From Nutrition Support to Pharmacologic Nutrition in the ICU

Keyword(s):  
Farmacist ro ◽  
2019 ◽  
Vol 3 (188) ◽  
pp. 9
Author(s):  
Cristina Daniela Marineci ◽  
Emil Ștefănescu ◽  
Cornel Chiriţă

1997 ◽  
Vol 97 (5) ◽  
pp. 473-474 ◽  
Author(s):  
Linda S. Heller ◽  
Deborah Shattuck
Keyword(s):  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Jenkins ◽  
H t Ho ◽  
O Santin

Abstract Issue Informal carers provide an important and often overlooked role in the care of people with a cancer diagnosis. Our study sought to better understand carers needs and develop an online resource to help address the needs identified. There are not currently any widespread or embedded support services for cancer carers in Vietnam. Description of the Problem We conducted in-depth interviews and focus groups with both carers (n = 20) and healthcare providers (n = 22) to understand the needs and challenges of caring for someone with a cancer diagnosis. We discussed what resources would alleviate challenges and used these discussions to inform a process of co-designing an online resource. This process was modelled off a peer-led online resource intervention developed in the United Kingdom. This process of co-design is transferable to other contexts, and when adapted could help meet the needs of cancer carers in other lower and middle income countries. Results Carers in Vietnam reported (i) economic challenges of care; (ii) not being able to access facilities and secure accommodation when caring for inpatients; (iii) lack of information about cancer and nutrition; (iv) lacking emotional support; and (v) requiring training to support both the treatment and recovery of people under their care. Suggestions for content of an online resource included the need for contextually appropriate Vietnamese content, specific information on diet and nutrition, support in making decisions around treatment, and signposting for other services. Lessons Successful co-design of resources requires input from multiple key stakeholders. This is necessary to successful adapt and modify interventions for new contexts. Our process revealed new information about the roles and needs of carers, and enabled us to incorporate solutions to these needs within our online resource. Given the lack of other supportive services for carers, the development of such resources should be considered a priority. Key messages Cancer carers in Vietnam experience specific challenges including provision of nutrition, supporting navigation of hospital administration, and taking a central role in treatment decision-making. Co-designed online resources have the potential to support carers in providing relevant and appropriate information and signposting to other important services.


Author(s):  
Matthew L. Bechtold ◽  
Hariharan Regunath ◽  
Renay Tyler ◽  
Peggi Guenter ◽  
Albert Barrocas ◽  
...  

2021 ◽  
Vol 8 ◽  
pp. 237437352098147
Author(s):  
Vanessa C Vaughan ◽  
Meg Harrison ◽  
Anna Dowd ◽  
Peter Eastman ◽  
Peter Martin

The Barwon Health Cachexia & Nutrition Support Service (CNSS) is an outpatient service focused on improving clinical outcomes and quality of life for patients with or at high risk of cancer cachexia. Patients see a multidisciplinary team, comprising a palliative medicine physician, physiotherapist, dietitian, and nurse practitioner. This study evaluated the service from patient and carer perspectives. In 2016/17, semistructured interviews were conducted with 12 patients and 9 carers attending the service, focusing on: (1) reflection on experience of the CNSS, and (2) describing how a cachexia-specific service can meet their needs and concerns. Analysis generated 4 superordinate themes: evolving perception of service value, empowerment through person-centered care, communication to patients and carers regarding health/disease information, and the importance of the multidisciplinary team-based approach. Generally, patients and carers reported overall positive experiences with the service, particularly with regard to improved communication and management of the patient. Findings confirmed the patient-centered and individualized approaches were particularly valued. These insights are a critical step in the development of recommendations for future clinical management of cancer cachexia.


Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 121
Author(s):  
Roland N. Dickerson ◽  
Christopher T. Buckley

Propofol, a commonly used sedative in the intensive care unit, is formulated in a 10% lipid emulsion that contributes 1.1 kcals per mL. As a result, propofol can significantly contribute to caloric intake and can potentially result in complications of overfeeding for patients who receive concurrent enteral or parenteral nutrition therapy. In order to avoid potential overfeeding, some clinicians have empirically decreased the infusion rate of the nutrition therapy, which also may have detrimental effects since protein intake may be inadequate. The purpose of this review is to examine the current literature regarding these issues and provide some practical suggestions on how to restrict caloric intake to avoid overfeeding and simultaneously enhance protein intake for patients who receive either parenteral or enteral nutrition for those patients receiving concurrent propofol therapy.


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