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1.
Rev. Nutr. (Online) ; 35: e210054, 2022. tab, graf
Article in English | LILACS | ID: biblio-1365432

ABSTRACT

ABSTRACT Objective To assess factors related to the achievement of the caloric estimates of enteral nutritional therapy and the survival of patients with advanced cancer in exclusively palliative care. Methods Retrospective study, where patients using enteral nutrition admitted from March 2019 to February 2020 were divided into two groups: Group 1 included patients who reached 75% of the estimated caloric goals, and Group 2 included those who did not. The data were extracted from the patients' electronic medical records. Logistic regression analyzes were performed to assess associations between the studied sociodemographic, clinical, and nutritional variables, and the Kaplan-Meier curve and Cox regression were used to assess the survival of the groups. Results A total of 158 patients participated in the study, with a median age of 63 (IIQ: 55-70) years. 57% reached the caloric goal (Group 1). In the logistic regression, the functional capacity (OR: 5.82; CI: 2.28-14.84; p<0.001) and symptoms of nausea or vomiting (OR: 0.050; CI: 0.005-0.455; p=0.008) were independent variables for achieving the caloric goal. Cox regression showed Karnofsky Performance Status as an independent predictor for survival (HR: 1.85; CI: 1.13-3.04). Conclusion Patients with better functionality have longer survival and are potential candidates for reaching the caloric goals proposed by national and international guidelines for cancer patients.


RESUMO Objetivo Avaliar os fatores relacionados ao alcance das estimativas calóricas da terapia nutricional enteral e a sobrevida dos pacientes com câncer avançado em cuidados paliativos exclusivos. Métodos Estudo retrospectivo no qual pacientes em uso de nutrição enteral internados no período de março de 2019 a fevereiro de 2020 foram divididos em dois grupos: Grupo 1, composto por pacientes que atingiram 75% das metas calóricas estimadas, e Grupo 2, composto por aqueles que não atingiram. Os dados foram extraídos do prontuário eletrônico dos pacientes. Análises de regressão logística foram realizadas para avaliar associações entre as variáveis sociodemográficas, clínicas e nutricionais estudadas, e a curva de Kaplan-Meier e regressão de Cox foram usadas para avaliar a sobrevida dos grupos. Resultados Participaram do estudo 158 pacientes, com mediana de idade de 63 (IIQ:55-70) anos. Cinquenta e sete por cento dos pacientes atingiram a meta calórica (Grupo 1). Na regressão logística, a capacidade funcional (OR:5,82; IC: 2,28-14,84; p<0,001) e os sintomas náuseas ou vômitos (OR:0,050; IC:0,005-0,455; p=0,008) se mostraram variáveis independentes para o alcance da meta calórica. A regressão de Cox mostrou o Karnofsky Performance Status como preditor independente para sobrevida (HR: 1,85; IC: 1,13-3,04) Conclusão Pacientes com melhor funcionalidade possuem sobrevida maior e são potenciais candidatos ao alcance das metas calóricas propostas por diretrizes nacionais e internacionais para pacientes com câncer em terapia nutricional enteral.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Enteral Nutrition/adverse effects , Neoplasms/therapy , Palliative Care/methods , Patients/statistics & numerical data , Survival , Retrospective Studies
3.
Rev. Nutr. (Online) ; 34: e200283, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250805

ABSTRACT

ABSTRACT Objective The present study assessed the differences in nutritional markers (albumin, transferrin, total body fat, and body mass index) and clinical complications (diarrhea, vomiting, and diet interruptions) associated with enteral nutrition. Methods This is an open-label, randomized, two-arm parallel-group controlled clinical trial. Out of 105 patients assessed for eligibility, 35 adult patients were randomly divided into two groups and followed for 28 days. The sample comprised a heterogeneous group of severely ill individuals initially treated in the intensive care units. Neurological conditions (i.e., strokes and brain tumours) were the most common reasons for hospitalization. Patients had one singularity: the clinical need for exclusive enteral nutrition therapy. One group received the diet via gastric tube and the other via a post-pyloric tube. Results The groups presented increases in the calories prescribed and administered, as well as reduced diet discontinuation. Although similar values were observed up to day 21, the post-pyloric group showed increased albumin levels compared to the gastric group on Day 28. Transferrin levels increased over time in both groups. Conclusion There were no differences in the complications recorded between groups, albeit serum albumin significantly increased in the post-pyloric group.


RESUMO Objetivo Avaliar diferenças tanto nos marcadores nutricionais (albumina, transferrina, gordura corporal e índice de massa corporal) quanto nas complicações clínicas (diarreia, vômitos e interrupções na dieta) associadas à nutrição enteral administrada através de duas vias tradicionais. Métodos Este é um ensaio clínico de tratamento, paralelo de dois braços, aberto e randomizado controlado. Dos 105 participantes avaliados para elegibilidade, 35 pacientes adultos foram divididos aleatoriamente em dois grupos e seguidos por 28 dias. A amostra foi formada por um grupo heterogêneo e gravemente enfermo, tratados inicialmente em unidades de terapia intensiva. Condições neurológicas, como acidente vascular e tumores cerebrais foram as razões principais para hospitalização. Os pacientes tinham em comum um aspecto, a saber, a necessidade clínica exclusiva de receber nutrição enteral. Um grupo recebeu a dieta via sonda gástrica e o outro através de sonda pós-pilórica. Resultados Os grupos apresentaram aumento de calorias prescritas e administradas, bem como redução da descontinuação da dieta. Embora valores semelhantes tenham sido observados até o 21° dia, o grupo pós-pilórico apresentou aumento dos níveis de albumina em relação ao grupo gástrico no dia 28. Os níveis de transferrina aumentaram ao longo do tempo em ambos os grupos. Conclusão Não houve diferenças nas complicações registradas entre os grupos, embora níveis séricos de albumina aumentaram significativamente no grupo pós-pilórico.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Serum Albumin/analysis , Transferrin/analysis , Body Mass Index , Enteral Nutrition/methods , Intubation, Gastrointestinal/methods , Biomarkers/blood , Enteral Nutrition/adverse effects
4.
Article in English | LILACS, SES-SP | ID: biblio-1136706

ABSTRACT

ABSTRACT Objective: To correlate the nutritional status with variables associated to the type of diet and feeding route of children and adolescents with spastic quadriplegic cerebral palsy (CP). Methods: This cross-sectional study included 28 patients aged ≤13 years old who presented a diagnosis of spastic quadriplegic CP and were followed by the nutrition team of the Outpatient Clinic for Special Patients of Hospital de Clínicas de Uberlândia - Universidade Federal de Uberlândia (HC-UFU), between July/2016 and January/2017. Consent forms were signed by the legal guardians. The nutritional status was evaluated and data on dietary complications food route and type of diet were collected. For the description of data, average and median values were used. Correlation was tested with Spearman's index. Significance was set at p<0.05. Results: 75% of patients used alternative feeding routes (nasoenteral, catheter or gastrostomy), 57% were eutrophic. The most frequent complications were oropharyngeal dysphagia, reflux and intestinal constipation. No correlation was found between the occurrence of complications and the nutritional status. There was a positive correlation between the diet received and the patient's nutritional status (0.48; p=0.01), i.e. individuals with adequate caloric and macronutrients intake had a better nutritional status. Conclusions: The results reinforce the need for continued nutritional guidance for the children's parents/caregivers, as well as the choice of an adequate rout of feeding to each child by the multi-professional team, in order to contribute to improved nutritional status and adequate dietary intake.


RESUMO Objetivo: Correlacionar o estado nutricional com variáveis associadas ao tipo de dieta e via de alimentação de crianças e adolescentes com paralisia cerebral (PC) tetraparética espástica. Métodos: Estudo de corte transversal com 28 pacientes com idade ≤13 anos, atendidos pela equipe de nutrição do Ambulatório de Pacientes Especiais do Hospital de Clínicas de Uberlândia da Universidade Federal de Uberlândia (HC-UFU), entre julho de 2016 e janeiro de 2017, que apresentavam diagnóstico de PC tetraparética espástica. Os pacientes incluídos tiveram o termo de consentimento assinado pelo responsável legal. Avaliou-se o estado nutricional e coletaram-se dados sobre complicações alimentares, via de alimentação e tipo de dieta. Para descrição desses dados, foram utilizadas média e mediana; para análises de correlação, correlação de Spearman, sendo significante p<0,05. Resultados: Neste estudo, 75% dos pacientes utilizavam via alternativa para alimentação (sonda nasoenteral ou gastrostomia) e 57% eram eutróficos. As complicações mais frequentes foram disfagia orofaríngea, refluxo e obstipação intestinal. Não houve correlação entre ocorrência de complicações e estado nutricional. Observou-se correlação positiva entre dieta recebida e estado nutricional dos pacientes (0,48; p=0,01), sendo que indivíduos com adequada ingestão calórica e de macronutrientes apresentaram melhor classificação do estado nutricional. Conclusões: Os resultados obtidos reforçam a necessidade de orientações nutricionais contínuas para os pais/cuidadores das crianças do estudo, bem como a escolha de uma via de alimentação adequada a cada uma delas pela equipe multiprofissional, a fim de contribuir para a melhora do estado nutricional e da ingestão alimentar.


Subject(s)
Energy Intake , Cerebral Palsy/complications , Nutritional Status , Parents/education , Severity of Illness Index , Cross-Sectional Studies , Enteral Nutrition/adverse effects , Malnutrition/etiology , Feeding Behavior
5.
Rev. gaúch. enferm ; 41(spe): e20190159, 2020.
Article in English | LILACS, BDENF | ID: biblio-1058520

ABSTRACT

Abstract Objective: Knowing the perceptions of nursing technicians about the risks to the patient in the use of enteral nutritional therapy, in a scenario of clinical simulation. Method: A qualitative study, performed through a clinical simulation with nursing technicians from a university hospital in the South of Brazil, in August 2017. The simulation sessions were recorded in audio and later transcribed. Content analysis was used for data analysis. Results: Four thematic categories resulted from the analysis: Risks related to the tube; Risks related to diet; Risks related to contamination and Risks related to routine. Conclusion: The clinical simulation allowed nursing technicians to identify risks in the practice of enteral nutritional therapy and ways to minimize them. Promoting spaces for continuing education in the service, using clinical simulation methodology, gives an opportunity for critical reflection, which can contribute to safer, effective and quality nursing care.


Resumen Objetivo: Conocer la percepción de los técnicos de enfermería sobre los riesgos para el paciente al emplear la terapia nutricional enteral, en un escenario de simulación clínica. Método: Estudio cualitativo, realizado a través de una simulación clínica con técnicos de enfermería de un hospital universitario en el sur de Brasil, en agosto de 2017. Las sesiones de simulación se grabaron en audio y luego fueron transcriptas. Para el análisis de los datos, se utilizó el análisis de contenido. Resultados: El resultado del análisis fueron cuatro categorías temáticas: Riesgos relacionados con la sonda; Riesgos relacionados con la dieta; Riesgos relacionados con la contaminación y Riesgos relacionados con la rutina. Conclusión: La simulación clínica permitió que los técnicos de enfermería identificasen riesgos en la práctica de administración de terapia nutricional enteral y diversas formas de minimizarlos. Promover espacios para la educación permanente en el servicio por medio de la metodología de simulación clínica brinda oportunidades de reflexión crítica, lo que puede contribuir a cuidados de enfermería más seguros, efectivos y de calidad.


Resumo Objetivo: Conhecer a percepção dos técnicos de enfermagem sobre os riscos ao paciente em uso de terapia nutricional enteral, durante um cenário de simulação clínica. Método: Estudo qualitativo, utilizou a simulação clínica com técnicos de enfermagem de um hospital universitário do Sul do Brasil, em agosto de 2017. As sessões foram gravadas em áudio e, posteriormente, transcritas. Para a análise dos dados utilizou-se a análise de conteúdo. Resultados: A análise resultou em quatro categorias: Riscos relacionados com a sonda; Riscos relacionados com a dieta; Riscos relacionados à contaminação e Riscos relacionados à rotina de cuidados. Conclusão: A simulação clínica permitiu que os técnicos de enfermagem identificassem riscos na prática de administração de terapia nutricional enteral e meios de minimizá-los. Promover espaços para a educação permanente no serviço, utilizando metodologia de simulação clínica, oportuniza a reflexão crítica, o que pode contribuir para cuidados de enfermagem mais seguros, efetivos e de qualidade.


Subject(s)
Humans , Male , Female , Enteral Nutrition/adverse effects , Attitude of Health Personnel , Nursing , Risk Assessment , Qualitative Research , Simulation Training
6.
Einstein (Säo Paulo) ; 18: eRC5409, 2020. graf
Article in English | LILACS | ID: biblio-1133733

ABSTRACT

ABSTRACT Percutaneous endoscopic gastrostomy is used to provide enteral nutritional support for patients with obstructive oropharyngeal or esophageal neoplasms. The placement of the catheter is considered safe, with few complications. Despite this, a specific complication that is considered rare, has been increasingly described in the literature, i.e., metastasis of head and neck cancer in the gastrostomy stoma. In this report, we described a case of metastasis of squamous cell carcinoma of the larynx in the gastrostomy site, and discussed the possible etiologies and alternatives, seeking to reduce the incidence of this complication.


RESUMO A gastrostomia endoscópica percutânea é utilizada para oferecer suporte nutricional enteral para pacientes com neoplasias obstrutivas de orofaringe ou esôfago. A colocação da sonda é considerada segura, com poucas complicações. Apesar disso, uma complicação em particular, considerada rara, está sendo cada vez mais descrita na literatura: a metástase de neoplasia de cabeça e pescoço para o estoma da gastrostomia. Neste relato, descrevemos um caso de metástase de carcinoma espinocelular de laringe para o sítio da gastrostomia, e discutimos as possíveis etiologias e alternativas, buscando diminuir a incidência desta complicação.


Subject(s)
Humans , Male , Stomach Neoplasms/secondary , Esophageal Neoplasms/pathology , Gastrostomy/adverse effects , Carcinoma, Squamous Cell/secondary , Oropharyngeal Neoplasms/pathology , Laryngeal Neoplasms/pathology , Head and Neck Neoplasms/pathology , Stomach Neoplasms/surgery , Carcinoma, Squamous Cell/therapy , Carcinoma, Squamous Cell/diagnostic imaging , Enteral Nutrition/adverse effects , Head and Neck Neoplasms/therapy , Middle Aged , Neoplasm Metastasis
7.
Rev. chil. pediatr ; 90(2): 222-228, abr. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1003741

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/standards
8.
Rev. bras. ter. intensiva ; 30(3): 358-365, jul.-set. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-977979

ABSTRACT

RESUMO Para atender as necessidades nutricionais de pacientes admitidos às unidades de terapia intensiva, é necessário estabelecer um plano dietético. As complicações associadas com a nutrição enteral administrada por tubo não são incomuns e podem reduzir o fornecimento das necessidades nutricionais a pacientes internados na unidade de terapia intensiva. Encontram-se em andamento pesquisas relativas a osmolaridade, gorduras, intensidade calórica e conteúdo de fibras das fórmulas, e muitos estudos têm focado na tolerabilidade ao conteúdo de fibras ou na redução de sintomas. Conduzimos uma revisão sistemática do uso e segurança das fibras dietéticas em pacientes críticos, que envolveu oito estudos e teve como base diarreia, outros sintomas gastrintestinais (distensão abdominal, volume gástrico residual, vômitos e constipação), microbiota intestinal, tempo de permanência na unidade de terapia intensiva, e óbito. Discutimos os resultados encontrados na literatura científica, assim como as recomendações atuais. Esta abordagem contemporânea demonstrou que o uso de fibras solúveis em todos os pacientes graves hemodinamicamente estáveis é seguro e deve ser considerado benéfico para redução da incidência de diarreia nesta população.


ABSTRACT To meet the nutritional requirements of patients admitted to intensive care units, it is necessary to establish a diet schedule. Complications associated with enteral nutrition by tube feeding are not uncommon and may reduce the delivery of required nutrient to patients in intensive care units. Research on the osmolality, fat content, caloric intensity and fiber content of formulas are under way, and a substantial number of studies have focused on fiber content tolerability or symptom reduction. We conducted a systematic review of dietary fiber use and safety in critically ill patients in 8 studies based on diarrhea, other gastrointestinal symptoms (abdominal distension, gastric residual volume, vomiting and constipation), intestinal microbiota, length of stay in the intensive care unit and death. We discussed the results reported in the scientific literature and current recommendations. This contemporary approach demonstrated that the use of soluble fiber in all hemodynamically stable, critically ill patients is safe and should be considered beneficial for reducing the incidence of diarrhea in this population.


Subject(s)
Humans , Dietary Fiber/administration & dosage , Enteral Nutrition/methods , Intensive Care Units , Dietary Fiber/adverse effects , Critical Illness , Enteral Nutrition/adverse effects , Critical Care/methods , Diarrhea/etiology , Diarrhea/prevention & control , Length of Stay , Nutritional Requirements
9.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 10(2): 406-412, abr.-jun. 2018. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-908458

ABSTRACT

Objective: to identify the frequency that the hospitalized infant is underwent gastric/jejunal tube and analyze the reasons that lead to the tube loss during hospitalization. Method: Quantitative study approach that had the sample of 61 infants. Data were analyzed by determining the frequency values and their 95% confidence intervals. Results: It appears that the incidence of gastric enteral tube loss is relatively high, considering that 25 infants were underwent tube reposition between two to eight times, configuring 98 tube withdrawal procedures/ loss during the study period. The main reason for the loss was accidental with 44.9%, 11.2% occurred due to unknown causes and 8.2% for obstruction. Conclusion: Data indicate the importance of frequent qualification of health professionals in order to reduce the impact and stress which occurs in the infant and his companion, during the procedure.


Objetivo: trata-se de um estudo que tem como objetivo identificar a frequência que o lactente internado é submetido à sondagem gástrica/ jejunal e analisar os motivos que levam a perda da sonda durante a hospitalização. Método: Estudo de abordagem quantitativa que teve a amostra de 61 lactentes. Os dados foram analisados determinando os valores de frequência. Resultados: Verifica-se que a incidência de perda da sondagem enteral é relativamente alta, tendo em vista que 25 lactentes foram submetidos ao reposicionamento da sonda entre duas e oito vezes, configurando-se em 98 procedimentos da perda da sonda durante o período do estudo. O principal motivo de perda foi a acidental, com 44,9%, 11,2% ocorreram por causa ignorada e 8,2% por obstrução. Conclusão: Os dados apontam para importância da qualificação frequente dos profissionais de saúde com o intuito de reduzir o impacto e estresse que ocasiona no lactente e seu acompanhante, durante o procedimento.


Objetivo: se trata de un estudio que tiene como objetivo identificar la frecuencia que el niño hospitalizado es sometió al tubo gástrico / jejunal y analizar los motivos que conducen a la pérdida del tubo durante la hospitalización. Métodos: Estudio de abordaje cuantitativo que tuvo la muestra de 61 lactantes. Los datos fueron analizados determinando los valores de frecuencia y sus intervalos de confianza del 95 %. Resultados: Se verifica que el frecuencia de la pérdida de tubo gastrointestinal es relativamente alto, considerando que 25 niños fueron sometidos a la nueva posición de tubo entre dos a ocho veces, configurando 98 procedimientos de retirada/pérdida de tubo durante el período de estudio. La razón principal de la pérdida era casual, el 44.9 %, el 11.2 % ocurrió debido a causas desconocidas y el 8.2 % para la obstrucción. Conclusión: Los datos indican la importancia de la calificación frecuente de profesionales de salud a fin de reducir el impacto y el estrés que ocurre en el niño y su acompañante, durante el procedimiento.


Subject(s)
Male , Female , Humans , Infant , Enteral Nutrition/adverse effects , Enteral Nutrition/methods , Enteral Nutrition/nursing , Pediatric Nursing , Brazil
10.
Clin. biomed. res ; 38(3): 265-272, 2018.
Article in English | LILACS | ID: biblio-1046875

ABSTRACT

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)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Deglutition Disorders/complications , Enteral Nutrition/adverse effects , Deglutition Disorders/therapy , Enteral Nutrition/methods , Malnutrition/rehabilitation , Emergency Service, Hospital
11.
Rev. cuba. enferm ; 33(2): 0-0, jun. 2017. tab
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1093202

ABSTRACT

Introducción: debido a las circunstancias especiales de los pacientes críticos, resulta complicado determinar el aporte energético. Objetivo: determinar la prevalencia del estado nutricional de los pacientes críticos ingresados en la Unidad de Cuidados Intensivos del Hospital Universitario de Burgos (España), y si se les aportó el 60 por ciento de los requerimientos energéticos al cuarto día de ingreso. Métodos: estudio observacional, descriptivo y de prevalencia. Fueron incluidos 47 pacientes, a los que se realizó una evaluación nutricional al ingreso, mediante antropometría, escalas nutricionales validadas y calculando el aporte energético que precisaban. Resultados: el porcentaje de desnutrición al ingreso, según el Índice de Masa Corporal era de un 6,38 por ciento (1,3; 17,5), siendo superior en el sexo masculino. Con la Valoración Global Subjetiva, se obtuvo un resultado de 31,91 por ciento (19,1; 47,1) de sospecha de malnutrición, y un 8,51 por ciento (2,4; 20,4) de malnutrición. El porcentaje de riesgo de desnutrición con la Mini Nutritional Assessment, fue de 36,17 por ciento (22,7; 51,5), y de desnutrición de un 17,02 por ciento (7,6; 30,8). Según la ecuación de Ireton-Jones, a un 77 por ciento de los pacientes se les administró, al menos, el 60 por ciento de los requerimientos energéticos al cuarto día, mientras que con la de Harris-Benedict se obtuvo un 70 por ciento. Conclusiones: la elevada prevalencia de desnutrición y de riesgo de desnutrición en el paciente crítico, evidencia la importancia que supone realizar una valoración nutricional integral para adecuar los requerimientos individualmente. Resulta apropiado suplementar la nutrición enteral con la parenteral si no alcanzan los requerimientos energéticos necesarios(AU)


Introduction: Due to the special circumstances of critically-ill patients, the energy input is difficult to determine. Objective: To determine the prevalence of nutritional status of critically-ill patients admitted to the Intensive Care Unit of the University Hospital in Burgos, Spain, and whether 60 percent of the energy requirements were given on the fourth day of admission. Methods: Observational, descriptive and prevalence study. We included 47 patients, who underwent nutritional assessment at admission, using anthropometry, validated nutritional scales and calculating the energy input they needed. Results: The percentage of malnutrition at admission according to body mass index was 6.38 percent (1.3, 17.5), being higher in males. With subjective global assessment, we obtained a result of 31.91 percent (19.1, 47.1) of suspected malnutrition and 8.51 percent (2.4; 20.4) of malnutrition. The percentage of risk for malnutrition with the mini-nutritional assessment was 36.17 percent (22.7, 51.5), and malnutrition was 17.02 percent (7.6, 30.8). According to the Ireton-Jones equation, 77 percent of the patients were given at least 60 percent of energy requirements on the fourth day, while the Harris-Benedict rate was 70 percent. Conclusions: The high prevalence of undernutrition and risk for malnutrition in critically-ill patients shows the importance of performing an integral nutritional assessment to adapt individual requirements. Supplementing enteral nutrition with the parenteral one is appropriate if they do not meet necessary energy requirements(AU)


Subject(s)
Humans , Male , Nutritional Status/physiology , Enteral Nutrition/adverse effects , Parenteral Nutrition/methods , Protein-Energy Malnutrition/epidemiology , Intensive Care Units , Epidemiology, Descriptive , Critical Illness , Observational Study
12.
Rev. AMRIGS ; 61(1): 51-55, jan.-mar. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-849239

ABSTRACT

Introdução: Durante a internação hospitalar, os pacientes podem sofrer alterações funcionais, como limitações na ingestão de alimentos por via oral, por isso faz-se necessário o uso de via alternativa de alimentação. O fonoaudiólogo ingressa no atendimento hospitalar em uma equipe multidisciplinar, com a finalidade de prevenir e reduzir complicações, gerenciar a deglutição de maneira segura e eficaz. O objetivo deste estudo foi verificar os benefícios do tratamento fonoaudiológico aos pacientes em uso de via alternativa de alimentação. Métodos: Estudo desenvolvido em um hospital com pacientes internados nas enfermarias e Centro de Tratamento Intensivo. Analisaram-se prontuários de pacientes entre dezoito e noventa anos, em uso de via alternativa de alimentação, e classificou-se quanto ao tempo de internação, patologia de base, justificativa para o uso de via alternativa, ocorrência de pneumonia, evolução e via de alimentação na alta. A amostra dividiu-se em dois grupos, Com Acompanhamento Fonoaudiológico (CAF) e Sem Acompanhamento Fonoaudiológico (SAF). Resultados: A amostra foi composta por 288 prontuários, 32,5% com acompanhamento fonoaudiológico e 67,5% sem acompanhamento. A média de internação do grupo CAF foi maior que do grupo SAF. No CAF, 21,3% evoluíram a óbito e 78,7% tiveram alta hospitalar. No SAF, 47,4% evoluíram a óbito e 52,6% tiveram alta. No CAF, 45,7% receberam alta com via oral exclusiva, enquanto 18,6% do SAF tiveram alta com via oral exclusiva. Conclusão: O acompanhamento fonoaudiológico aumentou o tempo de internação hospitalar quando comparados os grupos, porém evidenciou uma diminuição do percentual de óbitos e aumentou a alta hospitalar com via oral exclusiva (AU)


Introduction: During hospitalization, patients may suffer functional changes, such as limitations in oral food intake, which demand the use of an alternative feeding route. The speech therapist enters the hospital's care in a multidisciplinary team, in order to prevent and reduce complications, to manage swallowing safely and effectively. The aim of this study was to determine the benefits of speech therapy for patients using an alternative feeding route. Methods: A study developed in a hospital with inpatients in the wards and Intensive Care Unit. Medical charts of patients between 18 and 90 years old using alternative feeding route were analyzed and classified as for time of hospitalization, baseline pathology, justification for the use of alternative route, pneumonia, evolution, and feeding route at discharge. The sample was divided in two groups, one with speech therapy (WST) and the other with no speech therapy (NST) follow up. Results: The sample consisted of 288 charts, 32.5% with speech therapy and 67.5% without it. The mean hospitalization rate in the WST group was higher than in the NST group. In the WST, 21.3% patients died and 78.7% were discharged from hospital. In the NST, 47.4% patients died and 52.6% were discharged. In the WST, 45.7% were discharged with exclusive oral route, while 18.6% of the NST were discharged with exclusive oral route. Conclusion: Speech therapy increased hospitalization time when the groups were compared, but it evidenced a decrease in the percentage of deaths and increased hospital discharge with exclusive oral route (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Deglutition Disorders/rehabilitation , Enteral Nutrition/adverse effects , Speech Therapy , Cross-Sectional Studies , Treatment Outcome
13.
Encarnación; s.n; 2017; 2017. 57 p. ilus; tab; graf.
Thesis in Spanish | LILACS | ID: biblio-1021608

ABSTRACT

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


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Critical Illness/therapy , Enteral Nutrition , Critical Care Outcomes , Intensive Care Units , Nutritional Requirements , Paraguay , Vomiting/etiology , Energy Intake , Prospective Studies , Enteral Nutrition/adverse effects , Malnutrition/complications , Malnutrition/prevention & control , Diarrhea/etiology , Diet, High-Protein , Gastrointestinal Contents
14.
Rev. chil. pediatr ; 88(4): 478-486, 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-900006

ABSTRACT

Introducción: Los niños y adolescentes con Parálisis Cerebral (PC) tienen elevada prevalencia de desnutrición, asociada a peor pronóstico. Para la adecuada evaluación nutricional existen nuevas curvas de crecimiento (Brooks y Col) que han planteado puntos de corte del índice Peso/Edad asociados a mayor morbimortalidad. Objetivo: Evaluar si pacientes con PC, en dicha categoría de riesgo nutricional (RN), presentan mayor riesgo de hospitalización y muerte. Pacientes y Método: Estudio observacional y prospectivo de una cohorte de pacientes con PC, controlados en un centro ambulatorio de referencia. Se registró: datos demográficos, socioeconómicos, evaluación funcional motora y nutricional basal. En seguimiento durante un año se constataron hospitalizaciones y mortalidad. Investigación aprobada por la comisión de ética. Resultados: Se reclutaron 81 niños con PC, edad 131,6 ± 60,4 meses (25-313), 60% de sexo masculino, 77,5% no se movilizaba por sí mismo. Los 23 pacientes con RN (28,4%), presentaban menor masa muscular y masa grasa (p = 0,000). Durante el año de seguimiento, 29 pacientes requirieron hospitalización (35,8%) y 4 fallecieron (4,9%). El grupo con RN no tuvo mayor morbilidad ni mortalidad que los sin RN. Sin embargo, ambos riesgos fueron mayores en los pacientes gastrostomizados versus los alimentados por vía oral (RR: 2,98 IC 95%: 1.32-6.75 al combinar ambas variables). Conclusiones: En esta cohorte de niños y adolescentes con PC seguidos durante un año, aquellos definidos como de riesgo nutricional según nuevas curvas, tuvieron similar morbimortalidad a los que tenían estado nutricional aceptable. La morbimortalidad fue mayor en los gastrostomizados.


Introduction: Children and adolescents with cerebral palsy (CP) have a high prevalence of malnutrition associated to poor prognosis. For an adequate nutritional assessment, new growth curves (Brooks, 2011) are available, in which precise cut-off points in Weight/Age index correlate to increased morbidity and mortality rate. Objective: To evaluate risk of hospitalization and death in patients with CP, according to nutritional risk (NR). Patients and Method: Observational and prospective cohort study of patients with CP in an outpatient referral center. We registered demographic, socioeconomic data and nutritional assessment. During a one-year follow-up, hospitalizations and mortality were recorded. The correspondent committee extended an ethical approval. Results: 81 CP patients were recruit, age 131.6 ± 60.4 months (25-313), 60 % male, 77.5 % without independent mobility. The 23 NR patients (28.4%) had lower muscle and fat mass (p = 0.000). During the follow-up, 29/81 patients required hospitalization (35.8%) and 4/81 died (4.9%). There was not an increased risk of hospitalization and/or mortality in NR group, but both were significantly higher in gastrostomy-fed children (RR: 2,98 CI 95%: 1.32-6.75 combining both variables). Conclusions: In this study, children and adolescents with severe CP and nutritional risk had similar morbidity and mortality during a one-year follow-up, compared to those with acceptable nutritional status. Both risks were higher in gastrostomy-fed than the orally fed children.


Subject(s)
Humans , Female , Child, Preschool , Child , Adolescent , Young Adult , Cerebral Palsy/complications , Cerebral Palsy/mortality , Enteral Nutrition/adverse effects , Malnutrition/etiology , Malnutrition/mortality , Hospitalization/statistics & numerical data , Gastrostomy , Nutrition Assessment , Cerebral Palsy/therapy , Chile/epidemiology , Nutritional Status , Prospective Studies , Risk Factors , Follow-Up Studies , Enteral Nutrition/methods , Malnutrition/diagnosis
15.
Rev. bras. enferm ; 69(5): 847-854, set.-out. 2016. tab, graf
Article in Portuguese | LILACS, BDENF | ID: lil-798041

ABSTRACT

RESUMO Objetivo: descrever o perfil de medicamentos orais padronizados em uma unidade hospitalar e verificar sua adequação quanto ao uso por cateteres enterais, de acordo com recomendações da literatura. Método: estudo descritivo, com dados sobre medicamentos coletados do Sistema de Dispensação do Serviço de Farmácia. As recomendações específicas para uso de tais medicamentos por cateteres enterais foram obtidas após busca em bases literárias, livros, manuais, guidelines e bulários. Resultados: dos 236 medicamentos orais dispensados, 86% estavam na forma sólida; destes, 32 eram "não trituráveis", havendo disponibilidade da forma líquida na instituição. Foram identificados 28 medicamentos com potenciais interações com a nutrição enteral. Sessenta porcento deles apresentavam recomendações específicas sobre sua administração por cateter enteral. Conclusão: a participação conjunta das equipes multidisciplinares de terapia nutricional e de assistência e a implementação de programas para treinamento contínuo constituem estratégias sugeridas para a prevenção de potenciais problemas na administração de medicamentos no espaço hospitalar.


RESUMEN Objetivo: describir el perfil de medicamentos orales estandarizados en una unidad hospitalaria y verificar su adecuación respecto del uso vía sondas gástricas, según recomendaciones de la literatura. Método: estudio descriptivo, con datos sobre medicamentos recolectados del Sistema de Dispensación del Servicio de Farmacia. Las recomendaciones específicas de uso por sondas gástricas fueron obtenidas por búsqueda en bases de literatura, libros, manuales, guidelines y vademécums. Resultados: De los 236 medicamentos orales dispensados, 86% se presentaban en forma sólida; de ellos, 32 eran "no triturables", existiendo disponibilidad de la forma líquida en la institución. Fueron identificados 28 medicamentos con potenciales interacciones con la nutrición enteral. El 60% incluía recomendaciones específicas sobre administración por sonda gástrica. Conclusión: la participación conjunta de equipos multidisciplinarios de terapia nutricional y de atención y la implementación de programas de capacitación permanente constituye estrategias sugeridas para prevenir potenciales problemas en administración de medicamentos en el ámbito hospitalario.


ABSTRACT Objective: to describe the profile of standardized oral drugs at a hospital unit and assess their adequacy for use via enteral feeding tubes, according to recommendations from the literature. Method: descriptive study, with data on drugs collected from the Pharmacy Service Dispensing System. Specific recommendations for the use of these drugs via enteral feeding tubes were found after searches in literary databases, books, manuals, guidelines and package insert collections. Results: among the 236 dispensed oral drugs, 86% were in solid form; of those, 32 were "non-crushable", with the liquid form available at the institution. Twenty-eight drugs with potential interactions with enteral nutrition were identified. Sixty percent of those presented specific recommendations on their administration via enteral feeding tube. Conclusion: the joint participation of multidisciplinary nutritional therapy and care teams and the implementation of programs for continuous training are suggested strategies for the prevention of potential problems in the administration of drugs in the hospital setting.


Subject(s)
Humans , Pharmaceutical Preparations/administration & dosage , Enteral Nutrition/nursing , Pharmacy Service, Hospital/standards , Pharmacy Service, Hospital/statistics & numerical data , Quality Assurance, Health Care , Brazil , Administration, Oral , Enteral Nutrition/adverse effects , Medication Errors
16.
Rev. cuba. enferm ; 30(4): 0-0, oct.-dic. 2014. ilus, tab
Article in Portuguese | LILACS, BDENF, CUMED | ID: lil-797670

ABSTRACT

Introdução: a Enfermagem desempenha um papel preponderante, ativo e de responsabilidade crescente no controle da nutrição enteral, uma vez que além de promover sua administração, realiza a vigilância, manutenção e controle da via escolhida e o volume administrado com importante atenção para a prevenção de possíveis complicações. Objetivo: caracterizar as principais falhas relacionadas ao conhecimento e a prática da assistência de enfermagem à pacientes em uso de sonda gastrointestinal, por meio de uma revisão integrativa. Métodos: trata-se de uma revisão integrativa de literatura realizada no período de abril a maio de 2013 nas bases de dados Literatura Latino-Americana e do Caribe (LILACS), Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Publicações Médicas (PubMed) e Isi Web of Knowledge, com uso de descritores controlados e não-controlados. Conclusão: a assistência de enfermagem apresentou condutas desfavoráveis que repercutiram de forma negativa no cuidado. Desse modo, evidencia-se a necessidade da implantação de protocolos para utilização durante a formação de recursos humanos em enfermagem, que norteiem a realização da assistência às pessoas alimentadas por sonda(AU)


Introducción: la Enfermería juega un papel importante, activo y creciente en el control de la nutrición integral, así como la promoción de su gestión, monitorización, mantenimiento y control del volumen administrado para la prevención de complicaciones. Objetivo: caracterizar las principales fallas relacionadas al conocimiento y la práctica de la asistencia de enfermería a pacientes sometidos al uso de sonda gastrointestinal. Métodos: revisión integrativa de la literatura realizada en el periodo de abril a mayo de 2013 en las bases de datos Literatura Latino-Americana e do Caribe (LILACS), Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Publicações Médicas (PubMed) e Isi Web of Knowledge, con el uso de los descriptores controlados y no controlados. Conclusión: la asistencia de enfermería presentó conductas desfavorables que repercutieron de manera negativa en el cuidado. De ese modo, se evidencia la necesidad de la implantación de protocolos para utilización durante la formación de recursos humanos en enfermería, que guíen la realización de la asistencia a las personas alimentadas por sonda(AU)


Introduction: nursing play an important rol in the integral nutrition control. Objective: to characterize the main defects related to the knowledge and the practice of the nursing care regarding patients using gastrointestinal tube, thru an integrative revision. Method: it is an integrative revision of literature performed in the period between April and May of 2013 in the databases Literatura Latino-Americana e do Caribe (LILACS), Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Publicações Médicas (PubMed) and Isi Web of Knowledge, using controlled and non-controlled descriptors. Conclusion: the nursing care presented unfavorable behaviors that affected the care in a negative way. Thus, it became evident the necessity of the implementation of protocols to be used during the training of human resources in nursing, to guide the performance of the care to people being fed by tube(AU)


Subject(s)
Humans , Enteral Nutrition/adverse effects , Intubation, Gastrointestinal/methods , Nursing Care/methods , Review Literature as Topic
17.
Rev. gaúch. enferm ; 35(2): 53-59, 06/2014. tab, graf
Article in English | LILACS, BDENF | ID: lil-716380

ABSTRACT

Aimed at verifying the occurrence of adverse events related to enteral nutrition use in patients of a public hospital in the countryside of Rio Grande do Sul. A quantitative, longitudinal and descriptive study, conducted in January-May 2012, that accompanied 46 patients admitted to the Intensive Care Unit and Medical Clinic. For evaluating the adverse events, we used quality indicators: inadvertent exit, tube obstruction and volume of infused diet. For analysis, we used descriptive statistics. The results showed that inadvertent exit of the tube and obstruction presented incidence rates of 4.6% and 2.1%, respectively. The volume of diet infused was less than that prescribed, due to pauses for body hygiene, tests and procedures, nausea / vomiting and delay in the availability of installation of the bottle in the unit. We conclude that the use of quality indicators in the assessment of care can help reduce damage to the patient.


Este estudio evaluó el acontecimiento de eventos adversos relacionados con el uso de la nutrición enteral en pacientes de un hospital público en Rio Grande do Sul. Método: Cuantitativo, longitudinal y descriptivo, llevado a cabo de enero a mayo 2012, con 46 pacientes ingresados en la Unidad de Cuidados Intensivos y Medicina Clínica. Para la evaluación de los eventos adversos utilizado los indicadores de calidad de salida: obstrucción inadvertida de la sonda y el volumen infundido dieta. Para el análisis, se utilizó estadística descriptiva. Ya en los resultados se hizo evidente que la salida de la sonda y la obstrucción inadvertida mostró tasas de incidencia del 4,6% y 2,1%, respectivamente. El volumen de la dieta fue menor que el prescrito infundido (mediana 81,4 ml) y la pausa para la higiene corporal, pruebas y procedimientos, náuseas/vómitos y retardo en la disponibilidad de la instalación de la botella en la unidad. Llegamos a la conclusión de que el uso de indicadores de calidad en la evaluación de la atención puede ayudar a reducir el daño al paciente.


Objetivou-se verificar a ocorrência de eventos adversos relacionados ao uso de nutrição enteral em pacientes de um hospital público do interior do Rio Grande do Sul. Estudo quantitativo, longitudinal e descritivo, realizado de janeiro a maio de 2012, com acompanhamento de 46 pacientes internados nas unidades de Terapia Intensiva e Clínica Médica. Para avaliação dos eventos adversos, utilizaram-se os indicadores de qualidade: saída inadvertida, obstrução da sonda e volume de dieta infundido. Para as análises, utilizou-se a estatística descritiva. Como resultados, a saída inadvertida da sonda e a obstrução apresentaram taxas de incidência de 4,6% e 2,1%, respectivamente. O volume de dieta infundido foi inferior ao prescrito, por pausa para higiene corporal, exames e procedimentos, náusea/vômito e demora na instalação do frasco por indisponibilidade na unidade. Conclui-se que a utilização de indicadores de qualidade na avaliação da assistência pode auxiliar na redução de danos ao paciente.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Enteral Nutrition/adverse effects , Longitudinal Studies
18.
Article in English | WPRIM | ID: wpr-62193

ABSTRACT

We presented two interesting cases of gastrocolocutaneous fistula that occurred after percutaneous endoscopic gastrostomy (PEG) tube placement, and its management. This fistula is a rare complication that occurs after PEG insertion, which is an epithelial connection between mucosa of the stomach, colon, and skin. The management of the fistula is controversial, ranging from conservative to surgical intervention. Endoscopists should be aware of the possibility of gastrocolocutaneous fistula after PEG insertion, and should evaluate the risk factors that may contribute to the development of gastrocolocutaneous fistula before the procedure. We reviewed complications of gastrostomy tube insertion, symptoms of gastrocolocutaneous fistula, and its risk factors.


Subject(s)
Aged , Cerebral Infarction/diagnosis , Digestive System Fistula/etiology , Endoscopy, Gastrointestinal , Enteral Nutrition/adverse effects , Gastrostomy , Humans , Male , Middle Aged , Nervous System Diseases/diagnosis , Risk Factors , Tomography, X-Ray Computed
19.
Gut and Liver ; : 248-253, 2014.
Article in English | WPRIM | ID: wpr-31103

ABSTRACT

BACKGROUND/AIMS: Knowledge of the risk factors associated with adverse outcomes after percutaneous endoscopic gastrostomy (PEG) may be helpful for developing PEG recommendations. The purpose of this study was to identify the clinical risk factors associated with adverse clinical outcomes after PEG, especially regarding the use of proton pump inhibitors (PPIs). METHODS: We retrospectively reviewed the data from PEG patients at seven university hospitals between June 2006 and January 2012. All patients were followed up through February 2012 after PEG, and the clinical risk factors for adverse clinical outcomes after PEG were analyzed. RESULTS: Data from 1,021 PEG patients were analyzed. PPI users were more frequently included in the complication group than the noncomplication group (p=0.040). PEG-related complications (p=0.040) and mortality (p=0.003) were more frequent in the PPI group than in the control group. In the subgroup analysis of complicated PEG cases, infectious complications were more frequently found in the PPI group than in the control group (35.8% vs 27.8%). After adjustment for multiple possible confounding factors, PPI users (odds ratio, 1.531; 95% confidence interval, 1.017 to 2.305) and diabetic patients had increased mortality after PEG. CONCLUSIONS: PPI use may be associated with adverse outcomes in patients with PEG; however, further prospective studies investigating this issue are warranted.


Subject(s)
Aged , Case-Control Studies , Enteral Nutrition/adverse effects , Female , Gastroscopy/adverse effects , Gastrostomy/adverse effects , Humans , Male , Prognosis , Proton Pump Inhibitors/adverse effects , Republic of Korea , Retrospective Studies , Risk Factors
20.
Rev. bras. ter. intensiva ; 25(2): 162-167, abr.-jun. 2013. tab
Article in Portuguese | LILACS | ID: lil-681996

ABSTRACT

OBJETIVO: Descrever as interações entre fármacos e nutriente e sua frequência nas unidades de terapia intensiva bem como avaliar o grau de consciência a esse respeito por parte da equipe de profissionais. MÉTODOS: Foram revisados, na base de dados eletrônica PubMed, especificamente no MeSH, os unitermos: "drug interactions" e "nutrition therapy". Os estudos foram sistematicamente revisados para a descrição de tipos de interações entre fármacos e nutrientes, suas frequências e consequências. RESULTADOS: Foram encontrados 67 artigos. Dentre estes, 20 artigos estavam adequados à metodologia adotada e atingiram os objetivos do estudo. Destes, 14 artigos descreviam interações entre fármacos e nutrição enteral, 3 descreviam interações entre fármacos e nutrição parenteral, e 3 descreviam a importância e os cuidados para evitar tais interações. CONCLUSÃO: A literatura referente a interações entre fármacos e nutrientes é escassa e sugere a fragilidade das equipes assistenciais em reconhecer o potencial para interações. Possivelmente a construção de um protocolo para avaliação de interação fármaco-nutriente aumente a segurança e eficácia dos processos terapêuticos.


OBJECTIVE: To describe the interactions between drugs and nutrients and their frequency in the intensive care unit and to assess the professional team's awareness regarding this subject. METHODS: The keywords "drug interactions" and "nutrition therapy" were searched in the PubMed (specifically MeSH) electronic database. The studies were systematically reviewed for descriptions of the types of interactions between drugs and nutrients, including their frequency and consequences. RESULTS: Sixty-seven articles were found. Among these, 20 articles were appropriate for the methodology adopted and accomplished the objectives of the study. Of these 20 articles, 14 articles described interactions between drugs and enteral nutrition, three described interactions between drugs and parenteral nutrition, and three described the importance and care required to avoid such interactions. CONCLUSIONS: The literature about drug and nutrient interactions is limited and suggests the inability of health care teams to recognize the potential for these interactions. Possibly, the elaboration of a protocol to evaluate drug-nutrient interactions will increase the safety and efficacy of therapeutics.


Subject(s)
Humans , Enteral Nutrition/methods , Food-Drug Interactions , Parenteral Nutrition/methods , Enteral Nutrition/adverse effects , Intensive Care Units , Critical Care/methods , Nutritional Support/adverse effects , Nutritional Support/methods , Parenteral Nutrition/adverse effects
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