scholarly journals 67 Nutritional Assessment of Patients Admitted To “Adult Burns Unit” At Southmead Hospital from April To August 2017

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Babar ◽  
D Katechia ◽  
S Sen ◽  
J Pleat
Keyword(s):  
Nutritional Support ◽  
Nutritional Assessment ◽  
Good Practice ◽  
Retrospective Data ◽  
Weekly Assessment ◽  
Burns Unit ◽  
Southmead Hospital

Abstract Introduction Nutritional support is an integral part of Burns management. Local guidelines for malnutrition screen are available at Southmead Hospital. Aim Audit was aimed at compliance of malnutrition screen for all admissions to “Adult Burns Unit” to the local guidelines. Method A retrospective data of baseline and weekly malnutrition screen was collected and analysed for 106 patients between April and August 2017. These findings were compared to the following local guidelines; Results Of 106 patients, most (n = 72) had <5% TBSA burn. 9 were resus burns (TBSA >15%). 50 patients stayed less than a week while 34 discharged within 24hrs. 20 stayed longer than seven days. Compliance of recording weight on admission was 46.2% while weekly assessment 10%. Height and BMI were measured for 24.5% of admissions. 81% of patients had admission bloods and 19 out 20 staying longer than a week had weekly bloods. All major burns were referred to dietician. Conclusions Assessment of %TBSA, admission and weekly bloods, and dietician referral were areas of good practice. However, compliance with recording weight and height on admission did not meet the Trust target of 85% We recommended a checkbox for weight and height on admission in Trust’s electronic handover system, monitor at weekly burns MDT and re-audit.

Nutrition and the Use of Metabolic Assessment in the Ventilator-dependent Patient

1991 ◽  
Vol 2 (3) ◽  
pp. 453-461
Author(s):  
Robert E. ST. John ◽  
Patti Eisenberg
Keyword(s):  
Carbon Dioxide ◽  
Mechanical Ventilation ◽  
Dead Space ◽  
Indirect Calorimetry ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Caloric Intake ◽  
Elevated Carbon Dioxide ◽  
Carbon Dioxide Production ◽  
Dependent Patient

Nutritional support is an important aspect of care in hospitalized patients, especially those receiving mechanical ventilation. While nutritional assessments can help guide the clinician in determining appropriate caloric intake requirements and refeeding schedules, few tools exist to evaluate the consequences of over- or underfeeding. Metabolic assessment using indirect calorimetry is a new method of nutritional assessment for use at the bedside of the weaning patient. The data obtained from a metabolic assessment can be used to adjust formulas and total caloric intake as well as differentiate between dead space and elevated carbon dioxide production as reasons for persistent hypercarbia

Enteral nutritional support in patients undergoing chemoradiotherapy for esophageal carcinoma

2020 ◽  
Vol 16 (35) ◽  
pp. 2949-2957
Author(s):  
Bei Wang ◽  
Xiaowen Jiang ◽  
Dalong Tian ◽  
Wei Geng
Keyword(s):  
Esophageal Cancer ◽  
High Risk ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Assessment Tools ◽  
Tumor Patients ◽  
Selection Of

Esophageal cancer patients are at a high risk of malnutrition. Both the disease itself and chemoradiotherapy will lead to the deterioration of nutritional status. The development of nutritional oncology promotes the application of enteral nutrition in tumor patients. Through nutritional support, prognosis is improved and the incidence of adverse chemoradiotherapy reactions is reduced, especially in those with head and neck or esophageal cancer. This review summarizes enteral nutritional support in esophageal cancer patients undergoing chemoradiotherapy in recent years, including a selection of nutritional assessment tools, the causes and consequences of malnutrition in esophageal cancer patients, types of access and effects of enteral nutrition. More patients with esophageal cancer will benefit from the development of enteral nutrition technology in the future.

The Use, Efficacy and Monitoring of Artificial Nutritional Support in a Teaching Hospital

1995 ◽  
Vol 40 (6) ◽  
pp. 179-183 ◽  
Author(s):  
J P. McWhirter ◽  
K. Hill ◽  
J. Richards ◽  
CR Pennington
Keyword(s):  
Patient Outcomes ◽  
Teaching Hospital ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Nutrient Supply ◽  
Energy Requirements ◽  
Feeding Time

The implementation of circulated guidelines has been audited, by assessing the extent to which nutritional goals were set and achieved and recording the levels of morbidity as a result of complications. Adults receiving artificial nutritional support were studied over a six month period. Nutritional assessment was used to determine adequacy of prescription and efficacy of the support. Energy requirements were retrospectively calculated and compared with prescriptions and actual intakes. Complications and interruptions to the regimens which resulted in lost feeding time were recorded, as were patient outcomes. Nutrient prescriptions were inadequate, delivery of prescriptions was incomplete and thus nutrient supply inadequate.

Nutrition: A Critical Component of Wound Healing

1990 ◽  
Vol 1 (3) ◽  
pp. 585-592 ◽  
Author(s):  
Nancy A. Stotts ◽  
Donna F. Washington
Keyword(s):  
Health Care ◽  
Wound Healing ◽  
Critical Care ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Current Knowledge ◽  
Health Care Team ◽  
Critical Component ◽  
Assessment Technique

Nutrients are essential to wound healing and patients in critical care are often at risk for lack of sufficient nutrients that may result in impaired healing. Understanding the role of the various nutrients in healing provides the basis for assessment and therapy. Use of a practical and consistent nutritional assessment technique is an important part of care for critically ill patients with wounds. The health care team must provide care based on current knowledge of the effects of nutrition on wound healing and work collaboratively in doing nutritional assessment and providing nutritional support to optimize wound healing outcomes

General Metabolism in Patients with Acute Paraplegia and Quadriplegia

Neurosurgery ◽  
1985 ◽  
Vol 16 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Howard H. Kaufman ◽  
Brian J. Rowlands ◽  
Debra K. Stein ◽  
Dennis R. Kopaniky ◽  
Philip L. Gildenberg
Keyword(s):  
Spinal Cord ◽  
Nutritional Status ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
General Metabolism ◽  
Acute Paraplegia ◽  
A Prospective Study ◽  
Injured Patients ◽  
Infective Complications

Abstract This study measured the nutritional status of eight spine-injured patients during their first 10 to 14 days in the hospital. Initial and follow-up nutritional assessment showed that their nutritional status deteriorated at least partly due to an inadequate supply of protein and calories. Infective complications and prolonged respiratory support were common and may have been caused in part by impaired nutrition. This suggests that a prospective study of aggressive nutritional support for patients with spinal cord transection should be initiated to determine whether this acquired malnutrition and its associated complications can be prevented.

The effect of nutritional support on outcome from severe head injury

1987 ◽  
Vol 67 (5) ◽  
pp. 668-676 ◽  
Author(s):  
Byron Young ◽  
Linda Ott ◽  
Diana Twyman ◽  
Jane Norton ◽  
Robert Rapp ◽  
...  
Keyword(s):  
Septic Shock ◽  
Head Injury ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Favorable Outcome ◽  
Content Type ◽  
Point Increase ◽  
Gcs Score ◽  
Tract Infections ◽  
Injured Patients

✓ Fifty-one brain-injured patients with peak 24-hour admission Glasgow Coma Scale (GCS) scores of 4 to 10 were prospectively randomly assigned to receive total parenteral (TPN) or enteral (EN) nutrition. Patients were studied from hospital admission to 18 days postinjury. Outcome was assessed by the Glasgow Outcome Scale at 3 months, 6 months, and 1 year postinjury. The TPN group received a significantly higher cumulative mean intake of protein than the EN group (mean ± standard error of the mean: 1.35 ± 0.12 vs. 0.91 ± 0.9 gm/kg/day; p = 0.004). Mean cumulative caloric balance was also significantly higher in the TPN than in the EN group (75.6% ± 5.13% vs. 59% ± 4.26%; p = 0.02). Nitrogen balance was significantly more negative in the EN group during the 1st week postinjury (p = 0.002). The incidence of pneumonia, urinary tract infections, septic shock, and infections was not significantly different between groups. Classic nutritional assessment parameters such as anergy screens, total lymphocyte counts, and albumin levels were not significantly different between groups. The 11 patients in the EN group who did not tolerate tube feedings for 1 week postinjury had a significantly higher incidence of septic shock (p = 0.008). The change over time in GCS scores between groups was significantly different, with the TPN group showing a mean four-point increase in GCS score compared with a three-point increase in the EN group (p = 0.02). At 3 months the TPN group had a significantly higher percentage of favorable outcomes (43.5% vs. 17.9%, respectively; p = 0.05). At 6 months, 43.5% of the TPN group had a favorable outcome while 32.1% of the EN group had a favorable outcome (p = 0.29). By 1 year, 47.8% of the TPN group and 32.1% of the EN group had a favorable outcome (p = 0.20). In conclusion, more calories and protein usually can be administered to acute brain injury patients via the TPN route than by EN feedings via nasogastric or nasoduodenal routes. Traditional parameters for nutritional assessment are not useful in studying the efficacy of nutritional support during the first 2 weeks after head injury. Neurological recovery from head injury occurs more rapidly in patients with better early nutritional support.

scholarly journals Effect of Early Nutritional Assessment and Nutritional Support on Immune Function and Clinical Prognosis of Critically Ill Children

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Jie Guo ◽  
Zixuan Jin ◽  
Yibing Cheng ◽  
Jun Su ◽  
Zheng Li ◽  
...  
Keyword(s):  
Immune Function ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Nutritional Risk ◽  
Critically Ill Children ◽  
Control Group ◽  
Clinical Prognosis ◽  
Experimental Group

The aim of this study was to study the effect of early nutritional assessment and nutritional support on immune function and clinical prognosis of critically ill children. 90 critically ill children at the same level of severity admitted to the pediatric intensive care unit (PICU) of our hospital (June 2019–June 2020) were chosen as the research objects and were equally separated into the experimental group and the control group by the random number table method. The children in the control group were admitted to the PICU according to the routine process, and the nutritional support was provided to the malnourished ones. After admission to the PICU, the children in the experimental group were given nutritional assessment, nutritional risk screening, and nutritional support according to the screening results. The PICU stay time and total hospitalization time of the experimental group were obviously shorter than those of the control group ( P < 0.05 ), the hospitalization expenses of the experimental group were obviously lower than those of the control group ( P < 0.05 ), the clinical outcomes and immune function of the experimental group were obviously better than those of the control group ( P < 0.05 ), and the nutrition indicators of the experimental group were obviously higher than those of the control group ( P < 0.05 ). Early nutritional assessment and nutritional support can effectively improve the immune function and reduce the incidence of adverse clinical outcomes of critically ill children, which are worthy of clinical application and promotion.

131 PRACTICES IN PERIOPERATIVE NUTRITION PRECEDING OR FOLLOWING OESOPHAGECTOMY: RESULTS OF A EUROPEAN SURVEY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Hans Van Veer ◽  
Misha Luyer ◽  
Lieven Depypere ◽  
Philippe Nafteux ◽  
Willy Coosemans
Keyword(s):  
Nutritional Support ◽  
Nutritional Assessment ◽  
Enhanced Recovery ◽  
Oral Intake ◽  
Daily Practice ◽  
The Third ◽  
Preoperative Nutrition ◽  
Perioperative Nutrition ◽  
Feeding Regimen ◽  
Surgical Pathway

Abstract   The route and type of peri-operative feeding after oesophagectomy varies widely across centres, usually based on local experiences and standing orders. The aim of this survey on perioperative nutrition after oesophagectomy (PONOS) was to create a snapshot the way perioperative nutrition preceding or following oesophagectomy is established across reference centres in Europe, and what the reasons are for preferring one method over another. Methods A survey consisting of four parts was distributed to the membership of 3 European, mainly surgical oriented scientific societies between October 2019 and January 2020. The first part contained some general questions regarding demographics of the participants and type of performed surgery. In the second section, centres were asked about practices in preoperative nutrition. The third section questioned participants about their practices in postoperative nutrition; in the last part the daily practice was reflected against the current available ESPEN guidelines. Results Fifty-one surgeons from 49 centres in 16 countries participated. The majority had a structured nutrition team in their institution. An Enhanced Recovery Pathway was implemented in 2/3 of centres. ESPEN guidelines were followed in 50% of centers. Routine preoperative nutritional assessment was performed in 84%. Preoperative nutritional support consisted mainly of enteral and oral support; immediate postoperatively mostly a combination of oral and enteral or enteral only; at discharge mostly a combination of oral and enteral or only oral nutritional supplementation were used. Timing, definition and means of postoperative oral intake also seemed to differ widely across centres. Conclusion The PONOS survey confirmed our assumption that perioperative feeding after oesophagectomy exists in a wide variety across European centres performing oesophageal resections for cancer. Survey based feedback to the surgical community draws attention to this often underexposed part of the surgical pathway of a patient. As such, this might further enhance the exchange of experiences in order to try to harmonise peri-operative feeding regimen.

Nutritional Assessment of the Head and Neck Cancer Patient

1980 ◽  
Vol 88 (6) ◽  
pp. 695-699 ◽  
Author(s):  
Matthew J. Lambert
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Cancer Patient ◽  
Head And Neck ◽  
Neck Cancer ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Nutritional Deficiency ◽  
Neck Cancer Patient ◽  
Morbidity And Mortality

Malnutrition is a common problem in patients with head and neck cancer. Its presence may lead to an increase in morbidity and mortality following an operation, chemotherapy, and radiation therapy. A standard nutritional assessment will define the nature and degree of the nutritional deficiency while periodic reassessment will document the effects of nutritional support.

Long-term outcomes in patients with encapsulating peritoneal sclerosis managed with nutritional support

2020 ◽  
Vol 40 (5) ◽  
pp. 487-495
Author(s):  
Arunraj Navaratnarajah ◽  
Nevine El-Sherbini ◽  
Edwina A Brown
Keyword(s):  
Quality Of Life ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Radiological Score ◽  
Serial Ct ◽  
End Stage

Background: Little is known about long-term survivors with encapsulating peritoneal sclerosis (EPS). Published literature focuses on patients managed surgically. We describe our experience of the long-term outcomes in patients with EPS conservatively managed with nutritional support alone. Methods: This is a single-centre retrospective observational study of patients who had survived for ≥5 years since diagnosis. EPS survivors were invited for review of symptoms, nutritional assessment and evaluation of quality of life. Radiological progression was assessed based on serial computed tomography (CT) scores for each patient. Results: A total of 23 patients with a diagnosis of EPS for at least 5 years were identified, with 18 patients alive at the time of the study. Of these 18 patients, 10 patients transferred to haemodialysis (HD) and 8 patients received kidney transplants. Commonest symptoms were nausea (91%) and vomiting (73%). Mean body mass index for patients was within the ideal and healthy range, with only 11% suffering from continued weight loss. In all, 70% EPS survivors on HD received nutritional support compared to 15% of those with transplants; 17% required ongoing parenteral nutrition. Of the 11 patients with serial CT scans at least 4 years apart, 10 had an increase in radiological score for EPS but with no apparent correlation to clinical outcomes. There were no significant differences in the reported quality of life between EPS survivors on HD and those transplanted, with self-rated health status equivalent to that reported for the general end-stage kidney disease (ESKD) population. Conclusion: Long-term survival following EPS managed conservatively with nutritional support is feasible, with the majority no longer requiring nutritional support and having a quality of life similar to other patients with ESKD.

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