubes places clinicians at a therapeutic crossroad. One must either remove the current device and replace it, or remove the obstruction from the tube. The following article addresses issues related to clogged or obstructed enteral feeding tubes, and methods used to restore patency to these devices. Additionally, the article describes the approach the Nutritional Support Service at St. Mary of the Plains Hospital uses in restoring patency to occluded enteral feeding tubes.