Application of detail nursing in enteral nutrition in patients with severe craniocerebral injury / 中国实用护理杂志

Objective@#To analyze the effect of detail nursing in enteral nutrition in patients with severe craniocerebral injury.@*Methods@#A total of 96 patients with severe craniocerebral injury admitted to ICU department were divided into 2 groups of 48 cases according to the Stochastic numerical table method. Both groups were treated with enteral nutrition. During the treatment, the control group was given routine care, and the observation group was given detailed nursing, and the two groups were compared.@*Results@#The incidence of abdominal distension, constipation and diarrhea in the observation group was 4.17% (2/48) and 2.08% (1/48) lower than 16.67% (8/48) and 16.67% (8/48) in the control group, the difference was statistically significant (χ2=4.019, 4.414, P<0.05). The Glasgow Coma Scale (GCS) score was 9.45±1.42, which was significantly higher than 7.19±1.36 of the control group (t=7.963, P<0.05). Compared with the control group, the serum total protein (62.67±3.69) g/L, serum albumin (35.56±2.08) g/L, and peripheral lymphocyte count (1.68±0.15)×109 were significantly higher than (59.15±3.55) g/L, (31.62±2.17) g/L, (1.49±0.26)×109 in the control group (t=4.763, 9.081, 4.385, P<0.05).@*Conclusion@#During the period of enteral nutrition therapy for patients with severe craniocerebral injury, detailed nursing is helpful to reduce the related complications, improve the degree of illness, and improve the nutritional status of the body.

Application of detail nursing in enteral nutrition in patients with severe craniocerebral injury / 中国实用护理杂志

Objective To analyze the effect of detail nursing in enteral nutrition in patients with severe craniocerebral injury. Methods A total of 96 patients with severe craniocerebral injury admitted to ICU department were divided into 2 groups of 48 cases according to the Stochastic numerical table method. Both groups were treated with enteral nutrition. During the treatment, the control group was given routine care, and the observation group was given detailed nursing, and the two groups were compared. Results The incidence of abdominal distension, constipation and diarrhea in the observation group was 4.17% (2/48) and 2.08% (1/48) lower than 16.67% (8/48) and 16.67% (8/48) in the control group, the difference was statistically significant ( χ2=4.019, 4.414, P<0.05). The Glasgow Coma Scale (GCS) score was 9.45 ± 1.42, which was significantly higher than 7.19 ± 1.36 of the control group (t=7.963, P<0.05). Compared with the control group, the serum total protein (62.67±3.69) g/L, serum albumin (35.56±2.08) g/L, and peripheral lymphocyte count (1.68 ± 0.15)×109 were significantly higher than (59.15 ± 3.55) g/L, (31.62 ± 2.17) g/L, (1.49 ± 0.26)×109 in the control group (t=4.763, 9.081, 4.385, P<0.05). Conclusion During the period of enteral nutrition therapy for patients with severe craniocerebral injury, detailed nursing is helpful to reduce the related complications, improve the degree of illness, and improve the nutritional status of the body.

Treatment of enterocutaneous fistulas by double cannula with an early oral diet in non-high output enterocutaneous fistula / 临床外科杂志

Objective To investigate the efficacy of double cannula with an early oral diet as nutritional support treatment on non-high output enterocutaneous fistulas. Methods Clinical data from patients with non-high output enterocutaneous fistula, who treated with double cannula with an early oral diet (n = 39) and double cannula with enteral nutrition therapy (n = 43), were retrospectively analyzed. The fistulas status and its closure time were recorded. In order to investigate the effect of oral diet on fistula, the inflammation index and nutritional status indicators before and after therapy were recorded. Results Totally 33 cases of the 39 patients with non-high output fistula were cured after therapy on the average (16.4土7.2) days. The distal non-high output fistula patients had better results(93.1％ closed, 15.8 days)than that of the proximal fistula patients(60.0％, 19.8 days). Laboratory inflammation index(TNF-alpha, IL-6, plasma endotoxin and C-reactive protein) were improved significantly (P＜ 0.05) after therapy. The nutrition status of these patients, such as body weight, hemoglobin, serum total protein, albumin, transferrin, and prealbumin increased at the end of fistula compared to that at the beginning of treatment (P＜ 0.05). Prealbumin and retinol binding protein were significantly higher than that in the control group (P＜0.05). Conclusion With double cannula treatment, early normal eating for enteral nutrition is safe and effective, especially in distal enterocutaneous fistulas. Normal oral diet can achieve the results of fistula closure, reduction of the inflammatory reaction, improvement of the nutrition status, avoiding the infliction of the operation and lowering the cost.

Clinical efficacy of implementation of standardized enteral nutrition in patients with severe traumatic brain injury undergoing mechanical ventilation / 中国中西医结合急救杂志

Objective To investigate the clinical efficacy of implementation of standardized enteral nutrition (EN) and its effects on prognosis in patients with severe traumatic brain injury (sTBI) undergoing mechanical ventilation (MV). Methods Eighty-eight patients with sTBI undergoing MV admitted to the Department of Critical Care Medicine of Yuyao People's Hospital from January 2016 to December 2017 were enrolled, they were divided into a control group (42 cases) and an experiment group (46 cases) depending on the demarcation timing of January 1, 2017, the beginning time of implementing standardized EN. All the patients received early EN and conventional treatment in the two groups. Additionally, the procedure of standardized EN was implemented in the experiment group. The differences in starting time of EN, the first defecation time, the rates of EN therapeutic energy and protein supply reaching their respective targets, duration of MV and ICU stay and 28-day mortality were compared between the two groups. Results The starting time of EN (hours: 25.61±8.74 vs. 32.79±8.63) and first defecation time (days: 3.03±0.79 vs. 3.61±0.89) were significantly earlier in the experiment group than those in the control group (both P < 0.05); the rates of energy and protein supply reaching the respective targets on the 5th day and 7th day after receiving EN were all significantly higher in the experiment group than those in the control group [rates of energy supply reaching target on the 5th day: (44.83±13.99)% vs. 37.59±10.88, and on the 7th day: (68.07±10.68)% vs. (62.69±9.87)%; rate of protein supply reaching target on the 5th day: (31.93±9.49)% vs. (27.06±8.08)%, and on the 7th day: (62.09±9.91)% vs. (54.55±11.27) %, all P < 0.05]; the durations of MV (hours: 9.24±2.91 vs. 10.67±3.41) and ICU stay (days: 12.09±3.37 vs. 13.93±4.98) in the experiment group were significantly shorter than those in the control group (all P < 0.05). No statistical significant difference in the 28-day mortality was observed between the experiment group and control group [21.74% (10/46) vs. 19.05% (8/42), P > 0.05]. Conclusion The efficacy of implementation of standardized EN in patients with sTBI undergoing MV is very significant, as it can significantly improve the rate of reaching EN target, and shorten the duration of MV and ICU stay.

Adecuación de la terapia nutricional enteral y la relación con la evolución en pacientes adultos críticos durante su estancia en el Sanatorio San Sebastián / Adequacy of enteral nutritional therapy and the relationship with the evolution in critical adult patients during their stay at the San Sebastián Sanatorium

Introducción: La Terapia Nutricional Enteral (TNE) en el paciente crítico forma parte del manejo integral y se asociada a una mejor evolución clínica. Objetivo: Determinar el porcentaje de adecuación de la TNE y la relación con la evolución en pacientes adultos críticos durante su estancia en el Sanatorio San Sebastián en el año 2016 al 2017. Materiales y Métodos: Estudio Observacional, descriptivo, prospectivo con componente analítico en pacientes adultos críticos de la Unidad de Cuidados Intensivos (UCI) que cumplieron con los criterios de inclusión. Se evaluaron 54 pacientes críticos sometidos a NE mayores de 18 años de edad de ambos sexos desde el periodo 2016 al 2017. Se consideró un porcentaje de adecuación calórico-proteica como suficiente a partir de ≥ 70%. Resultados: El 85,2% recibió un aporte calórico suficiente y un aporte proteico suficiente, el 59,3%. El promedio de calorías y proteínas administradas fueron de 1303 ±308 kcal y 62,26 ±30,8 gr respectivamente, mientras que la adecuación calórica alcanzada fue 86 ±16% y la proteica 72,8 ±22,9%. La complicación gastrointestinal más frecuente fue la diarrea y Residuo Gástrico aumentado (RG). Conclusión: Aunque no se observaron diferencias significativas entre aporte calórico y proteico con los días de ventilación mecánica, estancia hospitalaria y mortalidad; no se descarta la posibilidad que los mismos resulten significativos con una población más homogénea y numerosa, junto con un aumento de los días de evaluación.

Introduction: Enteral Nutritional Therapy (ENT) is part of an integral management and has been associated to better clinical outcomes in critically ill adult patients. Purpose: To determine the percentage of adequacy to ENT and its relationship with clinical outcomes in critically ill adult patients during their stay at the Sanatorio San Sebastián from 2016 to 2017. Material and methods: Observational, descriptive, cross-sectional study with analytic component in critically ill adult patients admitted to the ICU who met the inclusion criteria. 54 patients of both sexes, over 18 years old with EN were studied during the evaluation period between 2016-2017. It was considered as a goal a percentage of caloric-protein adequacy of ≥ 70%. Results: 85.2% received a sufficient caloric intake and the 59.3% also received sufficient protein intake. The average intake of calories and protein were 1303 ±308 kcal and 62,26 ±30,8 gr respectively, while the adequacy of calories was 86 ±16% and protein 72,8 ±22,9%. The most common gastrointestinal complication was diarrhea and the increase in gastric residue. Conclusions: Although there was no statistical significant difference between the amount of energy and protein intake with days of mechanical ventilation, length of hospital stay and mortality, the possibility that these could be significant with a more homogeneous and numerous population, together with an increase of the evaluation days, is not ruled out

Indicadores nutricionais em pacientes alimentados por sonda, em sistema de ?Home Care?

Introdução: A TND (terapia nutricional domiciliar),representa hoje uma alternativa à permanência hospitalar,contribuindo para a redução de custos e complicações.Objetivo: Avaliar indicadores nutricionais depacientes em Home Care que recebem alimentaçãoenteral.Casuística e Métodos: Estudo transversal com 30pacientes em Home Care recebendo alimentação enteralvia GT (gastrostomia) ou SNE (sonda naso enteral), sendoavaliado o estado nutricional por meio de indicadoresantropométricos, laboratoriais e ANSG (avaliaçãonutricional subjetiva global). A análise estatística foirealizada pelo teste exato de Fischer, Qui-quadrado e oteste ?T? de Student, com nível de significância de 5%.Resultados: Não foi verificada diferençaestatísticamente significante (p>0,05) entre os pacientesalimentados por GT e SNE, quanto a ANSG e aosindicadores antropométricos; sendo verificada diferençaestatística (p<0,05) na análise dos indicadoresbioquímicos, entre os dois grupos de pacientes, porém;nos indicadores antropométricos avaliados, observou-semaior prevalência de desnutrição nos pacientesalimentados via GT.Conclusão: O presente estudo reporta possívelbenefício do uso da GT em comparação a SNE no quese refere à resposta nutricional dos pacientes em homecare.

Introduction: Home Enteral Nutrition (HEN) todayis an alternative to remaining in the hospital andcontributes to reduce costs and complications.Objective: To assess nutritional indicators in homecare patients who receive enteral feeding.Casuistic and Methods: This is a cross-sectionalstudy with 30 home care patients receiving enteral feedingvia percutaneous endoscopic gastrostomy (PEG) or nasogastricfeeding tube (NG-tube). Nutritional status wasdetermined by anthropometric and laboratory indicatorsand SGNA (Subjective Global Nutritional Assessment).The Fisher?s Exact Test, Chi-square Test and Student?sT Test were used for the statistical analyses. Thesignificance level was set at 5%.Results: There was no statistically significantdifference (p>0.05) between patients being fed via PEGor NG-tube regarding the SGNA and anthropometricindicators. However, there was a statistical difference(p<0.05) between PEG- and NG-tube-fed individualsregarding the biochemical indicators. The anthropometricindicators revealed a higher prevalence of malnutritionamong PEG-fed patients.Conclusion: The present study reports a possiblebenefit of using PEG over NG-tube regarding thenutritional response of patients under home care.

Perfil nutricional de pacientes oncológicos submetidos á terapia nutricional enteral / Nutritional profile of cancer patients undergoing enteral nutrition therapy / El perfil nutricional de los pacientes de cáncer sometidos a terapia nutricional enteral

Objetivo: Determinar o perfil clínico-nutricional dos pacientes oncológicos submetidos à Terapia Nutricional Enteral (TNE). Método: A pesquisa foi realizada nas clínicas médica e cirúrgica do Hospital das Clínicas/UFPE, no período de agosto a dezembro de 2006, com amostra de 39 pacientes, de ambos os sexos, sob TNE exclusiva. para avaliação antropométrica utilizou-se IMC, porcentual de perda de peso, CB, CMB e PCT. Resultados: De acordo com a avaliação antropométrica, observou-se a maior porcentual de eutóficos (57,6%), quando considerado o IMC, e graus variados de desnutrição para os demais parãmetros. A avaliação bioquímica hipoalbuminemia em 79,5%, com valores menores para os homens (2,86g/dL) quando comparados ás mulheres (3,01g/dL). Em relação à TNE, foram utilizadas fórmulas industrializadas com oferta calórico-protéica individualizada, sendo atingidas as necessidades nutricionais de todos os pacientes. As complicações gastrointestinais mais prevalentes foram diarréia, constipação e náusea (25%). Conclusão: Houve predominância de desnutrição leve nos pacientes que receberam adequada oferta calórico/protéica por meio de TNE.

Objective: To determine the clinical and nutritional profile of cancer patients undergoing Enteral Nutrition Therapy (NET). Method: The study was conducted in medical and surgical clinics of the Hospital das Clínicas / UFPE, in the period from August to December 2006 with a sample of 39 patients of both sexes under TNE alone. anthropometric assessment was used BMI, percentage of weight loss, CB, CMB and PCT. Results: According to the anthropometric evaluation, there was a higher percentage of eutóficos (57.6%), when considering the BMI, and varying degrees of malnutrition for the other parameters. The biochemical evaluation hypoalbuminemia in 79.5%, with lower values for men (2.86 g / dL) compared to women (3.01 g / dL). In relation to TNE were used formulas industrialized with protein-calorie offering individualized, being affected the nutritional needs of all patients. Gastrointestinal complications were most prevalent diarrhea, constipation and nausea (25%). Conclusion: There was a slight prevalence of malnutrition in patients who received adequate supply calorie / protein by means of TNE.

Objetivo: Determinar el perfil clínico y nutricional de los pacientes de cáncer que reciben tratamiento con nutrición enteral (NET). Método: El estudio se llevó a cabo en las clínicas médicas y quirúrgicas del Hospital de Clínicas / UFPE, en el período de agosto a diciembre de 2006 con una muestra de 39 pacientes de ambos sexos menores TNE solo. evaluación antropométrica se utilizó el IMC, porcentaje de pérdida de peso, CB, CMB y el PCT. Resultados: De acuerdo a la evaluación antropométrica, hubo un mayor porcentaje de eutóficos (57,6%), al considerar el índice de masa corporal, y diferentes grados de desnutrición de los demás parámetros. La hipoalbuminemia evaluación bioquímica en el 79,5%, con valores más bajos para los hombres (2,86 g / dl) en comparación con las mujeres (3,01 g / dL). En relación con la TNE se utilizaron fórmulas industrializadas con la oferta proteico-calórica individualizada, siendo afectadas las necesidades nutricionales de todos los pacientes. Las complicaciones gastrointestinales más frecuentes fueron la diarrea, estreñimiento y náuseas (25%). Conclusión: Hubo un ligero predominio de la malnutrición en los pacientes que recibieron suministro adecuado de calorías y las proteínas por medio de la TNE.