Terms, concepts and definitions in clinical artificial nutrition. The ConT-SEEN Project. / Términos, conceptos y definiciones en nutrición clínica artificial. Proyecto ConT-SEEN.

BACKGROUND: Imprecision in terms used in the field of clinical nutrition may lead to misinterpretations among professionals. OBJECTIVE: For this reason, the Spanish Society of Endocrinology and Nutrition (SEEN) promoted this document on the terms and definitions used in clinical artificial nutrition (enteral and parenteral), establishing an agreement between Spanish experts of this specialty. METHODS: Forty-seven specialists in endocrinology and nutrition, members of the Nutrition Area of the SEEN, participated between April and September 2016. After a systematic literature review, 52 concepts were proposed. The coordinators included two additional concepts, and 57were finally selected by the working group: 13 of a general nature, 30 referring to enteral nutrition and 14 to parenteral nutrition. The degree of agreement was subsequently determined using a two-round Delphi process. It was finally ratified by consistency and concordance analysis. RESULTS: Fifty-four of the 57 terms had a very consistent agreement and were concordant. Only three showed no concordance, of whom two were very consistent and one inconsistent. In conclusion, there was consensus in the definition of 54 basic terms in the practice of clinical nutrition.

Solución del caso 15. Angina intestinal de causa no ateroesclerótica en mujer joven / Solution to case 15. Non-atherosclerotic intestinal angina in a young woman

No disponible

Análise evolutiva do padrão de sucção e da influência da estimulação através da sucção não-nutritiva em recém nascidos pré-termo / Sucking pattern evolution analysis and the influence of nonnutritive sucking stimulation in preterm newborns

Os recém-nascidos pré-termo (RNPT) têm uma imaturidade global, o que dificulta a realização da função de sucção e a alimentação por via oral. Para descrever a evolução do padrão de sucção e analisar a influência da estimulação da sucção não-nutritiva (SNN) foram estudados 95 RNPT, divididos em 3 grupos: controle/sem SNN; SNN com chupeta e SNN com dedo enluvado. Os resultados sugerem um aumento da probabilidade de ocorrência da maioria das características de sucção estudadas de acordo com o avanço da idade gestacional corrigida. A SNN e o tipo de estímulo oferecido influenciaram na evolução do padrão de sucção, sendo o dedo enluvado o estímulo mais eficaz.The preterm newborns (PT-NB) immaturity makes it difficult to accomplish an efficient sucking function and oral feeding. 95 PT-NB were divided into three groups: control/without nonnutritive sucking (NNS); NNS with pacifier and NNS with a gloved finger, with the objective of describing the sucking pattern and analyzing the influence of the type of NNS stimulation performed. The results suggest an increase of the probability of the major occurrence of the studied sucking characteristics according to the advance of corrected gestational age. NNS and the type of stimulation used influenced the sucking pattern evolution, being the gloved finger the most efficient manner of NNS stimulation...

Perioperative nutrition support for patients undergoing gastrointestinal surgery: critical analysis and recommendations.

There is a high incidence of malnutrition in hospitalized patients undergoing gastrointestinal surgery. Malnutrition is clearly associated with increased morbidity and mortality after major gastrointestinal surgery. The efficacy of perioperative nutrition support to reduce surgical complications and mortality significantly has been an area of active clinical investigation over the past three decades. From multiple prospective, randomized trials, significant benefit from perioperative nutritional support has been demonstrated in severely malnourished patients undergoing major surgery. Results of the prospective, randomized trials studying the effects of perioperative nutrition support on patients undergoing gastrointestinal surgery are reviewed and critically analyzed.

Review article: artificial nutritional support for improved patient care.

Malnutrition is common and undiagnosed in the majority of affected hospital patients; it is associated with impaired organ function, morbidity, and increased length of hospital stay. Artificial nutritional support in malnourished patients leads to improvement in nutritional status and clinical outcome. Nutritional support is required in malnourished patients, patients who are unable to take normal diet and patients with intestinal failure. Gastroenterologists are required to supervise patients with intestinal failure, to insert endoscopic feeding devices, and increasingly to participate in, or lead, nutritional support teams. Major developments in nutrient delivery have included percutaneous endoscopic feeding devices, the recognition that enteral feeding is possible in patients with gastric stasis, and that nutrient needs can be met by peripheral parenteral nutrition. There is much interest in the use of new substrates, or substrates delivered in pharmacological doses such as glutamine and arginine, to manipulate the response to disease. Many hospitals lack an organized approach to artificial nutritional support. Patients continue to suffer from a lack of treatment or the consequences of inappropriate or inadequate treatment. This article reviews the current status of artificial nutritional support and provides guidelines for patient management.