RESUMO
Desde hace más de una década, la Unidad de Nutrición del Hospital General Universitario Gregorio Marañón inició una línea de trabajo encaminada a la detección precoz de pacientes desnutridos. En el año 2003 participó en el estudio multicéntrico europeo EuroOOPS, sobre prevalencia de pacientes con riesgo nutricional al ingreso hospitalario. El estudio PREDyCES, realizado a nivel nacional en el año 2009, aportó resultados muy relevantes, justificando la necesidad de hacer un cribado nutricional. En el año 2013, la Unidad de Nutrición implantó un sistema de gestión de calidad (SGC) según la norma UNE-EN ISO 9001:2008, poniendo en marcha el cribado nutricional. Desde el año 2014 hasta la actualidad, se ha conseguido implantar el cribado nutricional trabajando conjuntamente profesionales de la Unidad de Nutrición, enfermeras de hospitalización y Subdirección de Sistemas de Información, utilizando un programa informático incluido dentro de la prescripción de dieta oral (Dietools) que ya se utilizaba en las unidades de hospitalización
From more than a decade ago the Nutrition Unit of the Hospital General Universitario Gregorio Marañón launched a line of work aimed at the early detection of malnourished patients. In the year 2003 participated in the european multicenter study EuroOOPS, on the prevalence of patients with nutritional risk at admission to the hospital. The PREDyCES study conducted at the national level in the year 2009 provided very relevant results, justifying the need to make a nutritional screening. In the year 2013 the Nutrition Unit introduced a quality management system (QMS) according to the standard UNE-EN ISO 9001:2008 by launching nutritional screening. From the year 2014 until the present it has been able to implement nutritional screening working together professionals from the Nutrition Unit, nurses of hospitalization and subaddress of information systems using a computer program included within the prescription of oral diet (Dietools) that was already used in the units of hospitalization
Assuntos
Humanos , Avaliação Nutricional , Estado Nutricional , Desnutrição/epidemiologia , Programas de Rastreamento/métodos , Hospitalização/estatística & dados numéricos , Fatores de RiscoRESUMO
La disfagia es un síntoma altamente prevalente, que puede ser debido a múltiples procesos patológicos, tanto estructurales como funcionales, y localizarse a nivel orofaríngeo o esofágico. La Disfagia Orofaríngea puede causar desnutrición hasta en 1/3 de los pacientes que la padecen, como consecuencia de alteraciones en la eficacia de la deglución, y ocasionar alteraciones en la seguridad de la misma (penetraciones y aspiraciones) en hasta 2/3 de los pacientes que la presentan, con elevado riesgo de neumonías por aspiración e infecciones respiratorias. En enfermos neurológicos, ancianos o personas institucionalizadas su prevalencia puede oscilar entre un 30-60%, con grados de severidad variables que pueden llegar a hacer necesaria una nutrición artificial. Se la relaciona además con mayor discapacidad, estancias hospitalarias prolongadas y mayor mortalidad. Por todo ello es fundamental un diagnóstico precoz de la misma y la instauración de un tratamiento eficaz que incluya maniobras posturales, soporte nutricional y rehabilitación (AU)
Dysphagia is a highly prevalent symptom, which may be due to multiple disease processes, both structural and functional, and located at the oropharyngeal or esophageal level. Oropharyngeal dysphagia can cause malnutrition even in 1/3 of patients as a result of alterations in the efficiency of swallowing and cause changes in the security of swallowing (penetration and aspiration) in up to 2/3 of the patients who present it, with high risk of aspiration pneumonia and respiratory infections. In neurological, elderly or institutionalized patients its prevalence may range from 30 to 60%, with different degrees of severity that may become necessary artificial nutrition. It is also related to greater disability, prolonged hospital stays and increased mortality. Therefore, early diagnosis and the establishment of an effective treatment that includes postural exercises, nutritional support and rehabilitation are critical (AU)
Assuntos
Humanos , Transtornos de Deglutição/complicações , Desnutrição/etiologia , Terapia Nutricional/métodos , Transtornos de Deglutição/terapia , Desnutrição/terapia , Aspiração Respiratória/complicações , Suplementos Nutricionais , Tempo de Internação/estatística & dados numéricosRESUMO
OBJECTIVE: To investigate the effectiveness of an oral nutritional supplement that is rich in protein and enriched with arginine, vitamin C and zinc on the healing of pressure ulcers. METHOD: Thirty-nine patients with grade III or IV pressure ulcers were enrolled into this open intervention study. Subjects received an oral nutritional supplement daily for three weeks. Wound area and the wound condition of the ulcers were assessed weekly. RESULTS: After three weeks of supplementation, median wound area reduced significantly (p < 0.001) from 23.6 cm2 (1.6-176.6 cm2) to 19.2 cm2 (1.2-132.7 cm2), a reduction of 29%. Median healing of wound area was 0.34 cm2 per day, taking approximately two days to heal 1 cm2. Within three weeks the amount of exudate in infected ulcers (p = 0.012) and the incidence of necrotic tissue (p = 0.001) reduced significantly. CONCLUSION: Nutritional intervention in the form of a specific oral nutritional supplement resulted in a significant reduction in wound area and an improvement in wound condition in patients with grade III and IV pressure ulcers within three weeks.
