Profile of patients using nasoenteric probe at the adult emergency service in a public hospital

Introduction: Part of the prognosis of hospitalized patient depends on nutritional status and the safety and efficacy of the feeding administration route. Therefore, the aim of this study was to identify data on the indication of nasoenteric tube (NET) prescription to analyze the profile of these patients. Methods: A retrospective cross-sectional study was carried out with data collection in medical records of patients over 18 years of age, of both sexes, treated at the Emergency Adult Service (EAS), using NET. Results: there was a predominance of females (51.9%); neurological disease was the most prevalent underlying disease, and 57.8% had more than one diagnosed disease. Malnutrition, bronchopneumonia, and dysphagia were present in 23.6%, 27% and 40% of the cases, respectively. There was a request for speech-language evaluation in only 8.7% of the patients. And 80.7% did not use NET prior to emergency care. Regarding the indications for the use of NET by group of underlying disease, low food intake was the most prevalent clinical reason described in the medical records, followed by dysphagia, with a higher prevalence of patients taking NET for nutritional reasons. There was no justification for prescription in 15.2% of the sample. There was an association between the variables bronchopneumonia and dysphagia (p = 0.01). Conclusion: It was verified that in the studied population there are risk factors for dysphagia. The analysis of the population profile in the present study contributed to increased knowledge and information about this population regarding the criteria for indication of the use of the alternative route. (AU)

Enfoque clínico del niño desnutrido según recomendaciones de la OMS: segunda parte

La desnutrición (DNT) en niños, afecta cerca de una décima parte de los < 5 años a nivel mundial, y se asocia con la mitad de las muertes en esta misma edad, sobre todo, en poblaciones que viven en circunstancias de pobreza extrema. En algunos casos, según las condiciones sociales de cada paciente, se puede continuar con la fase de rehabilitación de forma ambulatoria, con visitas domiciliarias, suplementosnutricionales y administración de micronutrientes. Se considera que el niño está preparado para entrar en lafase de rehabilitación cuando ha recuperado el apetito, habitualmente una semana después del ingreso. Losniños DNT presentan un retraso del desarrollo mental y del comportamiento, que si no se trata puede convertirse en la secuela más grave a largo plazo de la DNT. Se considera que un niño se ha recuperado si su peso es del 90% del que le correspondería según su talla (equivalente a –1 DE); no obstante, puede seguirteniendo bajo peso para su edad, debido al retraso del crecimiento. Es esencial un seguimiento planificado del niño con intervalos regulares después del alta. Pacientes con DNT moderada y severa sin complicaciones, sin enfermedad crónica, con manejo en casa, alcanzan tasas de recuperación entre el 85-90%.

Malnutrition (UND) in children, affecting about onetenth of <5 years worldwide, and is associated with halfof the deaths in this age, especially in populations living in conditions of extreme poverty. In some cases, depending on the social conditions of each patient can continue the rehabilitation on an outpatient basis, withhome visits, nutritional supplements, and administration of micronutrients. It is believed that the child is ready to enter the rehabilitation phase when it has regained appetite, usually one week after admission. UND children have delayed mental development and behavior, which if untreated can become the worst sequel in the long term UND. It is believed that a child has recovered if its weight is 90% which would correspond by size (equal to -1 SD), however, may still underweight for their age due to growth retardation. Planned follow-up is essential the child at regular intervals after discharge.

Recomendaciones para la alimentación del Niño sano y hospitalizado / Recommendations for feeding of the healthy and hospitalized children

Una de las etapas más importantes de la vida postnatal son sus primeros meses de vida, tanto en el desarrollo psicomotor, social y afectivo como en el cognoscitivo, que son fundamentales dentro de la estructura del niño. Nuestro referente, con relación al estado nutricional de la niñez colombiana son las principales conclusiones de la Encuesta Nacional de la Situación Nutricional en Colombia (ENSIN 2005). Los objetivos propuestos por el grupo de profesionales que participaron en el Consenso Colombiano sobre alimentación normal en el niño menor de dos años de edad, incluyen asegurar un crecimiento adecuado y un patrón de hábitos de vida saludables, promocionar una alimentación saludable, recomendar normas de alimentación para lactantes y niños, realizar guías alimentarias donde participen expertos nacionales, y proporcionar guías prácticas para los padres o tutores de niños. La alimentación del niño hospitalizado estable colabora con su bienestar y pronta recuperación, contando con que el grupo tratante posea los conocimientos necesarios para prestar la atención del niño hospitalizado estable quien estará acompañado entodo momento por sus familiares, convirtiendo la alimentación en un acto social. Los administradoresdeben satisfacer las necesidades del paciente, incluso ofreciendo al niño un ambiente cuasi-familiar.

One of the most important stages of postnatal life are the first months of life, both in psychomotor development, social and emotional as the cognitive, which are fundamental in the structure of the child. Ourrelation with the nutritional status of Colombian children are the main findings from the National Survey of the Nutritional Situation in Colombia (ENSIN 2005). The objectives proposed by the group of professionals who participated in the Consensus of Colombian normal feeding in children under two years old, include ensuring adequate growth and a pattern of healthy lifestyles, promoting healthy eating, food standards recommended for infants and children, making dietary guidelines which involve national experts, and provide practical guidelines for parents or guardians of children. The stable supply of hospitalized children working with their welfare and speedy recovery, with the dealer group has the necessary knowledge to provide care for hospitalized children who will be stable at all times accompanied by their families, making food in a social act. Managers must meet patient needs, even offering the child a quasifamily atmosphere.

Desnutrição hospitalar. (Editorial) / Hospital malnutrition. (Editorial)

A desnutrição hospitalar é aquela diagnosticada durante a internação. Quando é constatada nas primeiras 72 horas após a admissão é decorrente, parcial ou totalmente, de causas externas e no período posterior é mais relacionada a um deficiente aporte de nutrientes durante o tratamento. Nas duas situações a desnutrição ao hospitalar é reconhecida como fator de risco para morbidade e letalidade de crianças, adolescentes e adultos...