关于为多病症医疗住院患者提供营养支持的ESPEN指南
Carla Wunderle1, Filomena Gomes2, Philipp Schuetz1
1Cantonal Hospital Aarau and University of Basel, Switzerland.
Clinical nutrition (Edinburgh, Scotland)
|July 21, 2023
概括
与疾病相关的营养不良在多病性住院患者中很常见,增加了并发症和死亡率. 这份更新的指南提供了基于证据的营养支持建议,以改善这些脆弱患者的治疗结果.
科学领域:
- 临床营养学 临床营养学
- 内部医学 内部医学
- 老年病的医生 老年病的医生
背景情况:
- 多病症医疗住院患者经常患有与疾病相关的营养不良.
- 这种情况显著提高了发病率,死亡率和医疗保健成本.
- 现有的指导方针可能无法充分解决多种并发症患者营养不良的复杂性.
研究的目的:
- 制定基于证据的建议,以支持住院多病症患者的营养支持.
- 为了解决将疾病特异性营养指南应用于复杂患者群体的不确定性.
主要方法:
- 在三个数据库 (Medline,Embase,Cochrane Library) 和二次来源中进行系统的文献搜索.
- 对获取的摘要进行选,以确定制定指南的相关研究.
- 使用SIGN分级开发的建议通过强大的共识通过Delphi投票进行验证.
主要成果:
- 从3527份获取的摘要中分析了60项新的相关研究.
- 制定一份指导方针草案,其中包含32条建议,涵盖营养支持的各个方面.
- 在线投票期间,在所有建议方面达成了高度共识 (>90%).
结论:
- 营养支持显然可以减少多病症患者的发病率和并发症.
- 常规查营养不良风险和个性化干预对住院患者至关重要.
- 这份更新的指南提供了一种基于证据的方法,以改善多病性医疗住院患者的治疗结果.
相关概念视频
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
200
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
200
Chronic Kidney Disease III: Interprofessional Care
43
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
43
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
215
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
215
Heart Failure VI: Adjunct Therapies
16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
Peritoneal Dialysis III: Nursing Management
47
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
47
Nephrotic Syndrome III : Nursing Management
20
Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
20


