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1.
Nutr Clin Pract ; 35(5): 792-799, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32786117

RESUMO

Worldwide, as of July 2020, >13.2 million people have been infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The spectrum of coronavirus disease 2019 (COVID-19) ranges from mild illness to critical illness in 5% of cases. The population infected with SARS-CoV-2 requiring an intensive care unit admission often requires nutrition therapy as part of supportive care. Although the various societal guidelines for critical care nutrition meet most needs for the patient with COVID-19, numerous factors, which impact the application of those guideline recommendations, need to be considered. Since the SARS-CoV-2 virus is highly contagious, several key principles should be considered when caring for all patients with COVID-19 to ensure the safety of all healthcare personnel involved. Management strategies should cluster care, making all attempts to bundle patient care to limit exposure. Healthcare providers should be protected, and the spread of SARS-CoV-2 should be limited by minimizing procedures and other interventions that lead to aerosolization, avoiding droplet exposure through hand hygiene and use of personal protective equipment (PPE). PPE should be preserved by decreasing the number of individuals providing direct patient care and by limiting the number of patient interactions. Enteral nutrition (EN) is tolerated by the majority of patients with COVID-19, but a relatively low threshold for conversion to parenteral nutrition should be maintained if increased exposure to the virus is required to continue EN. This article offers relevant and practical recommendations on how to optimize nutrition therapy in critically ill patients with COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Cuidados Críticos/métodos , Apoio Nutricional/métodos , Pacotes de Assistência ao Paciente/métodos , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Betacoronavirus , Cuidados Críticos/normas , Nutrição Enteral/métodos , Nutrição Enteral/normas , Humanos , Apoio Nutricional/normas , Pandemias
2.
Medicine (Baltimore) ; 99(32): e21569, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769901

RESUMO

BACKGROUND: This study aims to assess the effect of early enteral nutrition support (EENS) for the management of acute severe pancreatitis (ASP). METHODS: This study will search Cochrane Library, PUBMED, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, CNKI, and WANGFANG from their inception to the present without language limitations. In addition, this study will also search clinical trial registry and reference lists of included trials. Eligible comparators will be standard care, medications, and any other interventions. Two authors will independently scan all citations, titles/abstracts, and full-text studies. The study methodological quality will be appraised using Cochrane risk of bias tool. If it is possible, we will pool out data and perform meta-analysis. Strength of evidence for each main outcome will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. RESULTS: This study will summarize the most recent evidence to assess the effect of EENS for the management of ASP. CONCLUSION: The findings of this study will help to determine whether EENS is effective for patients with ASP. STUDY REGISTRATION: INPLASY202070009.


Assuntos
Protocolos Clínicos , Nutrição Enteral/normas , Apoio Nutricional/normas , Pancreatite/dietoterapia , Gerenciamento Clínico , Nutrição Enteral/métodos , Humanos , Apoio Nutricional/métodos , Pancreatite/fisiopatologia , Revisões Sistemáticas como Assunto
3.
PLoS One ; 15(7): e0236644, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730360

RESUMO

BACKGROUND: Gastrostomy tubes (G-tubes) are typically used when people cannot eat food by mouth. The connector section that allows G-tubes to connect to other devices, such as feeding sets or syringes, has been modified on some of the devices to reduce misconnections in hospital settings. The narrow internal diameter of the new connector, standardized under ISO 80369-3, has caused some users to express concern about a reduced flow rate. Previous studies performed on commercial devices determined that it was not conclusive how much the ISO 80369-3 connector contributed towards the reduced flow rate, because when manufacturers designed these new connector-based devices, they often changed other geometric variables (such as distal tube diameter, or length) at the same time. Thus, it became difficult isolating the effect of the connector from other geometric variables. METHOD: The key objective of this study was to investigate how different design variables impacted the flow rate through the G-tubes. 3D-printed devices were used to assess the geometric parameters in a systematic manner. Commercial diets and Newtonian analog fluids with matched viscosities were used for testing. RESULTS: The flow path length of the "transition section" encompassing the standardized ISO 80369-3 connector in the new devices was found to cause reduced flow. Additionally, results showed that a shortened (≤ 10 mm) transition section, along with a 10% increase in the distal inner diameter of large bore devices (e.g., 24 Fr), can restore flow rates to levels consistent with the previous devices prior to the connector standardization. CONCLUSIONS: The strategy for restoring flow rates to previous levels may help alleviate concerns raised by multiple stakeholders such as health care professionals, patients, caregivers and device manufacturers. In addition, the approach proposed here can be used as a tool for designing future G-tube devices.


Assuntos
Nutrição Enteral/instrumentação , Nutrição Enteral/métodos , Nutrição Enteral/normas , Planejamento Ambiental , Alimentos Formulados , Gastrostomia , Humanos , Impressão Tridimensional , Viscosidade
4.
Pediatr Blood Cancer ; 67 Suppl 3: e28378, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32614140

RESUMO

Nutrition therapy is a therapeutic approach to treating medical conditions and symptoms via diet, which can be done by oral, enteral or parenteral routes. It is desirable to include nutritional interventions as a standard of care in pediatric cancer units (PCUs) at all levels of care. The interventions are dependent on available resources and personnel across all clinical settings. Enteral nutrition is easy, inexpensive, uses the gastrointestinal tract, maintains gut mucosal integrity, and allows for individualized nutritional strategies. This narrative review describes enteral nutritional interventions for children undergoing cancer treatment and is aimed at PCUs of all levels of care located in a low- and middle-income country.


Assuntos
Nutrição Enteral/métodos , Desnutrição/terapia , Neoplasias/dietoterapia , Neoplasias/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Nutrição Enteral/normas , Humanos , Masculino , Desnutrição/prevenção & controle
7.
Crit Care ; 24(1): 35, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019607

RESUMO

Nutrition therapy during critical illness has been a focus of recent research, with a rapid increase in publications accompanied by two updated international clinical guidelines. However, the translation of evidence into practice is challenging due to the continually evolving, often conflicting trial findings and guideline recommendations. This narrative review aims to provide a comprehensive synthesis and interpretation of the adult critical care nutrition literature, with a particular focus on continuing practice gaps and areas with new data, to assist clinicians in making practical, yet evidence-based decisions regarding nutrition management during the different stages of critical illness.


Assuntos
Estado Terminal , Apoio Nutricional , Adulto , Cuidados Críticos/normas , Estado Terminal/terapia , Nutrição Enteral/normas , Humanos , Estado Nutricional , Apoio Nutricional/normas , Nutrição Parenteral/normas
8.
BMJ Open Qual ; 9(1)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32075805

RESUMO

BACKGROUND: Patients with nasogastric/nasoenteric tube (NGT/NET) are at increased risk of adverse outcomes due to errors occurring during oral medication preparation and administration. AIM: To implement a quality improvement programme to reduce the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients. METHODS: An observational study was carried out, comparing outcome measures before and after implementation of the integrated quality programme to improve oral medication preparation and administration through NGT/NET. A collaborative approach based on Plan-Do-Study-Act (PDSA) cycle was used and feedback was given during multidisciplinary meetings. INTERVENTIONS: Good practice guidance for oral medication preparation and administration through NGT/NET was developed and implemented at the hospital sites; nurses were given formal training to use the good practice guidance; a printed list of oral medications that should never be crushed was provided to all members of the multidisciplinary team, and a printed table containing therapeutic alternatives for drugs that should never be crushed was provided to prescribers at the prescribing room. RESULTS: Improvement was observed in the following measures: crushing enteric-coated tablets and mixing drugs during medication preparation (from 54.9% in phase I to 26.2% in phase II; p 0.0010) and triturating pharmaceutical form of modified action or dragee (from 32.8 in phase I to 19.7 in phase II; p 0.0010). Worsening was observed though in the following measures: crush compressed to a fine and homogeneous powder (from 7.4%% in phase I to 95% phase II; p 0.0010) and feeding tube obstruction (from 41.8% in phase I to 52.5% phase II; p 0.0950). CONCLUSION: Our results highlight how a collaborative quality improvement approach based on PDSA cycles can meet the challenge of reducing the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients. Some changes may lead to unintended consequences though. Thus, continuous monitoring for these consequences will help caregivers to prevent poor patient outcomes.


Assuntos
Administração Oral , Nutrição Enteral/normas , Erros de Medicação/prevenção & controle , Melhoria de Qualidade , Brasil , Nutrição Enteral/métodos , Nutrição Enteral/estatística & dados numéricos , Humanos
9.
Bull Cancer ; 107(1S): S36-S43, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31615648

RESUMO

Given the absence of consensus on oral feeding of patients undergoing allogeneic hematopoietic transplantation, the ninth workshops of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) allocated one session to address this topic, especially during the hospitalization. A questionnaire was sent to all SFGM-TC pediatric and adult centers in order to investigate oral feeding practices. The results demonstrated a large disparity among centers regarding oral feeding. Here, we report our recommendations regarding the oral feeding after allogeneic hematopoietic cell transplantation in terms of quality, quantity and bacterial authorized load.


Assuntos
Nutrição Enteral , Transplante de Células-Tronco Hematopoéticas , Aloenxertos , Culinária , Dieta , Nutrição Enteral/métodos , Nutrição Enteral/normas , Alimentos/efeitos adversos , Alimentos/classificação , Alimentos/normas , Manipulação de Alimentos/normas , Microbiologia de Alimentos , Conservação de Alimentos , Humanos , Pacientes Internados
12.
Medicina (Kaunas) ; 55(12)2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31810303

RESUMO

The group of patients most frequently in need of nutritional support are intensive care patients. This year (i.e., 2019), new European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines of clinical nutrition in intensive care were published, updating and gathering current knowledge on the subject of this group of patients. Planning the right nutritional intervention is often a challenging task involving the necessity of the choice of the enteral nutrition (EN) or parenteral nutrition (PN) route of administration, time of initiation, energy demand, amino acid content and demand as well as the use of immunomodulatory nutrition. The aim of this study was to specify and discuss the basic aspects of the clinical nutrition of critically ill patients recommended by ESPEN guidelines. Clinical nutrition in intensive care seems to be the best-studied type of nutritional intervention. However, meta-analyses and clinical studies comparing EN and PN and their impact on the prognosis of the intensive care patients showed ambiguous results. The nutritional interventions, starting with EN, should be initiated within 24-48 h whereas PN, if recommended, should be implemented within 3-7 days. The recommended method of calculation of the energy demand is indirect calorimetry, however, there are also validated equations used worldwide in everyday practice. The recommended protein intake in this group of patients and the results of insufficient or too high supply was addressed. In light of the concept of immunomodulatory nutrition, the use of appropriate amino acid solutions and lipid emulsion that can bring a positive effect on the modulation of the immune response was discussed.


Assuntos
Calorimetria Indireta/normas , Cuidados Críticos/normas , Estado Terminal/terapia , Nutrição Enteral/normas , Nutrição Parenteral/normas , Proteínas na Dieta/análise , Europa (Continente) , Humanos , Unidades de Terapia Intensiva , Guias de Prática Clínica como Assunto , Sociedades Médicas
13.
Rev Bras Ter Intensiva ; 31(3): 393-402, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31618360

RESUMO

OBJECTIVE: To review the scientific evidence regarding the initiation of enteral nutrition in the pediatric burn population. METHODS: This study was a systematic review and meta-analysis of randomized clinical trials comparing early enteral nutrition and late enteral nutrition in individuals aged 1 month to 18 years with burns. The MEDLINE/PubMed, Embase and Cochrane Library databases were searched using the terms "burns", "fires", "child nutrition disorders", "nutritional support" and related terms. RESULTS: Three articles that included a total of 781 patients were identified. There was no significant difference in the mortality rate between the early and late groups (OR = 0.72, 95%CI = 0.46 - 1.15, p = 0.17). Patients who received early enteral nutrition had a 3.69-day reduction in the length of hospital stay (mean difference = -3.69, 95%CI = -4.11 - -3.27, p < 0.00001). There was a higher incidence of diarrhea and vomiting and decreased intestinal permeability in the early group. This group also presented higher a serum insulin concentration and insulin/glucagon ratio as well as lower caloric deficit and weight loss when compared to the control group. CONCLUSION: Analysis of the different intragroup variables suggests the importance of starting nutritional support early. Considering the number of pediatric burn patients, there is a need for robust studies with greater scientific impact.


Assuntos
Queimaduras/terapia , Nutrição Enteral/normas , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
14.
Ir Med J ; 112(7): 967, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553148

RESUMO

Aims To examine; (a) the number of registered dietitians (RDs) with blended tube fed (BTF) patients, work setting and caseload; (b) attitudes and experiences towards BTF; (c) current BTF supports and future resources required. Methods An online survey collected information from Irish RDs over one month. Data was examined using cross-tabulations and Mann-Whitney U tests. Free-text was categorized into thematic domains. Results A significant number of RDs with HEN paediatric patients concurrently managed BTF patients (n = 27/48, 56.3%, p<0.05). The majority were based in tertiary hospitals (HEN; n = 20/48, 41.7%, BTF; n = 12/27, 44.4%). Equal numbers were willing to support BTF or on a patient-case basis (n = 36/77, 46.8%). International guidelines were most used to inform RDs (n = 40/69, 58.0%). Professional training workshops were the preferred learning method (n = 60/73, 82.2%). Conclusion Overall, BTF appears to be a growing practice. Community services, professional guidelines, training and information are needed.


Assuntos
Nutrição Enteral/estatística & dados numéricos , Nutricionistas/estatística & dados numéricos , Criança , Nutrição Enteral/métodos , Nutrição Enteral/normas , Serviços de Assistência Domiciliar , Humanos , Nutricionistas/psicologia , Pediatria , Inquéritos e Questionários
15.
Am J Health Syst Pharm ; 76(19): 1492-1510, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31532507

RESUMO

PURPOSE: Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. SUMMARY: The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. CONCLUSION: The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.


Assuntos
Desenvolvimento Infantil/fisiologia , Nutrição Enteral/normas , Necessidades Nutricionais/fisiologia , Nutrição Parenteral/normas , Serviço de Farmácia Hospitalar/organização & administração , Adulto , Fatores Etários , Criança , Pré-Escolar , Composição de Medicamentos/normas , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/normas , Guias de Prática Clínica como Assunto
16.
Rev. bras. ter. intensiva ; 31(3): 393-402, jul.-set. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1042579

RESUMO

RESUMO Objetivo: Revisar as evidências científicas que reportem o período de início da nutrição enteral na população pediátrica vítima de queimadura e seus achados. Métodos: Revisão sistemática e metanálise de estudos clínicos randomizados comparando nutrição enteral precoce e nutrição enteral tardia em indivíduos de 1 mês de idade a 18 anos com queimaduras. As bases de dados MEDLINE/PubMed, Embase e Cochrane Library foram acessadas utilizando os termos "burns", "fires", "child nutrition disorders", "nutritional support" e termos relacionados. Resultados: Três artigos foram identificados, sendo incluídos 781 pacientes. Não houve diferença significativa na taxa de mortalidade entre os grupos precoce e tardio (RC = 0,72; IC95% 0,46 - 1,15; p = 0,17). Pacientes que receberam nutrição enteral precoce tiveram o tempo de internação reduzido em 3,69 dias (diferença média = -3,69; IC95% -4,11 - -3,27; p < 0,00001). Houve maior incidência de diarreia e vômito, além de diminuição da permeabilidade intestinal no grupo precoce. Esse grupo também apresentou concentração maior de insulina sérica e relação insulina/glucagon, além de menor déficit calórico e perda ponderal em comparação com o grupo controle. Conclusão: As análises das diferentes variáveis intragrupos sugerem a importância de iniciar o suporte nutricional de forma precoce. A necessidade de estudos robustos com maior impacto científico é importante, considerando o número de casos de queimaduras em pacientes pediátricos.


ABSTRACT Objective: To review the scientific evidence regarding the initiation of enteral nutrition in the pediatric burn population. Methods: This study was a systematic review and meta-analysis of randomized clinical trials comparing early enteral nutrition and late enteral nutrition in individuals aged 1 month to 18 years with burns. The MEDLINE/PubMed, Embase and Cochrane Library databases were searched using the terms "burns", "fires", "child nutrition disorders", "nutritional support" and related terms. Results: Three articles that included a total of 781 patients were identified. There was no significant difference in the mortality rate between the early and late groups (OR = 0.72, 95%CI = 0.46 - 1.15, p = 0.17). Patients who received early enteral nutrition had a 3.69-day reduction in the length of hospital stay (mean difference = -3.69, 95%CI = -4.11 - -3.27, p < 0.00001). There was a higher incidence of diarrhea and vomiting and decreased intestinal permeability in the early group. This group also presented higher a serum insulin concentration and insulin/glucagon ratio as well as lower caloric deficit and weight loss when compared to the control group. Conclusion: Analysis of the different intragroup variables suggests the importance of starting nutritional support early. Considering the number of pediatric burn patients, there is a need for robust studies with greater scientific impact.


Assuntos
Humanos , Criança , Queimaduras/terapia , Nutrição Enteral/normas , Fatores de Tempo , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
17.
Zhonghua Gan Zang Bing Za Zhi ; 27(5): 330-342, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31177656

RESUMO

Malnutrition is common in patients with end-stage liver disease (ESLD) and is an independent risk factor for survival, therefore it should be treated as the same important guideline as ascites and hepatic encephalopathy. However, up to now, there is no clinical nutrition guideline for patients with ESLD in China. In order to standardize the nutrition treatment, Chinese Society of Hepatology (CSH) and Chinese Society of Gastroenterology (CSGE), Chinese Medical Association(CMA) co-organized and co-developed this guideline. Recommendations on nutritional screening and assessment as well as principles of intervention and management in patients with ESLD were provided to help clinicians make rational decisions on clinical malnutrition.


Assuntos
Doença Hepática Terminal/complicações , Gastroenterologia/normas , Encefalopatia Hepática , Cirrose Hepática/complicações , Desnutrição/dietoterapia , Guias de Prática Clínica como Assunto , Ascite , China , Doença Hepática Terminal/fisiopatologia , Nutrição Enteral/normas , Humanos , Desnutrição/fisiopatologia , Avaliação Nutricional , Estado Nutricional
18.
Nutr Hosp ; 36(3): 734-742, 2019 Jul 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31144978

RESUMO

Introduction: The Management Working Group of SENPE has among its objectives the development of evaluation processes in Clinical Nutrition. Previously, the document entitled "Process of nutritional care: self-evaluation guide" was prepared as a tool designed to help assess the quality of nutritional therapy in hospitalized patients, mainly from the perspective of artificial nutrition. Now a complementary text of the previous one is presented, that describes the process by which hospitalized patients are fed. We have divided the hospital feeding process into six sections, for which a general description is made and quality indicators are proposed. We hope that this work will serve to improve the quality of hospital food and to help hospital food professionals to make their work more satisfactory and effective.


Assuntos
Serviço Hospitalar de Nutrição/normas , Terapia Nutricional/normas , Nutrição Enteral/normas , Alimentos Formulados/normas , Humanos , Pacientes Internados , Apoio Nutricional , Indicadores de Qualidade em Assistência à Saúde
19.
Intensive Care Med ; 45(5): 647-656, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31062046

RESUMO

PURPOSE: Enteral feeding intolerance (EFI) is a frequent problem in the intensive care unit (ICU), but current prokinetic agents have uncertain efficacy and safety profiles. The current study compared the efficacy and safety of ulimorelin, a ghrelin agonist, with metoclopramide in the treatment of EFI. METHODS: One hundred twenty ICU patients were randomized 1:1 to ulimorelin or metoclopramide for 5 days. EFI was diagnosed by a gastric residual volume (GRV) ≥ 500 ml. A volume-based feeding protocol was employed, and enteral formulas were standardized. The primary end point was the percentage daily protein prescription (%DPP) received by patients over 5 days of treatment. Secondary end points included feeding success, defined as 80% DPP; gastric emptying, assessed by paracetamol absorption; incidences of recurrent intolerance (GRV ≥ 500 ml); vomiting or regurgitation; aspiration, defined by positive tracheal aspirates for pepsin; and pulmonary infection. RESULTS: One hundred twenty patients were randomized and received the study drug (ulimorelin 62, metoclopramide 58). Mean APACHE II and SOFA scores were 21.6 and 8.6, and 63.3% of patients had medical reasons for ICU admission. Ulimorelin and metoclopramide resulted in comparable %DPPs over 5 days of treatment (median [Q1, Q3]: 82.9% [38.4%, 100.2%] and 82.3% [65.6%, 100.2%], respectively, p = 0.49). Five-day rates of feeding success were 67.7% and 70.6% when terminations unrelated to feeding were excluded, and there were no differences in any secondary outcomes or adverse events between the two groups. CONCLUSIONS: Both prokinetic agents achieved similar rates of feeding success, and no safety differences between the two treatment groups were observed.


Assuntos
Nutrição Enteral/normas , Compostos Macrocíclicos/normas , Metoclopramida/normas , APACHE , Adulto , Idoso , Antieméticos/normas , Antieméticos/uso terapêutico , Canadá , Estado Terminal/terapia , Método Duplo-Cego , Nutrição Enteral/métodos , Nutrição Enteral/estatística & dados numéricos , Feminino , Esvaziamento Gástrico/efeitos dos fármacos , Esvaziamento Gástrico/fisiologia , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Compostos Macrocíclicos/uso terapêutico , Masculino , Metoclopramida/uso terapêutico , Pessoa de Meia-Idade , Países Baixos , Escores de Disfunção Orgânica , Espanha , Estados Unidos
20.
Rev Chil Pediatr ; 90(2): 222-228, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31095240

RESUMO

The use of home enteral or parenteral nutrition has been a necessary step in the optimization of nu tritional support in patients who, due to several diseases, fail to meet their nutritional requirements by oral feeding. This article presents the recommendations of the Chilean Pediatric Society Nutritio nal Branch, aimed at health teams that treat pediatric patients who require enteral feeding for a long time. The general objective is to provide guidelines for the proper management of these patients. It describes the ideal conformation of the health team for the care and follow-up of those patients, the program admission criteria, and its evaluation method over time. In addition, it describes general characteristics of enteral feeding, routes of administration, available enteral formulas, complications, and patient follow-up.


Assuntos
Nutrição Enteral/normas , Serviços de Assistência Domiciliar/normas , Adolescente , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normas , Criança , Chile , Doença Crônica , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Humanos , Pediatria , Sociedades Médicas
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