Fistuloclysis as a method of nutritional management in a patient with high output enteroatmospheric fistula – a case report

2019 ◽  
Vol 98 (7) ◽  
pp. 287-290 ◽  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Nutritional Support ◽  
Surrounding Tissue ◽  
Nutritional Management ◽  
Enteric Fistula ◽  
Enteroatmospheric Fistula ◽  
High Output

Enteric fistula is a pathological communication between the small intestine and surrounding tissue. In case of communication with body surface it is called an enterocutaneous or enteroatmospheric fistula. There are many causes of enterocutaneous/enteroatmospheric fistula occurrence. A common result is malnutrition and organ dysfunction which leads to increased morbidity and mortality of the patients. Adequate nutritional support is a very important element in the management of patients with enterocutaneous/enteroatmospheric fistulas. One of the options of nutritional support is fistuloclysis which means administration of enteral nutrition formula to the distal fistula. We present the case of 76-year-old patient with a high-localized and high output enteroatmospheric fistula in whom we were able to reach adequate nutritional status using fistuloclysis, followed by closure of the fistula

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.

scholarly journals Efficacy and Efficiency of Nutritional Support Teams

2019 ◽  
Vol 8 (9) ◽  
pp. 1281 ◽  
Author(s):  
Reber ◽  
Strahm ◽  
Bally ◽  
Schuetz ◽  
Stanga
Keyword(s):  
Nutritional Status ◽  
Hospital Stay ◽  
Nutritional Support ◽  
Care Plan ◽  
Current Evidence ◽  
Nutritional Management ◽  
Complication Rates ◽  
Nutritional Care ◽  
Support Teams

Malnutrition is frequent in patients during a hospital admission and may further worsen during the hospital stay without appropriate nutritional support. Malnutrition causes greater complication rates, morbidity, and mortality rates, which increases the length of hospital stay and prolongs rehabilitation. Early recognition of individual nutritional risk and timely initiation of a tailored nutritional therapy are crucial. Recent evidence from large-scale trials suggests that efficient nutritional management not only improves the nutritional status, but also prevents negative clinical outcomes and increases patients’ quality of life. Multifaceted clinical knowledge is required to ensure optimal nutritional support, according to a patient’s individual situation and to avoid potential complications. Furthermore, clear definition of responsibilities and structuring of patient, and work processes are indispensable. Interdisciplinary and multiprofessional nutritional support teams have been built up to ensure and improve the quality and safety of nutritional treatments. These teams continuously check and optimize the quality of procedures in the core areas of nutritional management by implementing nutritional screening processes using a validated tool, nutritional status assessment, an adequate nutritional care plan development, prompt and targeted nutritional treatment delivery, and provision of accurate monitoring to oversee all aspects of care, from catering to artificial nutrition. The foundation of any nutritional care plan is the identification of patients at risk. The aim of this narrative review is to provide an overview about composition, tasks, and challenges of nutritional support teams, and to discuss the current evidence regarding their efficiency and efficacy in terms of clinical outcome and cost effectiveness.

scholarly journals Nutritional management of a kitten with thermal burns and septicaemia

2020 ◽  
Vol 6 (1) ◽  
pp. 205511692093048
Author(s):  
Rachael Birkbeck ◽  
Rebekah Donaldson ◽  
Daniel L Chan
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Body Weight ◽  
Enteral Nutrition ◽  
Nutritional Support ◽  
Burn Injury ◽  
Caloric Intake ◽  
Nutritional Management ◽  
Primary Care Clinician ◽  
Thermal Burns

Case summary A 3-month-old entire female British Shorthair cat presented for further management of thermal burns after falling into a bath of scalding water. On presentation to the primary care clinician the kitten was obtunded, markedly painful and relatively bradycardic, consistent with a state of shock. The haircoat was wet, with erythematous skin and sloughing from the digital pads and anal mucosa. The primary care clinician administered opioid analgesia, sedation, antibiotics and started intravenous (IV) fluid therapy prior to referral. On arrival to the referral hospital the kitten was obtunded with respiratory and cardiovascular stability but was overtly painful and resistant to handling. The kitten required intensive management with IV and regional analgesia, IV broad-spectrum antibiosis, IV fluid therapy, enteral nutrition and wound management, including surgical debridement and topical antibiotic therapy. Septicaemia developed during the hospitalisation. Multidrug-resistant Escherichia coli and Pseudomonas aeruginosa were cultured, and antibiosis was escalated to IV imipenem. Acute respiratory distress syndrome was suspected following the development of dyspnoea. Early enteral nutrition within 24 h of admission was initiated using an oesophageal feeding tube and a veterinary therapeutic liquid diet. Over the ensuing 72 h the kitten started voluntary intake of food alongside oesophageal tube feeds. The kitten experienced continued weight loss despite the provision of nutritional support to meet, and then later exceed, the estimated resting energy requirements. Caloric intake was gradually increased to a total of 438% of the calculated resting energy requirement using the most recent daily body weight, eventually resulting in stabilisation of weight loss and weight gain. Relevance and novel information There is limited published information on the nutritional management of veterinary patients with thermal burn injury. Hypermetabolic states related to burn injuries are induced and maintained by complex interactions of catecholamines, stress hormones and inflammatory cytokines on proteolysis, lipolysis and glycogenolysis. Secondary infections are common following burn injury and the subsequent proinflammatory state perpetuates hypermetabolism and catabolism. These states present a challenge in both predicting and providing adequate nutrition, particularly in a paediatric septic patient. This subset of patients should be monitored closely during hospitalisation to ensure body weight and condition are maintained (while taking into consideration hydration status), and caloric intake is adjusted accordingly to meet nutritional support goals. Extensive research exists regarding the nutritional requirements and metabolic derangements of people with thermal burns. However, the importance of maintaining body weight and body condition in veterinary burn patients, and the association between nutritional support and reduced morbidity and mortality, has not been investigated and remains to be elucidated.

scholarly journals Effect of Qihuang Decoction Combined with Enteral Nutrition on Postoperative Gastric Cancer of Nutrition and Immune Function

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Qing-sheng Yu ◽  
Zhou Zheng ◽  
Hui Peng ◽  
Yi Shen ◽  
Ju-da Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Immune Function ◽  
Nutritional Support ◽  
Urinary Infection ◽  
Control Group ◽  
Study Group ◽  
Cellular And Humoral Immunity ◽  
The Impact

Objective. Early nutritional support in patients with gastric cancer can improve their nutritional status, but the impact on immune function has not been confirmed. This study aimed to analyze the effects of Qihuang decoction combined with enteral nutrition on nutrition and the immune function of postoperative gastric cancer. Methods. 120 patients with postoperative gastric cancer in the study group and 117 in the control group were selected as the study subjects from our hospital at random. Indications of nutrition and immune and the rates of complications were compared the day before surgery and 1, 3, 7, and 14 days after surgery. Results. Indications of nutrition except hemoglobin (HB) in the study group were significantly higher than those before operation and the albumin (ALB) and prealbumin (TP) were significantly increased 7 and 14 days after surgery (P<0.001 and P<0.001 versus P<0.001 and P<0.001) and the protein (PA) 3, 7, and 14 days after surgery (P=0.011, P=0.002, and P=0.022) in the study group compared to those in the control group. Cellular and humoral immunity indications in the study group are significantly higher than those before operation compared to those in the control group, and the CD3+, CD4+, and CD4+/CD8+ were significantly increased 7 and 14 days after surgery (P=0.027 and P<0.001 versus P=0.008 and P<0.001 versus P=0.010 and P<0.001) and IgA, IgG, and IgM 3, 7, and 14 days after surgery in the study group (P<0.001, P<0.001, and P<0.001 versus P<0.001, P<0.002, and P<0.001 versus P<0.001, P<0.001, and P<0.001). The complications such as abdominal, lung, wound, and urinary infection were also significantly decreased (Pχ2=0.017; Pχ2=0.036; Pχ2=0.041; Pχ2=0.004). Conclusions. Qihuang decoction combined with enteral nutrition can promote the absorption of enteral nutrition with improving the immune and reducing complications of infection.

Enteral Nutrition in Crohn's Disease With a High Output Enteroatmospheric Fistula

2016 ◽  
Vol 94 (9) ◽  
pp. 547-550
Author(s):  
Luis Sánchez-Guillén ◽  
Ramón López de los Reyes ◽  
Eulalia Vives-Rodríguez ◽  
Almudena Mato Iglesias ◽  
Ana Cantón-Blanco
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Enteroatmospheric Fistula ◽  
High Output

scholarly journals Fistuloclysis Improves Liver Function and Nutritional Status in Patients with High-Output Upper Enteric Fistula

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Yin Wu ◽  
Jianan Ren ◽  
Gefei Wang ◽  
Bo Zhou ◽  
Chao Ding ◽  
...  
Keyword(s):  
Liver Function ◽  
Nutritional Status ◽  
Total Bilirubin ◽  
Group Versus ◽  
Biliary Fistula ◽  
Control Group ◽  
Enteric Fistula ◽  
Laboratory Variables ◽  
Total Enteral Nutrition ◽  
High Output

Background.We aimed to determine the efficacy of fistuloclysis in patients with high-output upper enteric fistula (EF).Methods.Patients were assigned into the fistuloclysis group (n=35, receiving fistuloclysis plus total enteral nutrition (TEN)) and the control group (n=60, receiving TEN). Laboratory variables were measured during the four-week treatment.Results.At baseline, variables were similar between the two groups. Delta value was defined as the changes from baseline to day 28. Compared with the control group, the fistuloclysis group showed greater improvements in liver function (Delta total bilirubin (TB):20.3±9.7in the fistuloclysis group versus15.6±6.3in the control group,P=0.040; Delta direct bilirubin (DB):12.5±3.4versus10.0±3.6,P=0.011; Delta alkaline phosphatase (ALP):98.4±33.5versus57.6±20.9,P<0.001); nutritional status (Delta total protein:21.8±8.7versus10.7±2.1,P<0.001; Delta albumin:11.3±2.5versus4.2±1.3,P<0.001). In the fistuloclysis subgroups, biliary fistula patients had the maximum number of variables with the greatest improvements.Conclusions.Fistuloclysis improved hepatic and nutritional parameters in patients with high-output upper EF, particularly in biliary fistula patients.

Nutrition Support on Retroperitoneal Ganglioneuroblastoma - A Case Report

2018 ◽  
Vol 55 (1) ◽  
pp. 116
Author(s):  
B. Manimegalai
Keyword(s):  
Case Report ◽  
Nutritional Status ◽  
Nutritional Support ◽  
Nutrition Support

Patients undergoing surgery face many metabolic and physiological challenges that may compromise nutritional status. Importance of Nutritional Support (NS) in improving the nutritional status of a patient is narrated in this case report.

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