1 / 9

Nutrition

Nutrition. Nov 2013. Outline. Nutritional status & requirements Enteral vs parenteral Complications Managing problems Constipation & diarrhoea . Nutritional status & requirements. Many patients malnourished on presentation This includes obese patients

trapper
Download Presentation

Nutrition

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Nutrition Nov 2013

  2. Outline • Nutritional status & requirements • Enteral vs parenteral • Complications • Managing problems • Constipation & diarrhoea

  3. Nutritional status & requirements • Many patients malnourished on presentation • This includes obese patients • If not malnourished can we wait? Short predicted stay? • Aim for 20-25 kcal/kg/day • Catabolism  high protein diet up to 2g/kg/day

  4. Enteral vs parenteral • Not a conclusively settled argument • Probably early enteral with a switch to parenteral if fails and not a clear short stay patient • CALORIES trial • EN is simpler with benefit of gastrointestinal protection and fewer complications • but if it isn’t working properly you are starving the patient • Mortality increases if too large a calorie debt accumulates

  5. Complications Enteral Parenteral NG misplacement Underfeeding Aspiration Loose stools Line related complications Ongoing central access needed Increased infection Abnormal LFT’s Hyperglycaemia

  6. Managing problems • NG vs NJ • Prokinetics • The NG “never event” • Ileus

  7. Constipation • Easy to forget • Senna/lactulose • Glycerine suppositories/phosphate enema • Neostigmine

  8. Diarrhoea • Isolate and send samples • Hand hygiene • Non-infective diarrhoea is common, esp with NG feed • Loperamide • High stoma output • Bowel management systems

  9. Summary • Nutritional needs • NG vs TPN • Troubleshooting • Constipation & diarrhoea

More Related