RESUMO
A prospectively studied series of 1072 patients who received specialized nutritional support are presented to evaluate the patterns of such care in a large nonuniversity teaching center. Age, service, materials used, routes of administration, complications, assessment parameters, duration of treatment, diagnoses, and survival statistics are presented. Such patterns are considered to be of importance to medical scientists, basic researchers, hospital administrators, governmental agencies, and members of the health care insurance industry.
Assuntos
Nutrição Enteral , Fenômenos Fisiológicos da Nutrição , Nutrição Parenteral , Adulto , Idoso , Peso Corporal , Terapia Combinada , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Estudos de Avaliação como Assunto , Feminino , Humanos , Contagem de Leucócitos , Linfócitos/citologia , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral/efeitos adversos , Nutrição Parenteral/métodos , Prognóstico , Estudos Prospectivos , Albumina Sérica/análiseRESUMO
A prospective study analyzing the complications in 307 patients who had specialized nutrition support administered by their private practitioners was performed and compared to other series in which a nutrition support service exclusively provided such care of patients. The mechanical complication rate of 4.6%, septic complication rate of 2.9%, and metabolic complication rate of 4.2% compared favorably with the reported literature. A new category of complications, the judgmental complication, is described and was 12.7% in the reported series. The Saint Barnabas Medical Center experience suggests that individual practitioners can satisfactorily administer intravenous specialized nutrition support if in fact an involved nutrition support service functions administratively and supportively in the background.
Assuntos
Nutrição Parenteral Total/efeitos adversos , Nutrição Parenteral/efeitos adversos , Adulto , Idoso , Cateterismo/efeitos adversos , Feminino , Hospitais Filantrópicos , Humanos , Infecções/etiologia , Julgamento , Masculino , Doenças Metabólicas/etiologia , Pessoa de Meia-Idade , New Jersey , Estudos ProspectivosRESUMO
A review of 253 patients treated with enteral nutrition support via tube feedings is presented for the purpose of evaluating the incidence of complications. Thirty patients, (11.7%) experienced either gastrointestinal, (6.2%) mechanical (3.5%), or metabolic (2.0%) complications. The recognition and treatment of such complications are discussed and it is concluded that tube feedings are safely tolerated by most patients; however, constant attention must be exerted to either avoid or recognize such complications.
Assuntos
Nutrição Enteral/efeitos adversos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Diarreia/etiologia , Feminino , Esvaziamento Gástrico , Hemorragia Gastrointestinal/etiologia , Humanos , Intubação Gastrointestinal/instrumentação , Masculino , Pessoa de Meia-Idade , Pneumonia Aspirativa/etiologia , Estudos Prospectivos , Vômito/etiologia , Desequilíbrio Hidroeletrolítico/etiologiaRESUMO
Instant nutritional assessment of the critically ill patient using serum albumin level and total lymphocyte count is reported. When an intensive care unit population is compared to the general hospital population a 6-fold increase in albumin level depressions, a 2-fold increase in lymphocyte count depression, and an 11-fold increase in depression of both parameters was noted in the intensive care unit population. Surgical intensive care unit (SICU) patients with depressed albumin levels and total lymphocyte counts had twice the complication rate and 4.5 times the death rate of those SICU patients with normal albumin levels and lymphocyte counts. It is concluded that serum albumin levels and total lymphocyte count determinations are valuable tools for instant nutritional assessment of the critically ill patient.
