Home Enteral Nutrition in Adults: Effectiveness of Nutritional Therapy and Educational Programme

Abstract PurposeHome Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational programme of HEN patients was evaluated.MethodsA prospective, observational, real-life, multicentre study of patients receiving HEN by nasogastric tube or ostomy in 21 hospitals was conducted. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational programme. All data were analysed using SPSS.24.Results414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 patients (25.3%) were diabetic. The mean weight was 59.3±10.4kg and BMI 22.6±3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p<0.05). Tolerance problems, diarrhoea and abdominal distension fell between the 3- and 6-month visits (p <0.05). Patients who received intermittent Enteral Nutrition (EN) had fewer tolerance-related effects (OR: 0.042; 95% CI: 0.006-0.279) and less diarrhoea (OR: 0.042; 95% CI: 0.006-0.279), while those who received EN via nasogastric tube had fewer tolerance-related effects (OR: 0.042; 95% CI: 0.006-0.279). At the baseline and 6-month visits, compliance with the educational measures proposed by the prescriber was ≥ 99%. ConclusionThe nutritional assessment to prescribe individualised HEN to each patient, together with educational measures and training in the proper use of this treatment for both patients and trainers, improves nutritional status and reduces the onset of adverse reactions.

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Nasointestinal tube in mechanical ventilation patients is more advantageous

Open Medicine ◽

10.1515/med-2019-0045 ◽

2019 ◽

Vol 14 (1) ◽

pp. 426-430

Author(s):

Wu Ge ◽

Wu Wei ◽

Pan Shuang ◽

Zheng Yan-Xia ◽

Lv Ling

Keyword(s):

Mechanical Ventilation ◽

Enteral Nutrition ◽

Nutritional Status ◽

Nasogastric Tube ◽

Intestinal Tract ◽

Abdominal Distension ◽

Ventilator Associated Pneumonia ◽

Duration Of Stay ◽

Nutritional Mode ◽

Nasointestinal Tube

AbstractObjectiveTo assess the effects of two different nutritional mode on the occurrence of ventilator-associated pneumonia (VAP) in patients on mechanical ventilation.Methods70 patients admitted to the ICU and under mechanical ventilation, were randomly divided into the nasointestinal tube group and nasogastric tube group. Patients from both groups received enteral nutrition, using the same nutritional agent, through intubation. The duration of stay in the ICU, duration of mechanical ventilation, incidence of VAP, nutritional state, and survival of the intestinal tract were compared between the two groups.ResultsThe duration of stay in the ICU, duration of mechanical ventilation and incidence of VAP in the nasointestinal tube group was lower than that in the nasogastric tube group (P<0.05). There was an increase in the levels of prealbumin and transferrin in the nasointestinal tube group (P<0.05). However, there were no obvious difference in the nasogastric tube group (P<0.05). The incidence of abdominal distension, diarrhea, regurgitation, aspiration, and hyperglycemia in the nasointestinal tube group was much lower than that in the nasogastric tube group (P < 0.05).ConclusionThis study showed that enteral nutrition delivery using a nasointestinal way can effectively reduce the incidence of VAP and improve the nutritional status of patients under mechanical ventilation.

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Enteral nutritional support in patients undergoing chemoradiotherapy for esophageal carcinoma

Future Oncology ◽

10.2217/fon-2020-0181 ◽

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.

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Serum BCHE as an indicator of nutritional status in patients on home enteral nutrition

Nutritional Therapy & Metabolism ◽

10.5301/ntm.2013.11463 ◽

2013 ◽

Vol 31 (3) ◽

pp. 130-133

Author(s):

Italia Odierna ◽

Alfonso Natale ◽

Franco Contaldo ◽

Lidia Santarpia

Keyword(s):

Enteral Nutrition ◽

Nutritional Status ◽

Home Enteral Nutrition

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Nutritional risk factors in hospitalized nonagenarian patients

Abr-Jun - Braspen Journal ◽

10.37111/braspenj.2020352009 ◽

2020 ◽

Vol 2 (35) ◽

pp. 160-165

Author(s):

Ludiane Alves do Nascimento ◽

Grasiela K. P. Andrade ◽

Juliana Bonfleur Carvalho ◽

Ana Lucia Chalhoub Chediac Rodrigues ◽

Ariane Nadólskis Severine

Keyword(s):

Nutritional Status ◽

Clinical Outcomes ◽

Positive Relationship ◽

Nutritional Assessment ◽

Disease Process ◽

Mini Nutritional Assessment ◽

Nutritional Therapy ◽

Nutritional Risk ◽

Cross Sectional ◽

Nutrition Assistance

Introduction: In 2050, we estimate that the population of individuals who are 90 years of age or older will be five times higher than that in 2010. Among elderly people, the disease process can contribute to a worsening nutritional status. This article aims to examine the associations among nutritional status and initial diagnoses, muscle mass, routes of feeding, and clinical outcomes. Despite the progressive increase in this population and their particularities, few studies have been conducted among nonagenarians. Methods: This was a cross-sectional study that included patients over 90 years old admitted to Hospital Sírio Libanês. The following parameters were assessed: calf circumference (CC), body mass index (BMI), routes of feeding and medical diagnosis. Nutritional screening was performed using the Mini Nutritional Assessment (MNA). Results: A total of 79 patients were assessed, and they had a median age of 92 years, a median BMI of 22.6 kg/m2 and median hospital stay of 13 days. A total of 59.5% of the patients (n=47) were female. The frequency of malnutrition (as assessed by the BMI) was 54.4%. There was a positive relationship (71.4%) between CC <31 cm and underweight (as assessed by the BMI) (p=0.032). Malnutrition (classified using the MNA) was significantly associated with dysphagia (77.4%) (p=0,003), the use of supplements (p=0.002) and enteral nutrition therapy (p=0.005). Mortality (25.8%) was also significantly related to malnutrition, showing that nutritional status contributed to poor clinical outcomes in patients (p=0.042). Conclusion: Dysphagia had a positive relationship with malnutrition because it is a condition that affects food intake. The use of supplements and a higher indication for enteral nutritional therapy both had a positive relationship with malnutrition because they are conducts indicated to improve nutritional status, showing that specific nutrition assistance strategies for this age group can contribute to improved nutritional status in nonagenarians.

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The use of Lactobacillus plantarum 299v (DSM 9843) in patients with cancers receiving home enteral nutrition – study protocol for a randomized, double-blind, and placebo-controlled trial

10.21203/rs.2.23667/v1 ◽

2020 ◽

Author(s):

Kaźmierczak-Siedlecka Karolina ◽

Marcin Folwarski ◽

Karolina Skonieczna-Żydecka ◽

Jakub Ruszkowski ◽

Wojciech Makarewicz

Keyword(s):

Quality Of Life ◽

Enteral Nutrition ◽

Nutritional Status ◽

Cancer Patients ◽

Lactobacillus Plantarum ◽

Probiotic Strain ◽

Double Blind ◽

Home Enteral Nutrition ◽

Enteral Formula

Abstract Background Nutritional treatment is one of the most important components of multidisciplinary anti-cancer therapy. Home enteral nutrition is considered a safe procedure, however, may be associated with the risk of side effects, such as nausea, vomiting, abdominal pain, and diarrhoea. It is uncertain whether diarrhoea is the result of the enteral formula or gut dysbiosis. One of the methods which may be used to alter the composition of gut microbiota is the administration of a probiotic strain. Lactobacillus plantarum 299v may be used as a supportive therapy in patients suffering from irritable bowel syndrome and Clostridium difficile infection. Therefore, the primary aim of this study is to determine the effect of Lactobacillus plantarum 299v on nutritional status of cancer patients receiving home enteral nutrition. The secondary aims are to evaluate the role of this probiotic strain in the improvement of tolerance of enteral formula and patients’ quality of life. Methods Forty patients with cancer receiving home enteral nutrition will be enrolled in this clinical trial and randomized to receive one capsule of Lactobacillus plantarum 299v (Sanprobi IBS®) twice a day or placebo for 12 weeks in a double-blind manner. Laboratory tests (the level of albumin, total protein, transferrin, and total lymphocyte count), anthropometric parameters (body mass, the content of fat mass, muscle mass, and total body water), Nutritional Risk Screening (NRS 2002), tolerance of enteral nutrition as well as quality of life will be measured. Measurements will be obtained at the baseline and after 4 and 12 weeks of treatment. Discussion It is expected that the Lactobacillus plantarum 299v will provide beneficial effects, such as maintenance or improvement of nutritional status, enteral formula tolerance, and quality of life of cancer patients receiving home enteral nutrition. Trial registration ClinicalTrials.gov Identifier: NCT03940768

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Há diferenças nas práticas de terapia nutricional entre pacientes pediátricos graves clínicos e cirúrgicos?

Abr-Jun - Braspen Journal ◽

10.37111/braspenj.2019344010 ◽

2020 ◽

Vol 34 (4) ◽

pp. 367-373

Author(s):

Daniela B. Hauschild ◽

Julia C. Ventura ◽

Luna D. A. Oliveira ◽

Taís T. Silveira ◽

Eliana Barbosa ◽

...

Keyword(s):

Nutritional Status ◽

Critically Ill ◽

Pediatric Intensive Care ◽

Abdominal Distension ◽

Nutritional Therapy ◽

Surgical Patients ◽

Critically Ill Children ◽

Medical Patients ◽

Chi Square ◽

Pediatric Index Of Mortality

Introduction: Pediatric critically ill patients admitted for surgical reasons may differ from medical patients. However, guidelines for nutritional therapy (NT) include both medical and surgical patients. The aim of this study was to describe the NT practices of critically ill children admitted for medical and surgical reasons. Methods: Prospective cohort study conducted with critically ill children, between 1 month and 15 years old, admitted in a pediatric intensive care unit. Patients who were discharged within the first 48 hours, died within the first 72 hours or who received oral NT were excluded. Clinical and demographic were collected. Nutritional status was assessed at admission and NT data from the first 7 days was collected. Chi-square and Mann-Whitney tests were applied and p<0.05 was considered significant. Results: A total of 201 patients were included, with a median age of 2.2 years, 154 (76.6%) were admitted for medical reasons and 47 (23.4%) for surgical reasons. Compared to medical patients, surgical patients had a higher median age (5.0 vs. 1.4 years; p = 0.035), lower Pediatric Index of Mortality 2 (1.1 vs. 6.1%; p<0.001) and higher prevalence of complex chronic diseases (17 vs. 47%; p<0.001). There was no difference regarding nutritional status. Surgical patients showed higher median time for NT initiation (22.3 vs. 16.3 h; p=0.016), higher prevalence of parenteral nutrition (31.6 vs. 15.1%; p=0.019), lower energy (24.5 vs. 35.9 kcal/kg/d; p=0.003) and protein (0.82 vs. 0.99 g/kg/d; p=0.026) intake and higher prevalence of underfeeding (82.6 vs. 50%; p<0.001). There was a higher prevalence of abdominal distension (36.2 vs. 21.4%; p=0.04) and constipation (38.3 vs. 16.9%; p=0.002) in surgical patients. Conclusion: Surgical patients were older, less severe, had longer time for NT initiation, higher prevalence of underfeeding and abdominal distension in the first 7 days. NT protocols should be individualized according to the reason for hospitalization.

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Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status, enteral nutrition tolerance, and quality of life in cancer patients receiving home enteral nutrition – a double-blind, randomized, and placebo-controlled trial

10.21203/rs.3.rs-22190/v1 ◽

2020 ◽

Author(s):

Kaźmierczak-Siedlecka Karolina ◽

Marcin Folwarski ◽

Jakub Ruszkowski ◽

Karolina Skonieczna-Żydecka ◽

Waldemar Szafrański ◽

...

Keyword(s):

Quality Of Life ◽

Enteral Nutrition ◽

Nutritional Status ◽

Cancer Patients ◽

Lactobacillus Plantarum ◽

Gastrointestinal Symptoms ◽

Controlled Study ◽

Double Blind ◽

Home Enteral Nutrition

Abstract BackgroundSeveral human trials have confirmed that Lactobacillus plantarum 299v (Lp299v) relief the gastrointestinal symptoms observed in patients with irritable bowel syndrome, such as nausea, vomiting, and diarrhoea. These symptoms are similar to those associated with home enteral nutrition and they affect nutritional status as well as patients’ quality of life.MethodsThe current double-blind, randomized, and placebo-controlled study included 35 cancer patients receiving home enteral nutrition. There were 2 groups of participants consuming either 2 × 1010 CFU of Lp299v (n = 21) or placebo (n = 14) for 4 weeks. The aims of this study were to determine the effect of Lp299v on nutritional status, enteral formula tolerance, and quality of life in cancer patients.ResultsAn increase in serum albumin concentration was significantly higher in the Lp299v group than in the placebo group at the endpoint (p = 0.032). Moreover, the changes in the frequency of vomiting and flatulence were significantly reduced at week 4 compared to baseline in the Lp299v group (p = 0.0117). The improvement of quality of life was observed in both groups; however, with no statistically significant differences between the analysed groups (p > 0.05).ConclusionsWe have demonstrated that administration of Lp299v in cancer patients receiving home enteral nutrition may improve laboratory parameters, predominantly the concentration of albumin, however, overall it does not have an impact on nutritional status. Lp299v may reduce the gastrointestinal symptoms related to enteral nutrition; notwithstanding, the improvement of quality of life may be the result of enteral nutrition rather than the effect of administration of Lp299v.Trial registration ClinicalTrials.gov (identifier: NCT03940768)

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Objective Assessment of Superiority of Enteral Feeding by Traditional Home Kitchen-Based Feed V/S Commercial Formula Feed in Patients of Esophagogastric Corrosive Injury

Annals of International medical and Dental Research ◽

10.53339/aimdr.2022.8.1.14 ◽

2022 ◽

Vol 8 (1) ◽

pp. 98-105

Author(s):

Maulik S. Bhadania ◽

Hasmukh B. Vora ◽

Nikhil Jillawar ◽

Premal R. Desai

Keyword(s):

Enteral Nutrition ◽

Nutritional Status ◽

Nutritional Assessment ◽

Risk Index ◽

Objective Assessment ◽

Cost Effective ◽

Nutritional Risk ◽

Home Based ◽

Nutritional Risk Index ◽

Commercial Feeds

Background: Corrosive ingestion can cause severe chemical injury to upper gastrointestinal tract which leads to dysphagia, malnutrition and weight loss. Early nutritional assessment and support through feeding jejunostomy is important and it should be nutritionally optimum and economically balanced. The aim is to compare cost and nutritional status after nutritional support with traditional home kitchen made and commercial formula feed through feeding jejunostomy.Methods:A prospective study included patients on enteral nutrition based on traditional home kitchen feed (cohort-1) and on commercial formula feed (cohort-2). Patient’s body weight, BMI, haemoglobin, serum albumin, nutritional risk index, controlling nutritional status score were checked at the admission, 3rd and 6th month follow up.Results: In cohort 1 mean albumin and haemoglobin raised by 33.13% & 14.60% at 3rd month and 47.23% & 22.3% at 6th month respectively; In cohort 2 it was 9.12% & 2.69% at 3rd month and 17.62% & 6.53% at 6th month respectively. At 6th month in cohort 1 and 2 mean weight gain was 7.56% & 4.0%; mean increase in NRI was 34.78% & 11.5% respectively. Mean CONUT score at six months was better improved in cohort 1 which is 6 to 1 as compared to cohort 2 which was 6 to 3. Mean monthly cost of home-based feeds was significantly lower as compared to commercial feeds (62.14 Rs v/s 682-2354 Rs/day).Conclusions:In corrosive GI tract injury patient enteral nutrition with traditional home kitchen-based feeds is safe, cost effective and associated with better improvement in nutritional status objective parameters.

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