ABSTRACT
Resumen: El uso de apoyo nutricional ambulatorio, enteral o parenteral, ha sido un paso necesario en la opti mización del soporte nutricional en pacientes, que, por diversas patologías, no logran cumplir con sus requerimientos por vía oral (VO). En el presente artículo se presentan las recomendaciones de la Rama de Nutrición, dirigidas a los equipos de salud que atienden pacientes pediátricos, que requieran alimentación enteral por un tiempo prolongado. Su objetivo general es entregar pautas para un co rrecto manejo en estos pacientes. Se describe la conformación ideal del equipo de salud para atención y seguimiento de dichos pacientes, los criterios de ingreso al programa y su forma de evaluación en el tiempo. Además, se describen características generales de la alimentación enteral, vías de admi nistración, fórmulas enterales disponibles, complicaciones de este soporte nutricional y por último monitorización y seguimiento del paciente.
Abstract 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.
Subject(s)
Humans , Child , Adolescent , Enteral Nutrition/standards , Home Care Services/standards , Pediatrics , Societies, Medical , Chile , Chronic Disease , Enteral Nutrition/adverse effects , Enteral Nutrition/methods , Aftercare/methods , Aftercare/standardsABSTRACT
Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 +/- 0.35 days for the control group and 4.24 +/- 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.