[Participation of the clinical laboratory in the nutrition support team]

Recently, organization of the nutrition support team (NST) is progressing steadily in many hospitals in Japan. In our Yamagata University Hospital, NST services were started in March, 2004. As is well known, NST is a multidisciplinary team comprised of physicians, nurses, dietitians, pharmacists, social workers and medical technologists. Here, we report the participation of medical technologists and physicians belonging to our Clinical laboratory in NST activities. From our laboratory, two medical technologists and two physicians participate in the NST and provide the following services. Firstly, nutritional assessment of proteins in serum i.e. albumin, retinol binding protein (RBP) and transthyretin (TTR) is carried out, measured as part of routine work, and, especially, the data of RBP and TTR are applied to the assessment of nutrition status around the digestive surgical operations. They are also useful to assess the effect of dietary meal, immunonutrition "Impact", which improves the malnutrition status of the pre operative patient. Secondly, a weekly "malnutrition report", including numbers of patients with malnutrition in every ward, serial graphs, and detailed comments on their movements, is reported by e-mail to NST associated departments. This report is conveniently indicates the nutritional situation of inpatients in the hospital and aids consideration of countermeasures for malnutrition in the NST meeting. Thirdly, we medical technologists also participate in making rounds, where we state our opinions on a patient's data, and, if necessary, propose to the chief physician to request additional laboratory tests. We believe that these current activities of our laboratory as part of the NST will contribute to the development of our University NST, raising the quality of nutrition support services, and resulting in improvements of malnutrition and the quality of life of patients.