Dissertations / Theses: 'Enteral nutrition'

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Forslund, Linda, and Fanny Hillius. "Enteral nutrition : En litteraturstudie om patienters upplevelser av att leva med enteral nutrition." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-39702.

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Josefsson, Christina, and Siverman Angelica Kanth. "Behandling med enteral nutrition : patientens upplevelser." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20456.

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Behandling med enteral nutrition erbjuds de patienter som har tugg- och sväljsvårigheter främst av neurologiska orsaker. Behandling kan därför ske med nasogastrisk eller gastrostomisk sond. Gastrostomisk sond väljs då behandlingen planeras vara ett långvarigt alternativ. Forskning visar att enteral nutrition medför ökat oberoende och lättnad över att inte behöva vara orolig över sitt näringsintag. Sociala tillfällen som inkluderar mat och dryck upplevs dock som svåra. Det saknas tillräcklig uppföljning av hur behandlingen fungerar för dessa patienter i det dagliga livet, vilket kan medföra att patientens nutritionsbehov inte ses över.Syftet är att beskriva patienters upplevelser av behandling med enteral. Åtta personer med enteral nutrition har intervjuats och analyserats utifrån kvalitativ innehållsanalys. Resultatet av denna studie visar att upplevelsen av att inte kunna äta normalt skiljer sig åt beroende på patienternas utgångsläge, att förskrivningen av material har förbättrats sedan SÄRNÄR- teamet tagit över, men distributionen är däremot bristfällig. Vidare visar studien att information oftast är tillräcklig på specialistenheten, men sämre om patienten vårdas på annan enhet än den som är specialiserade på enteral nutrition. Att vänja sig vid nackdelar och se fördelar med enteral nutrition framkommer som betydelsefullt för dessa patienter och är avgörande för att gå vidare i livet. Patienterna upplever att omgivningen inte förstår deras situation. På grund av att inte kunna äta normalt saknar dessa patienter den sociala samvaron i samband med matsituationen och upplever ett utanförskap. Genom att patienters egna berättelser och livshistoria förs fram, kan det bidra till att utveckla och förbättra vården av enteral nutrition. Vår förhoppning är att resultatet från denna studie ska komma till nytta för SÄRNÄR – teamet i deras arbete med att följa upp patienter med enteral nutrition.
Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska

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Hotson, Brenda L. "Quality of life with home enteral nutrition." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0006/MQ32135.pdf.

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Craig, J. S. "Studies of enteral nutrition in preterm infants." Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391112.

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Conocimiento, Dirección de Gestión del. "Journal of Parenteral & Enteral Nutrition (JPEN)." Wiley, 2004. http://hdl.handle.net/10757/655341.

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Jörud, Susanne, and Anna Wahlin. "Enteral nutrition vid palliativ vård. En systematisk litteraturstudie." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26609.

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Syftet med denna litteraturstudie är att undersöka vad omvårdnad innebär utifrån ett sjuksköterskeperspektiv och etiska faktorer gällande enteral näringstillförsel vid palliativ vård. Forskningsansatsen har varit en systematisk litteraturstudie baserad på Goodmans sju steg i forskningsprocessen. Studiens resultat baseras på 10 vetenskapliga artiklar. Utifrån dessa artiklars resultat utkristalliserades olika teman såsom riktlinjer, dokumentation, åtgärder, komplikationer och effekter inom området omvårdnad kring enteral näringstillförsel. Resultatet påvisar att enteral nutrition ingår i sjuksköterskans ansvarsområde. Det finns skrivna riktlinjer gällande enteral nutrition. Dock visades sig att det finns luckor mellan vad som är rekommenderad vård och vad som sker ute i klinisk verksamhet. Den mest förekommande komplikationen med nasogastrisk sond är aspiration av maginnehåll till lungorna.
The aim of this systematic review is to study what nursing care can imply from a nursing perspective and ethical issues regarding enteral nutrition in palliative care. The research approach has been a systematic literature review based on Goodmans seven principles. The result of the study is based on 10 scientific articles. From the results of the articles different themes, emerged such as guidelines, documentation, interventions, complications and effects within the area of enteral nutrition and nursing care. The results show that enteral nutrition is part of the nurse’s scope of practice and that written recommendations and guidelines exist. However, the review also shows that gaps between recommended nursing care and practice exist. The most frequent complication concerning enteral nutrition is lung aspiration.

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Waara, James H. "Enteral Nutrition versus Total Parenteral Nutrition for Acute Pancreatitis: A Cost-Effectiveness Analysis." The University of Arizona, 2005. http://hdl.handle.net/10150/624775.

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Class of 2005 Abstract
Objectives: To develop a decision analytic model to compare the clinical and economic outcomes of enteral nutrition (EN) and total parenteral nutritional (TPN) support in acute pancreatitis patients. Methods: All randomized clinical trials comparing EN and TPN in acute pancreatitis patients published in the medical and pharmacy literature were identified. Six trials were identified by searching MEDLINE, Web of Science, Cochrane Controlled Trials Register, International Pharmaceutical Abstracts, HealthStar, Cumulative Index to Nursing & Allied Health Literature, and citation review of applicable literature. The costs used for the decision tree were from the perspective of a hospital. A literature based decision tree was formed based from these costs and the probabilities of events from the six identified clinical trials. The TreeAge Pro computer program (TreeAge Software, Inc.; Williamstown, MA) was used to conduct the cost effectiveness analysis. Therapeutic success was considered, for the purposes of the trial, as having no complications. Results: EN was associated with a lower risk of infections, a reduced length of hospital stay, and fewer surgical interventions. There was no statistical difference in the risk of mortality, adult respiratory distress syndrome or multiple organ failure between groups treated with EN or TPN. The results found that EN dominated TPN by being both less costly and more effective. The average costs for EN and TPN were $46,345 and $73,878, respectively. The success rates were 0.652 and 0.358 for EN and TPN, respectively. Conclusion: Enteral nutrition was the dominant route of administration for nutritional support, when compared to total parenteral nutrition both clinically and economically for acute pancreatitis patients.

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Lööf, Malin, and Iren Hemlin. "Nutrition hos patienter med Subarachnoidalblödning." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-175747.

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ABSTRACT In an intermediate section at a large university hospital are patients with subarachnoid hemorrhage (SAH) cared for. There are international, national and local guidelines how nutrition therapy should be implemented and how much energy each patient should be given when hospitalized. The purpose of this study was to examine the documentation and actions on nutrition in patients with SAH and to see if guidelines on nutrition were followed. The study was a quantitative, retrospective record review that was analyzed statistically and descriptive. 26 patients were included. The patient’s nutritional treatment and energy intake were analyzed for 4 days. A large proportion of patients in the study did not reach the level of energy intake as recommended. Nutritional assessment was performed in 3 patients. Of the 26 examined patient’s 10 received nasogastric tube within 3 days. Significant differences between patients receiving nasogastric tube and not receiving nasogastric tube were found regarding the energy supply both days 4 and treatment days 1-4. As the majority of patients did not meet their energy needs, adherence to guidelines must increase while local guidelines should be described and documented more clearly. A good nutritional treatment for this population should be achieved by simple guidelines and tailored to each individual. Keywords Enteral Nutrition, Guidelines, Intracranial hemorrhage, Documentation.

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Ringholm, Malin, and Jäger Pia Luokkanen. "Får patienten sina kalorier? : Utvärdering av flödesschema för enteral nutrition på en neurokirurgisk intensivvårdsavdelning." Thesis, Karlstads universitet, Institutionen för hälsa och vård, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-6247.

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Kritiskt sjuka patienter riskerar att utveckla malnutrition och ska erhålla nutritionsstöd i form av enteral nutrition (EN) och parenteral nutrition (PN). Trots att flödesscheman för EN används på många intensivvårdsavdelningar får patienter sällan 100 % av ordinerat kaloribehov. Syftet med denna studie var att utvärdera införandet av flödesschema för enteral nutrition på en neurokirurgisk intensivvårdsavdelning (NIVA). Som metod valdes en retrospektiv, kvantitativ studie. En granskning av journaldata från förgruppen (n =28), fem månader innan införandet av flödesschemat och data ifrån eftergruppen (n =20), fem månader efter införandet av flödesschemat har gjorts. En journalgranskningsmall användes vid insamlandet av data. Det som granskades är starttid av EN, antalet kalorier administrerat via EN, PN och EN+PN. Vidare granskades mängd ventrikelaspirat, frekvens av avföring och observerade avbrott av EN. Införandet av flödesschema för EN visade att eftergruppen administrerades totalt mera kalorier än om inte flödesschema användes. Eftergruppen administrerades signifikant mera kalorier via EN+PN och via PN enskilt. Skillnaden mellan ordinerade kalorier och administrerade kalorier var mindre i eftergruppen. EN startades några timmar senare i eftergruppen och förgruppen administrerades mera kalorier via EN. Eftergruppen redovisar signifikant mindre mängd ventrikelaspirat, och kräkning bredvid sond var mindre frekvent i eftergruppen. Fortsatt forskning behövs med RCT-studier som evidensbaserar flödesschema för EN.

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Rund, Joy E. J. "Investigation of diarrhoea in critically ill patients receiving enteral nutrition." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/25541.

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The incidence and causes of diarrhoea among critically ill patients receiving enteral tube feeding were investigated. Sixty acutely ill surgical or medical intensive care patients who had had a minimum of 48 hrs bowel rest were entered into the study. They were randomly assigned to receive one of two lactose free liquid formula diets - "Ensure", a commercially available feed containing 825 kCal/L and 34 g/L of protein with an osmolality of 441mOsm/1 or "Casilan Oil", a home-made feed containing 840 kCal /L and 45g/L of protein with an osmolality of 383 mOsm/1. The feeds were administered by constant nasogastric infusion. Patients received 1000ml at a rate of 40ml per hour for the first day and up to 2000ml at 80 ml per hour for the remainder of the study period. Investigations included documentation of medical history, medications administered and clinical details for each patient. Serum albumin was measured and the nutritional status of each patient was assessed using anthropometric measurements. Feeds were tested for bacterial contamination on the three days following the start of feeding and small intestinal bacterial overgrowth was assessed by the 1 g-¹⁴C Xylose breath test of Toskes and King. Twelve of the sixty patients had to be withdrawn from the trial within 24 hours of the start of enteral feeding for medical reasons. The remaining forty eight patients completed at least three days on enteral feeding and thereby became eligible for analysis. In 10/48 patients (21%) diarrhoea was present before enteral feeding began. Four of these 1 O patients continued to pass loose stools when enteral feeding was started while the remaining 6 settled. Diarrhoea developed in a further 10 patients (21%) after enteral feeding began. The overall incidence of diarrhoea in the group of critically ill patients studied was therefore 42% (20/48). However, of the fourteen patients who experienced diarrhoea during enteral feeding four had diarrhoea before feeding began. Therefore, the true incidence of diarrhoea related to enteral feeding was only 10/38 (26%). Furthermore, in 7 of these 10 patients, another possible cause of diarrhoea was present. There was no significant association between diarrhoea and nutritional status, hypoalbuminaemia, sepsis, length of bowel rest, sucralfate and antibiotic therapy other than amikacin. Twenty one patients received Ensure and 27 received Casilan Oil. Despite the differences in the composition of the feeds, the incidence of diarrhoea was similar on the Ensure and the Casilan Oil. No particular factor pertaining to the composition of the feeds was associated with diarrhoea. Significant contamination of feeds was universal but there was no constant relationship between bacterial counts, or types, and the occurrence of diarrhoea. Certain other factors were found to be significantly associated with diarrhoea. Abdominal injury was positively associated with the occurrence of diarrhoea (p<0.05). Diarrhoea could have been attributed to the underlying disease state in 7 of the patients. All three patients who were receiving lactulose as treatment for liver failure developed diarrhoea. While no association was noted between diarrhoea and antibiotic therapy in general, treatment with the antibiotic, amikacin, correlated significantly, albeit marginally, with the occurrence of diarrhoea (p<0.05). Twenty six patients were tested for small intestinal bacterial overgrowth. Only one patient, with an elevated excretion of ¹⁴CO₂, indicative of small intestinal bacterial overgrowth, developed diarrhoea. There was, however, a positive association between diarrhoea and decreased excretion of ¹⁴CO₂. It would appear that the bacterial flora was suppressed in patients with diarrhoea. Amikacin therapy was also associated with decreased excretion of ¹⁴CO₂. This may suggest that amikacin could have altered the bowel flora with resultant development of diarrhoea. While abdominal injury and disease were associated with the development of diarrhoea and amikacin was a possible factor associated with diarrhoea, the results of the present study indicate that enteral tube feeding with either the commercial feed, Ensure or the home-made feed, Casilan Oil was not a cause of diarrhoea in the majority of critically ill patients assessed. Furthermore, in most patients who commenced the trial with diarrhoea, improvement was noted on enteral feeding.

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Westfall, Una Elizabeth. "Physiological responses to different enteral feeding schedules in rats /." Thesis, Connect to this title online; UW restricted, 1990. http://hdl.handle.net/1773/7265.

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Oskarsson, Amanda, and Johanna Frännfors. "Enteral och parenteral nutrition : En allmän litteraturöversikt ur ett patientperspektiv." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-39889.

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Isaksson, Lina, and Emmie Rask. "Patienters påverkan av enteral och parenteral nutrition : Ur ett patientperspektiv." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-41214.

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Isaksson, Susanne, and Ann-Christin Nilsson. "Enteral nutrition vid avancerad demens : Anhörigas och sjuksköterskors upplevelser av beslutsprocessen." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-30967.

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Patienter med demenssjukdom får allt eftersom sjukdomen progredierar allt svårare att äta. I demenssjukdomens senare skede kan patienten sluta äta helt. Dels på grund av sväljningssvårigheter, dels på grund av att patienten inte längre känner någon hunger eller törst. På grund av patientens avancerade demens kan komplexa beslutssituationer kring enteral nutrition uppstå där anhöriga och sjuksköterskor deltar. Syftet med studien var att beskriva anhörigas och sjuksköterskors upplevelser av beslutsprocessen kring enteral nutrition till patienter med avancerad demens. En litteraturstudie gjordes och resultatet baseras på tio vetenskapliga artiklar. Analyserna utmynnade i följande teman. För anhöriga: att behöva kunskap, att vara delaktig vid beslut och att leva med beslutet. För sjuksköterskor: att vara en del av teamet, att vägleda de anhöriga och att bli emotionellt påverkad. Resultatet visar att anhöriga behöver mer kunskap om för- och nackdelar med enteral nutrition vid avancerad demens samt vägledning av sjuksköterskan för att lättare känna delaktighet vid beslut om enteral nutrition till patienten. Sjuksköterskor som har tillräcklig kunskap om enteral nutrition vid avancerad demens samt känner sig som en del av teamet vid beslut har lättare att vägleda och stötta de anhöriga i beslutsprocessen. Vidare forskning kring anhörigas och sjuksköterskors delaktighet vid beslut om enteral nutrition till patienter med avancerad demens behövs för att kunna ge en god personcentrerad omvårdnad och minska patientens lidande.

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Azevedo, Silvana de Oliveira. "Enfermagem em suporte nutricional: pesquisa qualitativa." Universidade Federal Fluminense, 2008. https://app.uff.br/riuff/handle/1/1419.

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Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2016-02-01T16:52:03Z No. of bitstreams: 1 Silvana de Oliveira Azevedo.pdf: 1236713 bytes, checksum: 0197b07a52dc0531de8c470dd21c8a38 (MD5)
Made available in DSpace on 2016-02-01T16:52:03Z (GMT). No. of bitstreams: 1 Silvana de Oliveira Azevedo.pdf: 1236713 bytes, checksum: 0197b07a52dc0531de8c470dd21c8a38 (MD5) Previous issue date: 2008
Universidade Federal Fluminense
Mestrado Profissional em Enfermagem Assistencial
Nas metas do suporte nutricional, incluindo a identificação dos pacientes candidatos à prática de uma avaliação nutricional, destaca-se a capacidade de dirigir a terapêutica e conseqüentemente ministrar suporte que seja seguro e eficiente. Para isso, é importante que haja uma equipe interdisciplinar interagindo, cada qual com suas funções e responsabilidades. Suporte Nutricional tem como definição o conjunto de procedimentos terapêuticos para a manutenção ou recuperação do estado nutricional podendo ser através de uma Nutrição Oral Especializada (NOE), Nutrição Enteral (NE) ou Nutrição Parenteral (NP). Em unidades de internação de um hospital público de grande porte, observa-se a precariedade do planejamento do cuidado de enfermagem ao cliente que faz uso do Suporte Nutricional. Uma situação constante que se encontra na assistência a esses clientes é a suspensão do tratamento devido a diversos fatores, os quais ocorrem muitas vezes por falta de avaliação e desconhecimento do enfermeiro e da equipe de enfermagem em relação à terapêutica nutricional. O presente estudo tem como objeto o planejamento do cuidado de enfermagem ao cliente hospitalizado em Suporte Nutricional e objetiva: descrever o planejamento da assistência ao cliente em suporte nutricional realizado pelo enfermeiro, identificar as dificuldades enfrentadas pelo enfermeiro ao cuidado a clientes em suporte nutricional, e criar modelo de planejamento da assistência ao cliente em terapia nutricional com base em procedimentos operacionais padrão (POP). O estudo de abordagem qualitativa do tipo exploratório foi desenvolvido em treze unidades de internação do Hospital Universitário Antonio Pedro da Universidade Federal Fluminense que possuem clientes em suporte nutricional, tendo como sujeitos vinte e cinco enfermeiros. A coleta de dados se deu a partir de observação participante e entrevista semi-estruturada, utilizando-se como técnica de análise, a análise de conteúdo. Os resultados apontam para uma assistência ao cliente em suporte nutricional restrita a uma ação mecânica, sem instrumentos administrativos (normas e rotinas) que favoreçam uma assistência planejada, bem como o registro do processo de cuidar deste cliente. A nutrição, tanto enteral como parenteral, se mostrou como um cuidado pouco valorizado pelos profissionais em detrimento dos demais procedimentos inerentes ao cuidar. No sentido de uma prática e cuidado ao cliente em suporte nutricional mais segura e com qualidade, criaram-se os Procedimentos Operacionais Padrão (POP), com base nos resultados desta pesquisa, relacionados à Terapia Nutricional Enteral e Parenteral. Os POPs objetivam uma normalização de condutas e a disseminação de boas práticas nas unidades de internação para uma assistência de enfermagem efetiva. A atenção à nutrição do cliente hospitalizado deve ser um fator a ser observado na instituição estudada, uma vez que a eficácia da terapia nutricional também depende das ações do enfermeiro e de sua equipe. Por ser uma atividade especializada e sujeita a complicações e riscos em todas as etapas de sua implementação, faz-se necessário o preparo tanto da instituição quanto dos profissionais para a terapêutica nutricional de qualidade
In the matter of nutricional support, including the identification of patients who are candidates to a nutricional assessment practice, is distinguished by the capacity to direct therapeutic and offers a safe and efficient support . In order for this to happen, it is important that a interdisciplinar team work together with functions and responsibilities of their own. Nutricional support has as definition a set of therapeutic procedures that maintain or recover the nutricional state that can be through an Specialty Oral Nutrition (SON), Enteral Nutrition (EN) or Parenteral Nutrition (PN). In inpatient units of a great public hospital, its common to observe precarious planning of nurse care developed to patients that use Nutricional Support. Different factors are associated to the treatment suspension of these patients, most of the times due to the lack of evaluation and knowledge expected from the nurse and its team according to therapeutic nutrition. The present study presents the planning of nurse care to the patient hospitalized in Nutricional Support and aims to: describe the planning care of the patient in nutricional support realized by the nurse, identify difficulties of the nurse when caring with patients in nutricional support and also create a model of care planning to the patient in nutricional therapy according to standard of operational procedures (SOP). The study of qualitative exploratory approach, was developed in thirteen inpatient units of the University Hospital Antonio Pedro, located in the state of Rio de Janeiro of the Fluminense Federal University. The subjects weretwenty and five nurses. staff . The data was collected from Participant observation and semistructured interviews. The content analysis was used for data analysis . The results points to an patient care in nutricional support restricted to mechanic action, without administrative instruments (norms and routines) that favor a planning care, as well as the care process of this patient. The nutrition, enteral or parenteral, was figured as a not valued care procedure among the professionals comparing to other extant procudures. The results of this research related to the Enteral and Parenteral Nutricional Therapy, Standard of Operacional Procedure were created in order to afford a safe and efficient practice and patient care in nutricional support. These SOPs lens to a conduct normalization and the dissemination of good practice in the inpatient units for an effective nursing care. The nutrition of a hospitalized patient must be considered in the studied institution, once the effectiveness of nutricional therapy depends on nurse and its team actions. For being such a specialized activity makes it vulnerable to complications and risks in all stages of its implementation, so it´s necessary to prepare not only the institution but also the professionals for a quality in therapeutic nutricional

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Nordqvist, Maria, and Marielle Misiak. "Patienters upplevelse av att leva med artificiell nutrition." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-43264.

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Bakgrund: Näring och vätska är grundbehov för människor och när behovet inte kan tillgodoses, finns det möjlighet att ge näring med hjälp av artificiell nutrition. Sjuksköterskor upplever kunskapsbrist inom ämnet och önskar utbildning. Förändring som sker i samband med behandling av artificiell nutrition påverkar även de närståendes livskvalitet och sjuksköterskors roll är att fungera som en länk mellan patienter och närstående. Problem: Sjuksköterskor har ansvar att framföra nödvändig information om artificiell nutrition till patienter. Forskning visar att sjuksköterskor saknar kunskap om artificiell nutrition. Genom att sjuksköterskor får kunskap om patienters upplevelse av att leva med artificiell nutrition, kan sjuksköterskors omvårdnadsarbete förbättras. Syfte: Att beskriva patienters upplevelse av att leva med artificiell nutrition. Metod: En systematisk litteraturstudie med beskrivande syntes, där tio stycken vetenskapliga artiklar har analyserats. Resultat: Patienternas upplevelse av att leva med artificiell nutrition påverkade patienternas liv, behandlingen gav trygghetskänsla men innebar samtidigt begränsningar i det dagliga livet och kroppslig påverkan. Patienterna behövde kunskap för att kunna hantera och acceptera livssituationen. Slutsats: Artificiell nutrition förändrade patienters liv och patienter behövde lära sig hantera den nya livssituationen. Att få tillgång till patienters upplevelse av att leva med artificiell nutrition kan öka sjuksköterskors kunskap och ge förhoppning att tillfredsställa patienters omvårdnadsbehov.

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Conocimiento, Dirección de Gestión del. "Guía de acceso para Journal of Parenteral & Enteral Nutrition (JPEN)." Wiley, 2021. http://hdl.handle.net/10757/655341.

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Höglund, Camilla, and Jesper Jakobsson. "Patienters upplevelser av att leva med enteral nutrition samt deras livskvalitet." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-54680.

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Introduktion: Enteral nutrition är en ökande behandlingsform inom den svenska sjukvården som berör både landsting och kommun. Behandling med enteral nutrition kan påverka patienters fysiska, psykiska och sociala upplevelser samt deras livskvalitet. Syfte: Litteraturstudiens syfte var att belysa patienters upplevelser av att leva med enteral nutrition samt deras upplevda livskvalitet. Metod: Litteraturstudien genomfördes enligt Polit och Becks (2017) niostegsmodell. Databassökningen genomfördes i CINAHL och PubMed där totalt tio artiklar identifierades som svarade på syftet. Artiklarna kvalitetsgranskades och analyserades induktivt. Resultat: Redovisades utifrån följande fyra teman: Vikten av socialt stöd samt betydelsen av relationer, Angelägenheten av information, Begränsningar och praktiska problem samt Oro och kluvenhet. Slutsats: Upplevelsen av stöd, information och hantering av praktiska problem relaterat till enteral nutrition har betydelse för patienternas livskvalitet. Sjuksköterskan har ett viktigt ansvar att tillgodose patienterna med omfattande information och stöd för att de ska uppleva en tryggare och mer lätthanterlig vardag.

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Boväng, Ellinor, and Källström Hannah Bågling. "Enteral nutrition och NEC hos underburna och underviktiga nyfödda barnEn litteraturöversikt." Thesis, Mittuniversitetet, Avdelningen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-30866.

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Harlin, Nathalie, and Frida Pettersson. "Att leva med enteral nutrition : En systematisk litteraturstudie utifrån ett patientperspektiv." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-42252.

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Prada, Maria Camila Abramides 1974. "Dieta enteral em UTI : análise descritiva da adequação da prescrição e infusão e a ocorrência de complicações." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309089.

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Orientador: Elizete Aparecida Lomazi
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivos: Avaliar a adequação da prescrição e infusão de nutrição enteral e verificar a relação entre a adequação dos valores infundidos na nutrição enteral e a ocorrência de complicações em unidade de terapia intensiva de hospital terciário. Métodos: Estudo prospectivo descritivo, analítico, conduzido de setembro de 2010 a agosto de 2011. O estado nutricional dos pacientes foi avaliado por: prega cutânea tricipital, circunferência muscular do braço e circunferência do braço. A porcentagem de adequação das calorias e proteínas recebidas e calorias prescritas foram calculadas pela divisão dessas pelas necessidades calóricas e proteicas calculadas, até a alta da Unidade de Terapia Intensiva, óbito ou alta do suporte nutricional. As complicações verificadas foram relacionadas à adequação da infusão da NE e ao estado nutricional por meio do teste qui-quadrado. Resultados: A taxa de desnutrição foi de 29,4%, de eutrofia 60% e de obesidade 9,8%. A porcentagem de adequação da infusão calórica foi de 92,3%, enquanto a adequação da proteína recebida em relação às necessidades recomendadas foi de 65,8%. Os efeitos adversos registrados foram: diarreia (29,4%), vômitos (21,6%), débito de dieta pela SNE (11,8%), distensão abdominal (5,9%), hiperglicemia (78,4%), hipoglicemia (21,6%) e constipação (56,9%). A taxa de adequação da infusão calórica de 92,3% (DP±37,86) e taxa de adequação de infusão proteica de 68,8% (DP±40,16). Não houve associação estatística significativa entre complicações e excesso ou déficit de nutrição infundida, desnutrição ou obesidade. Conclusões: Cerca da metade dos pacientes não recebeu suas necessidades calóricas e proteicas e alguns pacientes receberam quantidade de calorias acima de suas necessidades. À internação, a avaliação nutricional revelou que a maioria dos pacientes estava eutrófica. Nenhuma das complicações foi associada à porcentagem de adequação da infusão de nutrição enteral
Abstract: Background: To evaluate the relationship between the amount of enteral nutrition infusion and the occurrence of complications. Methods: It is a prospective descriptive study conducted from September/2010 to August/2011 in an Intensive Care Unit of a public general hospital in Brazil. Triceps skinfold, upper arm circumference and upper arm muscle circumference were used to assess nutritional status. To assess the nutritional adequacy, the total amount of energy and protein received from enteral nutrition was divided by the amounts prescribed and estimated caloric and protein needs up to Intensive Care Unit discharge, death or enteral support ending. The relation between the adequacy of enteral nutrition infusion and the variables was crossed by the chi-square test. Results: Adverse effects percentages were the following: diarrhea (29.4%), vomiting (11.8%), abdominal bloating (21.6%) and constipation (56.9%). The nutritional assessment findings were 29.4% - underweight, 60% - normal weight 9.8% - obesity. Caloric infusion adequacy ratio were 92.3% (mean±37,9) and the protein infusion adequacy were 68,8% (mean±40,2). There was no statistical relation between enteral nutrition infusion and the occurrence of complications, or the nutritional status. Conclusions: Twenty-five percent of the patients didn't achieve their needs. Almost half of patients were underfeeding according to caloric and protein infusion adequacy and even those ones who were overfeeding did not presented any association to the complications studied
Mestrado
Saude da Criança e do Adolescente
Mestra em Ciências

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22

Grenå, Madeleine, and Beata Gill. "Gastrostomi : Granulombehandling vid gastrostomi hos barn och ungdomar." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-165806.

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Syfte. Syftet med detta arbete var att undersöka förekomsten och behandling av granulom vid gastrostomier hos barn och ungdomar under 18 år i Sverige. Syftet var även att undersöka sjuksköterskors kunskaper om granulombehandling hos barn och ungdomar under 18 år med gastrostomi i Sverige. Metod. Den forskningsdesign som valdes var av kvantitativ metod genom enkätundersökning. Enkäterna skickades ut till sjuksköterskor som arbetar i Sverige och finns med i något av följande nätverk: Nätverket för habiliteringssjuksköterskor, Nätverket för habiliteringssjuksköterskor inom nutrition och/eller Nätverket för nutritionssjuksköterskor. Resultat. Det upplevdes att granulombesvären var varierande och berodde på barnets övriga hälsa. 52% uppskattade att barnen utvecklade granulom inom två månader efter inläggning av gastrostomin. 34% av deltagarna uppskattade att ca 25% av barn och ungdomar med gastrostomier utvecklar granulom. 46% använde en kombination av lapis och kortisonsalva som behandlingsmetod vid granulom. Slutsats. De behandlingar som idag används för granulom är lapis och kortisonsalva, dessa används av många i kombination med varandra och verkar ha ett gott resultat. Sjuksköterskors kunskap inom området är brett och många har en gemensam åsikt om att granulombildning ofta har ett samband med patientens övriga hälsa.
Aim. The aim of the study was to investigate the occurrence and treatment of granulomas in children and adolescents under the age of 18 with gastrostomy in Sweden. The aim was also to investigate nurses knowledge of granulomatreatment in children and adolescents under the age of 18 with gastrostomy in Sweden. Methods. The design was of quantitative method by questionnaire. A questionnaire was sent to nurses who work in Sweden and are included in one of the following networks: Network for rehabilitation nurses, Network for rehabilitation nurses in nutrition and / or Network for nutrition nurses. Results. The severity of granuloma varied, depending on the child's general health. 52% estimated that the children developed granulomas within two months after insertion of the gastrostomy. 34% of respondents estimated that about 25% of children and adolescents with gastrostomier develop granulomas.46% used a combination of lapis and cortisone ointment as a treatment for granuloma. Conclusion.The treatments currently used for granulomas is lapis and cortisone ointment, these are used by many in combination with each other and seem to have a good result. Nurses' knowledge in the field is extensive and many have a common view that granuloma formation is often linked to the patients general health.

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Bronston, Ashley Lynn. "Use of Homemade Blenderized Formula in Gastrostomy Tube Dependent Pediatric Patients with Feeding Intolerance: A Retrospective Analysis." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1461197803.

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Lindén, Sanna, and Anneli Thörnell. "Malnutrition hos barn med cancer; Nutritionsstöd och omvårdnad." Thesis, Högskolan Dalarna, Omvårdnad, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:du-3055.

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Syftet med denna systematiska litteraturstudie som inkluderar 18 artiklar, har varit att belysa vilka nutritionsstöd som kan förebygga och behandla malnutrition hos barn med cancer samt vilka omvårdnadsbehov som finns i samband med nutritionsbehandling. Resultatet visade att barn med cancer som behandlas med strålning och/eller cytostatika ofta drabbas av olika biverkningar som påverkar nutritionen. Cirka 46 % av barnen utvecklade malnutrition. Näringsintaget försämrades ofta på grund av biverkningarna vilket fick till följd att behandlingen försämrades samt tillväxt och utveckling påverkades negativt. Olika sätt fanns för att upprätthålla gott nutritionsstatus. Oralt intag förordades för att upprätthålla mag- tarmkanalens struktur och funktion. Alternativ för kostbehandling när barnet inte klarade att inta oral kost var nasogastrisk sond (NS), Perkutan Endoskopisk Gastrostomi (PEG) och Total Parenteral Nutrition (TPN). NS visade sig vara relativt biverkningsfritt och ett alternativ att tillgå under kortare nutritionsbehandlingar. PEG var ett gott alternativ med relativt få biverkningar då barnet behöver nutritionsstöd under längre tid. TPN var ett alternativ enbart då barnet inte kunde äta relaterat till bristande upptag i mag- tarmkanalen. Försämrat näringsintag påverkade barnets livskvalitet. Familjen påverkades genom att ätandet var en stark källa till konflikt mellan barnet och föräldrarna. Det var viktigt att barnet och familjen fick stöd i barnets förmåga att kunna äta samt att erbjudas näringsrik kost. Bedömning av nutritionsstatus och dokumentation av oralt intag, parenteralt intag och effekter av nutritionsbehandlingen var av stor vikt för att kunna ge barnet optimal omvårdnad.

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Cochran, Charlotte Norene. "Registered dietitans practicing advanced level skills in the state of Tennessee and their perceived job satisfaction." [Johnson City, Tenn. : East Tennessee State University], 2004. http://etd-submit.etsu.edu/etd/theses/available/etd-1112104-132236/unrestricted/CochranN112304f.pdf.

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Thesis (M.S.)--East Tennessee State University, 2004.
Title from electronic submission form. ETSU ETD database URN: etd-1112104-132236 Includes bibliographical references. Also available via Internet at the UMI web site.

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Jensen, Emma. "Artificiell Nutrition i hemmet." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-36105.

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Bakgrund: Patienter som vårdas med enteral eller parenteral nutrition har blivit mer förekommande i vården. Att sjuksköterskan hade hög kompetens gällande artificiell nutrition, kunde vara avgörande för hur patienterna kunde själva hantera problem som uppstod i samband med infusionen i hemmet. Syfte: är att beskriva patienters upplevelse av sitt dagliga liv med enteral eller parenteral nutrition i hemmet. Metod. Allmän litteraturöversikt med beskrivande design. Tio artiklar med kvalitativa och kvantitativa ansatser har inkluderats. Resultat: Social isolering, tidskrävande, biverkningar och nedsatta funktioner är upplevelser som kopplas ihop med att ha artificiell nutrition i hemmet. Välbefinnande är något som kan upplevas om patienterna får hjälp att hantera dom negativa aspekterna med artificiell nutrition. Slutsats: Genom att belysa patienternas upplevelser av att leva med artificiell nutrition i hemmet kan sjuksköterskorna lindra lidande och främja hälsa.

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Karlsson, Caroline, and Ewa Poijes. "När en person med demenssjukdom slutar äta : En litteraturstudie utifrån sjuksköterskans perspektiv." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1581.

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Bakgrund: Personer med demenssjukom får ofta i sjukdomsförloppet problem att äta och insatser för att behålla personens nutritionsstatus kan bli aktuella. En vanlig sådan insats som diskuteras är enteral nutriton i någon form. Då en person med demenssjukdom tappar sin förmåga att kommunicera och även den kognitiva förmågan att ta egna beslut ställs sjuksköterskor inför en svår arbetsuppgift. Att ta ställning till om det är etiskt riktigt att starta enteral nutrition eller om det är etiskt riktigt att acceptera matvägran är en av de svåraste dilemman en sjuksköterska kan ställas inför. Syfte: Att beskriva sjuksköterskans möjligheter att bevara autonomi hos personer med demenssjuksom vid enteral nutrition. Teroretisk utgångspunkt: Begreppet autonomi är den teoretiska utgångspunkten som används i resultatdiskussionen. Metod: En litteraturstudie inspirerad av Fribergs analysmodell inkluderande nio vetenskapliga artiklar med fokus på sjuksköterskans möjligheter att bevara autonomin hos personer med demenssjukdom vid enteral nutrition. De vetenskapliga artiklarna har valts ut efter passande sökord så att svar på syftet kunde ges. Resultat: Sjuksköterskor upplever att de känner personen med demenssjukdom väl då de spenderar mycket tid tillsammans med denne. Den kunskap sjuksköterskan har om personen med demensjukdom anser alla är viktig i beslutet om enteral nutrition. Det råder delade meningar om den används eller inte och det finns en rädsla och osäkerhet kring ämnet som många sjuksköterskor känner sig obekväma i. Evidensbaserad kunskap saknas och kommunikationen mellan sjuksköterska, läkare och närstående anses vara viktig för att bästa beslutet bör tas. Diskussion: För att kunna bevara autonomin hos en person med demenssjukdom vid enteral nutrition krävs en ökad förståelse kring problemet och ett bra samarbete mellan alla inblandade. Det verkar vara behövligt att öppet kommunicera kring problemet då sjuksköterskorna anser att de bör ta en större roll men inte tillåts. Genom att öppet kommunicera kring ämnet kan även rädslan och osäkerheten i ämnet minskas.
Background: People with dementia often get eating problems and efforts to maintain the person's nutritional status might be needed. A typical action to be considered is some form of enteral nutriton. When persons with dementia lose their ability to communicate and their cognitive ability to make decisions the nurses face a difficult task. To determine whether it is ethicaly to start enteral nutrition or if hunger strikes should be accepted is one of the most difficult dilemmas a nurse might have to face. Aim: To describe nurses’ ability to preserve the autonomy of a person with dementia disease through enteral nutrition. Theoretical basis: The concept of autonomy is the theoretical basis used in the results discussion. Method: A literature study inspired by Friberg analysis model including nine scientific papers focusing on nurses' experiences of enteral nutrition with people with dementia. The scientific papers were selected through matching keywords and used to answer the aim. Result: Nurses often feel like they know the person with dementia well as they spend much time with the person. The knowledge nurses have about the person with dementia can be important when the decision about enteral nutrition is about to be made. The opinion is divided whether that knowledge is used or not and there are fear and uncertainty surrounding the subject that many nurses feel uncomfortable about. Evidence based information is lacking about the subject and the communication between nurses, doctors and relatives is considered important to be able to take the best possible decision. Discussion: in order to preserv the autonomy of the person with dementia an understanding about this issue is required and a good cooperation between all parties involved. There seems to be a need to openly communicate about the problem since nurses often belive they have the knowledge to take a bigger role in the decision making than what thy currently are allowed to do. By openly communicating about the subject, fear and uncertainty in the subject may be reduced.

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Macarovscha, Greice Trevisan 1978. "Determinação de elementos metálicos em nutrição enteral." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/249405.

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Orientador: Solange Cadore
Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Química
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Resumo: A nutrição enteral é um alimento com finalidade de suprir todas as necessidades nutricionais de um indivíduo que está incapacitado de se alimentar da forma convencional. São alimentos encontrados comercialmente em forma sólida ou liquida, prontos para o consumo, cuja composição inclui carboidratos, proteínas, lipídios, vitaminas e minerais em quantidades suficientes para atingir a ingestão diária recomendada para um indivíduo saudável. A legislação brasileira regula os elementos metálicos essenciais e o limite máximo de contaminantes em alimentos. Para o estudo dessas espécies metálicas nas nutrições enterais, as técnicas de ICP OES e GF AAS foram utilizadas. As amostras foram analisadas por ICP OES após o tratamento em forno de microondas fechado. Após a otimização das condições experimentais do ICP OES (potência da RF, vazão de nebulização e vazão auxiliar) as espécies Al, As, Ba, Ca, Cd, Co, Cr, Cu, Fe , Hg, K , Mg, Mn, Mo, Na, Ni, Pb, Sb, Se, V e Zn tiveram sua exatidão avaliada através de experimentos de adição e recuperação, obtendo-se valores entre 90 e 110% e RSD menores que 5%, para a maior parte dos elementos. Ca, Fe, K, Mg, Mn, Na e Zn foram quantificados nas amostras enquanto que as espécies contaminantes (Cd, Hg, Pb e Se) e outros elementos essenciais (Cu, Cr, Mo, Se) não puderam ser quantificados pois estavam abaixo do LOQ do método. Com as condições de GF AAS (tempo e temperatura de pirólise e de atomização, uso de modificador químico) otimizadas e as amostras suspensas em CFA-C foram obtidas exatidões adequadas e RSD menores que 5% para as determinações de Al nas amostras. Diferentes tipos de embalagem não influenciaram o teor de Al nas amostras. Chumbo e cádmio também foram determinados por GF AAS, usando amostras mineralizadas em forno de micro-ondas fechado. Nas condições experimentais otimizadas a exatidão foi avaliada por um estudo de recuperação obtendo-se recuperações adequadas. O LOQ para Pb e Cd atendem os valores da legislação vigente. Essas espécies foram quantificadas nas amostras e todos os resultados observados se encontram abaixo do limite máximo tolerado de contaminantes. Um estudo de disponibilidade foi feito para avaliar a fração disponível dos elementos metálicos declarados na amostra. Esse estudo foi realizado in vitro, visando uma simulação dos processos digestivos e de absorção que ocorrem no trato gastrointestinal de um indivíduo. Os resultados mostraram que a disponibilidade dos elementos estudados nas amostras de nutrição enteral tornam esse tipo de alimento adequado para o seu fim
Abstract: Enteral nutrition is a food that aims to supply all the nutritional necessities of a person who is incapable of feeding in the conventional way. They are meals commercially available in solid or liquid forms, usually ready for consumption. These commercial meals include carbohydrates, proteins, lipids, vitamins and minerals in sufficient quantities in their composition, in order to reach the daily recommended amounts for a healthy individual. Brazilian legislation regulates the essential metallic elements and the maximum contaminants in food. For the study of metallic elements in enteral nutriments, the techniques of ICP-OES and GF AAS were used. ICP OES was used for the analysis after sample treatment in a closed microwave oven. After experimental optimization of the ICP OES parameters (RF power, nebulization flow, and auxiliary flow) the method accuracy was evaluated using addition and recovery experiments. For the majority of the elements recoveries between 90 and 110% and RSD less than 5% were obtained. Ca, Fe, K, Mg, Mn, Na and Zn were quantified in the samples. The contaminants species (Cd, Hg, Pb, Se) and the other essential elements (Cr, Cu, Mo, Se) were below the LOQ and could not be quantified. Using GF AAS optimized conditions (pyrolysis and atomization time and temperature and use of chemical modifiers) with the samples suspended in CFA-C it was possible to obtain adequate accuracies and RSD lower than 5% for the determination of Al in the enteral samples. Different types of packaging did not influence the content of Al in the samples. Lead and Cd were determined by GF AAS after sample treatment by microwave radiation. Under the optimized experimental conditions the method accuracy was evaluated by an addition and recovery study. The LOQ for Pb and Cd using GF AAS are in accordance with the values established by the legislation. The determination of Cd and Pb showed that the concentrations in all the samples analyzed are below the maximum tolerated value. A bioavailability study was carried out to evaluate the available fraction of the metallic elements declared in the sample¿s label. The in vitro study simulated the digestive and absorption processes that occur in the gastrointestinal treat of an individual. The results showed that the availability of elements in the samples of enteral nutrition make this type of food suitable for their purpose
Doutorado
Quimica Analitica
Doutor em Ciências

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Tranberg, Julia, and Caroline Rydberg. "Patienters erfarenheter och upplevelser av att få enteral nutrition via nasogastrisk sond : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-43466.

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Bakgrund: Enteral nutrition via nasogastrisk sond är en vanlig behandlingsform för kortsiktig nutritionsbehandling då den anses ha förhållandevis lätt inläggning och avlägsnande. Sondinläggning och behandling kan innebära risker som kan leda till aspiration och allvarliga infektioner. Syfte: Syftet var att beskriva vuxna patienters erfarenheter och upplevelser av näringstillförsel via nasogastrisk sond. Metod: En allmän litteraturstudie genomfördes. Nio vetenskapliga artiklar med kvalitativ ansats bearbetades i en innehållsanalys. Resultat: Innehållsanalysen presenterar fyra teman: Erfarenheter och upplevelser av fysiskt obehag, Erfarenheter och upplevelser av ett begränsat liv, Erfarenheter och upplevelser av en förändrad identitet samt Erfarenheter och upplevelser av att hantera vardagen. Deltagare beskrev upplevelser av fysiskt obehag vid insättning av sonden och under själva behandlingen, samt erfarenheter av begränsningar i vardagen och uttryckte även en ovilja att lämna hemmet. Vidare beskrevs upplevelser av en försämrad självbild relaterat till sondens synliga placering samt copingstrategier och behovet av stöd från sjukvårdspersonal och familj. Slutsats: Deltagarna upplevde både positiva och negativa erfarenheter och upplevelser vilket resulterade i motstridiga känslor. Ett individanpassat stöd från sjukvårdpersonal kan ha stor inverkan på deltagarnas välbefinnande och möjlighet till att klara sitt dagliga liv.
Background: Enteral nutrition via nasogastric tube is a common treatment form for short-term nutritional support since intubation and removal are rather simple to perform. Tube intubation and treatment may entail risks of aspiration and serious infections. Aim: The aim was to describe adult patients' experiences of nutritional support via nasogastric tube. Method: A general literature study was implemented. Nine articles with a qualitative approach were analyzed through content analysis. Results: The content analysis present four themes: Experiences of physical discomfort, Experiences of a limited life, Experiences of a changed identity and Experiences of dealing with everyday life. Participants described experiences of physical discomfort during insertion and the treatment itself, and experiences of limitations in their everyday lives and expressed a reluctance to leave their homes. Furthermore, experiences of an impaired self-image related to the tube’s visible location was described as well as coping strategies and a need for support from healthcare personnel and family. Conclusion: Participants described both positive and negative experiences, which resulted in conflicted emotions. Receiving personalized support from healthcare personnel can have a major impact on the participants' well-being and ability to cope with their everyday lives.

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Foley, Jo Anne. "Providing Optimal Nutrition in Critical Care." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2351.

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Malnutrition among hospitalized patients is prevalent and associated with adverse outcomes. At the health care facility for which this quality improvement (QI) initiative was developed, patients were not consistently fed within the nationally recommended 48 hours. The purpose of this project was to facilitate the early initiation of enteral feedings to prevent malnutrition in a vulnerable patient group by development of an evidence-based enteral feeding policy, algorithm, and nursing education module. The find, organize, clarify, understand, select, plan, do, check, and act model provided a systematic approach for development of the project. Validation of the QI initiative was through the use of Likert scale which was completed by 2 nurses and a head dietician. The content validity index average was 1.0 for the QI initiative products (policy, algorithm, educational module). Ten team members completed a summative evaluation of the educational module and presentation using a 7 item, Likert scale. Basic descriptive analyses were employed to analyze the data, revealing broad support for the module and the DNP student's leadership. A recommendation was made to conduct an audit using a formal software program to quantify the number of patients who were not being fed within the time frame of 48 hours. Implementing an evidence-based enteral feeding protocol can be a significant intervention that produces better patient outcomes.The implications for social change in this project relates to improvements within the critical care environment.

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Beck, Ana Raquel Medeiros 1973. "Correlação entre medidas antropometricas e biometricas na inserção da sonda gastrica em pediatria." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313617.

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Orientador: Elizete Aparecida Lomazi da Costa Pinto
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Até 50% dos tubos gástricos podem ser posicionados inadequadamente. A diversidade de técnicas e de pontos de referência utilizados para estimar a locação de sondas gástricas contribui para ocorrência de erros de posicionamento. JUSTIFICATIVA: Estudos internacionais caracterizam-se por incluir amostras reduzidas, grande amplitude nas faixas etárias e etnias específicas. OBJETIVOS: 1. Identificar o grau de correlação entre a medida do esôfago, obtida por endoscopia digestiva alta (EDA) e as medidas antropométricas e biométricas externas, tomadas em 153 crianças brasileiras, na faixa etária de 2 a 12 anos; 2. Desenvolver modelos de predição gerando equações para inserção de sondas na transição esôfago-gástrica (TEG) e no corpo do estômago (CE); 3. Comparar os valores do estudo com a medida NEX (distância do nariz, ao lóbulo da orelha até o apêndice xifóide) e com estudos internacionais. MÉTODO: Estudo analítico, observacional e transversal. Os dados foram coletados no período de janeiro de 2006 a janeiro de 2008. As medidas de biometria mensuradas foram: 1. Externas: arcada dentária superior-subnasal, subnasal-tragus, tragus-apêndice xifóide, apêndice xifóide-umbigo, subnasal-apêndice xifóide, altura e comprimento do joelho; 2. Internas: arcada dentária superior e subnasal à transição esofagogástrica e ao corpo do estômago. Modelos de predição foram ajustados para essas medidas, utilizando análise de regressão linear múltipla. Os modelos obtidos neste estudo foram comparados com os modelos provenientes de estudos internacionais, utilizando-se o coeficiente de correlação de Pearson. RESULTADOS: Altura e comprimento do joelho apresentaram as mais fortes correlações com o comprimento do esôfago, respectivamente, 0,91 e 0,88. A correlação entre a medida NEX e a medida arcada dentária superior-TEG apresentou coeficiente de correlação foi r=0,81 e com a medida ADS-CE de r=0,72. Forte correlação foi obtida entre os modelos desenvolvidos nesse estudo e modelos internacionais, r=1,00. CONCLUSÕES: A medida da altura, seguida pela medida do comprimento do joelho, apresentaram as mais fortes correlações com a medida esofágica. A medida até o corpo gástrico apresentou correlações mais fracas que as encontradas com a TEG. A medida NEX apresentou grau de correlação inferior aos obtidos nas correlações antropométricas. Houve forte correlação entre os achados no presente estudo e os valores obtidos em casuísticas internacionais.
Abstract: Errors in placement of orogastric and nasogastric feeding tubes may occur in more than 50% of procedures. The diversity of techniques and landmarks definitions used for estimating gastric tube location contributes to inadequate placement. JUSTIFICATION: International studies have included reduced samples, wide range age subjects and specific ethnic groups. OBJECTIVES: 1. Identifying correlation values between endoscopic esophageal length and anthropometric and external biometric data obtained from 153 Brazilian children (2 - 12 years old). 2. Developing statistical predictive models for inserting tubes at esophageal-gastric transition and in gastric body. 3. Comparing correlation values obtained with presented models and those obtained from international sample and with NEX (nose to ear lobe and xiphoid) measurement. METHOD: Analytical, observational and crossectional study. Data were collected from January 2006 to January 2008. The biometric measurements were: 1. External: ADS-subnasal, subnasal-tragus, tragus-xiphoid process, xiphoid processumbilicus, subnasal-xiphoid process, height and knee length; 2. Internal: superior dental arch (SDA) subnasal to the esophageal-gastric transition and to the body gastric. Correlation and determination values were obtained using multiple linear regressions. Presently predictive models were compared to international data using Pearson test. RESULTS: 1. Internal values were best correlated with height followed by knee length, respectively, 0.91 and 0.88. Correlation value between NEX and internal measurements were inferior than correlation between height and knee length, r = 0,81. Strong correlation was found between presently developed models and international samples, r=1.00. CONCLUSION: Height, followed by knee length, presented the strongest linear correlation with internal measurements. Gastric body showed weaker correlation values when compared to TEG. The NEX was hence confirmed to having a weaker correlation with the esophageal length than height. There was a strong correlation between present values and those generated from international samples.
Doutorado
Doutor em Saude da Criança e do Adolescente

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Taylor, Stephen J. "The effect of early aggressive enteral nutrition on clinical outcomes and treatment cost." Thesis, University of Surrey, 1996. http://epubs.surrey.ac.uk/844289/.

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Malnutrition and nutritional deprivation are common in hospital patients. Consequent dysfunction is exacerbated in the presence of an inflammatory state and leads to increased morbidity, mortality and treatment cost. This thesis tested the hypothesis that clinical outcome could be improved, and treatment cost reduced, if enteral nutritional (EN) was; a) initiated earlier after the pathological event, and b) when > 50% of a patient's estimated energy and nitrogen requirements were met by EN (ie. aggressive EN). A Preliminary Investigation found that patients starved for ≤ 5 days compared to > 5 days, had a lower mortality (p < 0.003) and shorter duration of nasogastric (NG) feeding (p = 0.049). The population studied was heterogenous and no account was taken of disease severity. The hypothesis was therefore re-tested in burned patients, controlling for disease severity. The delay before attempting aggressive EN was associated with major complications excluding (p < 0.001) and including mortality (p = 0.018), length of (hospital) stay (LOS) (p = 0.011), and treatment cost (p < 0.001). Finally, a prospective randomised controlled trial (PRCT) was used to test the hypothesis. A study of patients undergoing major GI surgery failed due to poor recruitment, but useful aspects of this protocol were adapted for a similar trial in head-injured patients. In this group, early aggressive EN was associated with a reduction in infective complications (p = 0.0195), duration of mechanical ventilation (p = 0.019) and treatment cost (p = 0.006). In certain conditions at least, early aggressive EN is associated with improved clinical outcome and reduced treatment cost. Much of this improvement appears to be due to a reduction in infective complications.

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Jack, Leanne C. "Exploring diarrhoea, enteral nutrition and intestinal microbial flora relationships in critically ill patients." Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/78409/1/Leanne_Jack_Thesis.pdf.

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Diarrhoea is a common complication observed in critically ill patients. Relationships between diarrhoea, enteral nutrition and aerobic intestinal microflora have been disconnectedly examined in this patient cohort. This research used a two-study, observational design to examine these associations. Higher diarrhoea incidence rates were observed when patients received enteral tube feeding, had abnormal serum blood results, received multiple medications and had aerobic microflora dysbiosis. Further, significant aerobic intestinal microflora changes were observed over time in patients who experienced diarrhoea. These results establish a platform for further work to improve the intestinal health of critically ill patients.

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Olne, Karin, and Anna Jemsby. "Undersökning av följsamhet till lokal riktlinje om enteral och parenteral nutrition hos intensivvårdspatienter - en journalgranskning." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-27588.

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En svårt sjuk patient som vårdas på en intensivvårdsavdelning, med svikt i ett eller flera organsystem, löper betydande risk att drabbas av malnutrition med ökad risk för infektioner och längre vårdtider. När en väl utarbetad riktlinje inom nutrition följs ökar patientens möjligheter att nå upp till sitt kalorimål med minskad malnutrition och förkortade vårdtider som följd. Syftet med studien var att undersöka följsamheten till en befintlig riktlinje om nutrition på en intensivvårdsavdelning i västra Sverige med hjälp av journalgranskning. Ett konsekutivt urval gjordes och 31 uppfyllde inklusionskriterierna. Journalerna granskades enligt deskriptiv analys. Resultatet visade en varierande följsamhet till riktlinjen med högst följsamhet mot slutet av vårdtiden och lägst följsamhet i början av vårdtiden. Med hjälp av resultatet i denna studie kan följsamheten till riktlinjen förbättras och på så sätt kan bedömning och behandling av nutrition för intensivvårdspatienten optimeras.
A critically ill patient within the intensive care unit, with failure in one or more organ systems, has an increased risk of malnutrition with infections and extended hospital stay as a result. When a wellestablished guideline of nutrition is used, the patients possibility of reaching the caloric goal increases which lead to decreased malnutrition and shortened hospital stay. The aim of the study was to investigate the compliance of an enteral and parenteral guideline in an intensive care unit in a hospital in the west of Sweden with a review of medical records. A consecutive sample was made and 31 patients met the criteria. The medical records were reviewed according to descriptive analysis. The results showed a varying compliance to the guideline, with the highest compliance in the end of hospital stay and the lowest compliance in the beginning of hospital stay. Using the results in this study, the compliance of the nutritional guideline can be improved, and nutritional assessment and treatment for the intensive care patient can be optimized.

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Andersson, Rikard. "Har administreringsformen av enteral nutrition betydelse för antalet lösa avföringar per dygn? : - En retrospektiv registerstudie av intensivvårdspatienter." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-17132.

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Bakgrund: Patienter inlagda på sjukhus behöver näringstillförsel för att kunna återhämta sig. Enteral nutrition är troligen att föredra framför parenteral nutrition, och bör sättas in så tidigt som möjligt. Enteral nutrition kan administreras på olika sätt. Den kan ges intermittent och innehålla nattvila, eller ges kontinuerligt för att undvika plötsliga sänkningar i blodsockernivåer. En oönskad komplikation är lösa avföringar hos patienten. Frågan är om administrationsformen av enteral nutrition kan påverka frekvensen av diarré. Syfte: Att med hjälp av en registerstudie jämföra antal lösa avföringar per dygn mellan två olika administrationsformer av enteral nutrition: intermittent med nattvila jämfört med kontinuerlig tillförsel över hela dygnet. Metod: En kvantitativ retrospektiv registerstudie har genomförts på totalt 50 intensivvårdspatienter med traumatisk skallskada vid Norrlands Universitetssjukhus. Journaler från 2007 till 2012 har använts i studien. Resultat: Ingen signifikant skillnad kunde påvisas mellan grupperna i antal lösa avföringar per dygn, p=0.5. Däremot visade denna studie att de patienter som fick intermittent enteral nutrition fick signifikant större mängd enteral nutrition (699±249 ml) per dygn jämfört med patienter som fick sin enterala nutrition kontinuerligt (505±278 ml/dygn), p = 0.008. Slutsats: Resultatet från studien visar att antalet lösa avföringar inte verkar bero på administreringsformen av enteral nutrition. Mängden tillförd enteral nutrition skiljer sig dock statistiskt signifikant varav betydelsen av det borde studeras vidare för att avgöra vilken administreringsform som är att föredra.
Background: Patients admitted to hospital need nutrition to recover. Enteral nutrition is probably preferable to parenteral nutrition should be initiated as early as possible. Enteral nutrition may be administered in various ways, it can be intermittent and include night rest, or given continuously to avoid abrupt reductions in blood sugar levels. An unwanted complication is loose stools of the patient. The question is whether the form of administration of enteral nutrition can affect the frequency of diarrhea. Aim: With the help of a retrospective registry study comparing number of loose stools per day between two different forms of administration of enteral nutrition: intermittent with night sleep compared with continuous supply throughout the day. Method: A quantitative retrospective registry study has been carried out on a total of 50 ICU patients with traumatic head injury at Norrlands University Hospital. Records from 2007 to 2012 were used in the study. Results: No significant difference was detected between the groups in the number of diarrhea per day, p = 0.5. However, this study demonstrated that patients receiving intermittent enteral nutrition was significantly greater amount of enteral nutrition (699 ± 249 ml) per day compared with patients who received their enteral nutrition continuously (505 ± 278 mL / day), p = 0008. Conclusion: The results from the study show that the number of loose stools do not seem to depend on the form of administration of enteral nutrition. Quantities of enteral nutrition differ statistically significantly significance of which it should be further studied to determine which form of administration is preferred.

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Lisboa, Caroline de Deus. "Preparo e administração de medicamentos por sondas em pacientes que recebem nutrição enteral." Universidade do Estado do Rio de Janeiro, 2011. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2463.

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O objeto de estudo foi o preparo e a administração de medicamentos por cateter pela enfermagem em pacientes que recebem nutrição enteral. O objetivo geral foi investigar o padrão de preparo e administração dos medicamentos por cateter em pacientes que recebem nutrição enteral concomitante. Os objetivos específicos foram apresentar o perfil dos medicamentos preparados e administrados de acordo com a possibilidade de serem administrados por cateter enteral e avaliar o tipo e a freqüência de erros que ocorrem no preparo e administração de medicamentos por cateter. Tratou-se de uma pesquisa com desenho transversal de natureza observacional, sem modelo de intervenção. Foi desenvolvida em um hospital do Rio de Janeiro onde foram observados técnicos de enfermagem preparando e administrando medicamentos por cateter na Unidade de Terapia Intensiva. Foram observadas 350 doses de medicamentos sendo preparados e administrados. Os grupos de medicamentos prevalentes foram os que agem no Sistema Cardiovascular Renal com 164 doses (46,80%), seguido pelos que agem no Sistema Respiratório e Sangue com 12,85% e 12,56% respectivamente. Foram encontrados 19 medicamentos diferentes do primeiro grupo, dois no segundo e cinco no terceiro. As categorias de erro no preparo foram trituração, diluição e misturas. Encontrou-se uma taxa média de 67,71% no preparo de medicamentos. Comprimidos simples foram preparados errados em 72,54% das doses, e todos os comprimidos revestidos e de liberação prolongada foram triturados indevidamente entre sólidos a categoria de erro prevalente foi trituração com 45,47%, preparar misturando medicamentos foi um erro encontrado em quase 40% das doses de medicamentos sólidos. A trituração insuficiente ocorreu em 73,33% das doses de ácido fólico, do cloridrato de amiodarona (58,97%) e bromoprida (50,00%). A mistura com outros medicamentos ocorreu em 66,66% das doses de bromoprida, de besilato de anlodipina (53,33%), bamifilina (43,47%), ácido fólico (40,00%) e ácido acetilsalicílico (33,33%). Os erros na administração foram ausência de pausa e manejo indevido do cateter. A taxa média de erros na administração foi de 32,64%, distribuídas entre 17,14% para pausa e 48,14% para manejo do cateter. A ausência de lavagem do cateter antes foi o erro mais comum e o mais incomum foi não lavar o cateter após a administração. Os medicamentos mais envolvidos em erros na administração foram: cloridrato de amiodarona (n=39), captopril (n=33), cloridrato de hidralazina (n=7), levotiroxina sódica (n=7). Com relação à lavagem dos cateteres antes, ela não ocorreu em 330 doses de medicamentos. O preparo e administração inadequados de medicamentos podem levar à perdas na biodisponibilidade, diminuição do nível sérico e riscos de intoxicações para o paciente. Preparar e administrar medicamentos são procedimentos comuns, porém apresentou altas taxas de erros, o que talvez reflita pouco conhecimento desses profissionais sobre as boas práticas da terapia medicamentosa. Constata-se a necessidade de maior investimento de todos os profissionais envolvidos, médicos, enfermeiros e farmacêuticos nas questões que envolvam a segurança com medicamentos assim como repensar o processo de trabalho da enfermagem.
This studys object was the medications preparation and administration by nursing probes in patients receiving enteral nutrition. The overall objective was to investigate the preparation pattern and drugs administration through tubes in patients receiving concomitant enteral nutrition. The specific objectives were to present the medications profile prepared and administered in accordance with the possibility to be administered by enteral probes and assess the errors type and frequency that occur in the medicines preparation and administration by probes. This was a cross-sectional survey of the observational nature without intervention model. It was developed in a hospital in Rio de Janeiro city, Brazil, observing practical nurses preparing and administering medications through tubes in the Intensive Care Unit. We observed the preparation of 350 medicines doses and subsequent administration to the patients. The prevalent drug groups were those acting on Cardiovascular Renal System with 164 doses (46.80%), followed by those acting on the Respiratory System and Blood with 12.85% and 12.56% respectively. We found 19 different drugs from the first group, two from the second group, and five in the third one. The error categories in the preparation were milling, mixing and dilution. We found a mean rate of 67.71% in medication preparation. Simple tablets were prepared by wrong way in 72.54% of the doses and all coated tablets and those of extended release were crushed incorrectly. Among solids, the prevalent error category was milling with 45.47%. The preparation by mixing drugs was an error in almost 40% from the solid drugs doses. The insufficient grinding occurred in 73.33% from the folic acid doses, amiodarone hydrochloride (58.97%), and from bromopride (50.00%). Mixing with other drugs occurred in 66.66% from bromopride doses, amlodipine besylate (53.33%), bamifilina (43.47%), folic acid (40.00%), and acetylsalicylic acid (33.33 %). The administration errors were no breaks and improper probe handling. The average errors rate of administration was 32.64%, being 17.14% for pause and 48.14% for the probe handling. Failure to wash the probe before administration was the most common mistake and not to wash the probe after that was the most unusual. The drugs most commonly involved in errors in the administration were amiodarone hydrochloride (n=39), captopril (n=33), hydralazine hydrochloride (n=7), and levothyroxine sodium (n=7). In 330 medication dosages, the probes were not washed, before the administration. The drugs inadequate preparation and administration can lead to losses in bioavailability, decreased serum levels, and risk of patient poisoning. Preparing and administering medications is a common procedure but showed high error rates, maybe reflecting little knowledge from these professionals about the best practices in drug therapy. There is a need for greater investment by all involved professionals, doctors, nurses, and pharmacists on issues involving the drug safety and rethink the process of nursing work.

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Bittencourt, Amanda Figueiredo. "Diarreia e constipação intestinal em terapia nutricional enteral." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-17102013-143334/.

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Introdução: Complicações gastrointestinais na terapia nutricional enteral são frequentes e podem afetar negativamente o desfecho de pacientes hospitalizados. Entre os principais problemas gastrointestinais observados na terapia nutricional enteral destacam-se a diarreia e a constipação intestinal, tema principal do presente estudo. Variáveis relacionadas aos pacientes, terapia medicamentosa e a própria terapia nutricional podem ser fatores predisponentes de diarreia e constipação intestinal. O objetivo do presente estudo foi identificar a frequência de diarreia e constipação intestinal em pacientes em terapia nutricional enteral exclusiva internados em hospital geral no Brasil e estudar os fatores associados a estes eventos. Método: Estudo monocêntrico, sequencial de inclusão aleatória e observacional que avaliou, de forma prospectiva e diária, a ocorrência de diarreia e constipação intestinal em pacientes em terapia nutricional enteral exclusiva durante 21 dias. Estudou-se o comportamento de variáveis relacionadas aos pacientes, a influência da terapia medicamentosa e o tipo de fórmula de nutrição enteral. Os pacientes foram categorizados retrospectivamente quanto a evacuação diária em: grupo D (diarreia; definida como três ou mais evacuações no período de 24h); grupo C (constipação intestinal, definida como menos do que uma evacuação em três dias) e grupo N (ausência de diarreia e constipação intestinal). Analisou-se a terapia medicamentosa administrada aos pacientes de acordo com cada classe terapêutica e quantidade recebida. Também se avaliou a presença de fibras na composição de fórmulas de nutrição enteral. Resultados: Dos 110 pacientes analisados, observou-se constipação intestinal em 70,0% (77), diarreia em 12,7% (14) e em apenas 17,3% (19) dos pacientes houve ausência de diarreia e constipação intestinal. A única variável associada à frequência de diarreia foi a terapia medicamentosa. Houve associação entre os medicamentos anti-inflamatórios não esteroidais e diarreia em pacientes que fizeram uso de fórmula de nutrição enteral sem fibras (p=0,021). No grupo constipação intestinal, a internação na UTI e insuficiência respiratória foram variáveis significativas (p=0,036 e p=0,003277, respectivamente). Houve associação também entre os medicamentos antagonistas H2 e constipação intestinal em pacientes que fizeram uso de fórmula de nutrição enteral sem fibras (p=0,013). Fórmula de nutrição enteral com fibra esteve associada à prevenção da constipação intestinal. A classe terapêutica de antidopaminérgico mostrou efeito benéfico na prevenção da diarreia (p=0,023) e de constipação intestinal (p=0,022) quando comparados com grupo N. Conclusão: A constipação intestinal foi mais frequente que diarreia em pacientes em TNE exclusiva, principalmente quando foi usada fórmula de nutrição enteral sem fibras. A classe terapêutica de medicamentos anti-inflamatórios não esteroidais associou-se à diarreia em pacientes que fizeram uso de fórmula de nutrição enteral sem fibras. A constipação intestinal esteve associada à internação na UTI, à indicação de TNE por necessidade de ventilação mecânica e a classe terapêutica de medicamentos antagonistas H2 em pacientes que fizeram uso de fórmula de nutrição enteral sem fibras. A prescrição de medicamentos pró-cinéticos se mostrou benéfica na prevenção de diarreia e constipação intestinal, assim como o acréscimo de fibras na fórmula de nutrição enteral associou-se à prevenção de diarreia e constipação intestinal influenciados pela terapia medicamentosa
Introduction: Digestive complications in enteral nutrition (EN) are frequent and can affect negatively in the clinical outcome of hospitalized patients. Diarrhea and constipation are the main gastrointestinal problems presented in these cases. Variables related to patients, drug therapy and nutritional therapy itself might be predisposing factors for diarrhea and constipation. The aim of this study was to analyze and assess the frequency and risk factors associated with diarrhea and constipation in hospitalized patients receiving exclusive EN therapy in a general hospital. Method: The authors performed a monocentric study, sequential with random inclusion that evaluated prospectively by observation the daily occurrence of diarrhea and constipation in hospitalized adult patients fed exclusively by EN through a feeding tube for 21 days. Variables related to patients, the influence of drug therapy and type of enteral formula were studied too. Patients were categorized retrospectively as evacuation daily: group D (diarrhea, 3 or more watery evacuations in 24 hours), group C (constipation, less than 1 evacuation during 3 days), and group N (absence of diarrhea or constipation). All prescription drugs were recorded, and patients were analyzed according to the type and amount of medication received. The authors also investigated the presence of fiber in the enteral formula. Results: Among the 110 patients included in the study, patients classified in group C represented 70.0% (77) of the study population; group D comprised 12.7% (14), and group N represented 17.3% (19). The only variable associated with frequency of diarrhea was drug therapy. There was an association between anti-inflammatory drugs and diarrhea in patients who used formula for enteral nutrition without fiber (p=0.021). In the constipation group, the ICU admission and orotracheal intubation as the indication for EN were significant variables (p=0.036 and p=0.003277, respectively). There was also an association between H2 drugs antagonists and constipated patients who used formula for enteral nutrition without fiber (p=0.013). Enteral nutrition formula with fiber was associated to prevention of constipation. The antidopaminergic therapeutic class showed beneficial effect in the prevention of diarrhea (p=0.023) and constipation (p=0.022) when compared with group N. Conclusion: Constipation was more frequent than diarrhea in patients fed exclusively by EN through a feeding tube, especially when it was used enteral nutrition formula without fiber. The therapeutic class of anti-inflammatory drugs was associated with diarrhea in patients who used formula for enteral nutrition without fiber. Constipation was associated with ICU admission, TNE indication for mechanical ventilation and therapeutic class of H2 drugs antagonists in patients who used formula for enteral nutrition without fiber. The prescription of prokinetic drugs seems to be beneficial in the prevention of diarrhea and constipation, as well as the addition of fiber in enteral nutrition formula was associated with prevention of diarrhea and constipation influenced by drug therapy

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Malone, Frances R. "Luminal nutrition during hepatopoietic cell transplantation and its effects on indices of intestinal barrier function in children and adults /." Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/7344.

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Joubert, Polly Ann. "Production of enteral feeds : manual vs mechanised vs 'ready to hang'." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53560.

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Thesis (Mnutr)--Stellenbosch University, 2003.
ENGLISH ABSTRACT: INTRODUCTION Many patients seen by dietitians in Tygerberg Academic Hospital require feeding via the enteral route. Prior to this study all enteral feeds were mixed individually by hand, and production was time consuming and very labour intensive. The purpose of this study was, therefore, to compare the current method of production, with mechanised bulk production (MP) and "Ready to hang" (RTH) products, taking time, safety and cost effectiveness into consideration. MATERIALS AND METHODS A machine was designed and built to produce and decant bulk volumes of enteral feed. Production methods were evaluated and data was obtained regarding the time taken to produce a feed, and the true cost of the feeds produced. Microbiological samples were collected and the safety of all the three systems was determined and compared. RESULTS MP production time was significantly longer than hand production (HP), but MP decanting was significantly more accurate. RTH feeds cost 152% more than HP feeds, and MP feeds cost 95% of HP feeds. Seventy-one per cent of HP feeds, 74% of MP feeds and 34% of RTH feeds were contaminated just after administration had began. CONCLUSIONS Mechanisation is less labour intensive than HP and helps to decrease total costs. RTH feeds quickly become contaminated after administration decreasing their other advantages.
AFRIKAANSE OPSOMMING: IN L E ID IN G Baie van die pasiente wat deur dieetkundiges in Tygerberg hospitaal gesien word, benodig buisvoedings. Vo or hierdie studie geloots was, was alle buisvoedings by Tygerberg hospitaal met die hand gemaak. Hierdie metode is baie tydsaam en arbeidsintensief. Die doel van hierdie studie was, om die voorlopige sisteem van produksie te vergelyk met gemeganiseerde grootmaat produksie en "ready to hang" (RTH). Die studie het die volgende in ag geneenv produksietyd, mikrobiologiese veiligheid en koste effektieweteit. METODE 'n Masjien was ontwerp en gebou om grootmaat buisvoedings aan te maak en aftegiet. Produksie metodes was geevalueer en inligting bymekaar gemaak met betrekking tot produksietyd, en die ware koste van die voedings. Mikrobiologiese monsters was versamel en die mikrobiologiese veiligheid van al drie sisteme is bepaal en vergelyk. RESULTATE Produksie met die masjien was betekenisvol longer as die voedings wat met die hand gemaak was, maar die masjien het betekenisvol meer akkuraat afgemeet met afgiet. RTH voedings se koste beloop 152% meer as voedings wat met die hand gemaak word, en voedings wat deur die masjien gemaak word kos 95% van die wat met die hand gemaak is. Een en sewentig persent van die voedings wat met die hand gemaak was, 74% van die masjiengemaakte voedings en 34% van die RTH voedings was besmet net na toediening begin was. GEVOLGTREKKINGS Meganisasie is minder arbeidsintensief as voedings wat met die hand gemaak is en help om die kostes af te bring. RTH voedings word vinnig besmet met organismes na die begin van toediening en dit verminder hulle ander voordele.

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Листопад, А. О., and Т. М. Попова. "Особливості ентерального харчування новонароджених дітей в критичних станах." Thesis, Сумський державний університет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/42206.

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Ентеральне харчування - це тип лікувального чи додаткового харчування спеціальними сумішами, при якому всмоктування їжі здійснюється фізіологічно адекватним шляхом. Мета ентерального харчування - забезпечення організму необхідними для росту і розвитку поживними речовинами.

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Kruger, Jeanne-Marie. "Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit." Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/1943.

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Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006.
INTRODUCTION: The primary objective was to determine whether acidified formulae (pH 3.5 and 4.5) decreased gastric and tracheal colonisation, as well as microbial contamination of the enteral feeding delivery system, compared with a non-acidified control formula (pH 6.8) in critically ill patients. Secondary objectives included tolerance of the trial formulae and mortality in relation to the administration of acidified formulas. DESIGN: The trial was a controlled, double-blinded, randomised clinical trial of three parallel groups at a single centre. METHOD: Sixty-seven mechanically ventilated, medical and surgical critically ill patients were randomised according to their APACHE II scores and included in the trial. Patients received either an acidified (pH 3.5 or 4.5) or control polymeric enteral formula via an 8-Fr nasogastric tube at a continuous rate. Daily samples were taken for microbiologic analyses of the enteral formulae at various stages of reconstitution and at 6-hour and 24-hour intervals during administration thereof (feeding bottle and delivery set). Daily patient samples included nasogastric and tracheal aspirates, haematological evaluation and gastro-intestinal tolerance. The trial period terminated when patients were extubated, transferred from the ICU, enteral nutrition became contraindicated, a patient died, or for a maximum of 21 days. RESULTS: Gastric pH showed no significant difference (p = 0.86) between the 3 feeding groups [pH 3.5 (n = 23), pH 4.5 (n = 23) and pH 6.8 (n = 21)] at baseline prior to the administration of enteral formulae. After initiation of feeds, the gastric pH decreased significantly (p< 0.0001) in the acidified formulae as compared to the control formula during the trial period. Patients who received acidified enteral formulae (pH 3.5 and 4.5) had significantly less (p < 0.0001) contamination from the feeding bottles and delivery systems in respect of Enterobacteriacea, and Enterococcus., The more acidified group (pH 3.5) showed significantly less gastric contamination (p = 0.029) with Enterobacteriacea, , but not for fungi. The 3.5 acidified group also had the lowest gastric growth in terms of colony counts (≤104) of these organisms, but not for fungi, when compared to the control group (≤105). Vomiting episodes were 22% and abdominal distension 12%, with a higher incidence in the control group. Adverse events occurred equally between the groups with a higher, but not significantly different incidence of 37% in the control group and 32% for the acidified groups. There was no evidence of gastro-intestinal bleeding in any patient. Overall, the mortality rate in this trial was 6%, with 6.5% for the acidified groups (n=46) and 4.8% for the control group (n=21), a statistically insignificant difference. CONCLUSION: Acidified enteral formulae significantly decrease gastric colonisation by preserving gastric acidity that decreases the growth of Enterobacteriaceaes organisms. Acidified formulae significantly decrease bacterial contamination of the enteral feeding system (bottle and delivery set) of Enterobacteriaceae and Enterococcus organisms. Acidified formulae are tolerated well in critically ill patients.

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Campos, Francimary de Alencar. "ConstruÃÃo e validaÃÃo de protocolo de terapia de nutriÃÃo enteral." Universidade Federal do CearÃ, 2013. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10925.

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Este estudo trata da construÃÃo e validaÃÃo de um protocolo de terapia de nutriÃÃo enteral para pacientes adultos em uso de sonda enteral. Ã um estudo metodolÃgico, em que, na sua primeira fase, realizou-se a revisÃo integrativa da literatura a respeito da atuaÃÃo do enfermeiro frente a um paciente adulto com indicaÃÃo de terapia de nutriÃÃo enteral. Para tanto, se procedeu Ã busca de estudos em bases de dados nacionais e internacionais, onde foram selecionados 36 estudos que atenderam aos critÃrios de inclusÃo, nas bases de dados SCIELO, LILACS, LEYES, MEDLINE, CINAHL e BDTD, apÃs o cruzamento dos descritores controlados: nutriÃÃo enteral, alimentaÃÃo enteral e terapia nutricional, e suas traduÃÃes em inglÃs e espanhol. A leitura e a sÃntese dos estudos apontaram para quatro linhas de atuaÃÃo relacionadas Ã TNE que orientaram na operacionalizaÃÃo da construÃÃo do protocolo. A coleta de dados com os especialistas aconteceu no perÃodo de junho a setembro de 2012, sendo usado um formulÃrio contendo dados referentes aos especialistas e dados avaliativos do protocolo. O estudo respeitou os preceitos Ãticos e recebeu a aprovaÃÃo do ComitÃ de Ãtica em Pesquisa da Universidade Federal do CearÃ sob Protocolo de nÃmero 05/12. A primeira versÃo do instrumento foi composta de duas seÃÃes. A primeira Ã composta de 20 itens distribuÃdos em seis domÃnios e se refere ao critÃrio de indicaÃÃo da TNE, qual tipo de sonda: oro ou nasoenteral, e ao procedimento da sua inserÃÃo, como deve ser a administraÃÃo de dieta e medicamentos. A segunda seÃÃo possui sete domÃnios com 12 itens que ilustram as situaÃÃes em que pode ocorrer a interrupÃÃo da dieta. O protocolo foi avaliado por meio de cinco itens, que correspondiam a cinco nÃveis de respostas possÃveis dispostas em uma escala de Likert variando de 1 a 5, sendo considerados: 1- inadequado e 5- totalmente adequado. Procedeu-se Ã anÃlise teÃrica do protocolo, submetendo-se Ã avaliaÃÃo de 15 especialistas. ApÃs os testes estatÃsticos (coeficiente α de Cronbach e Ãndice de Validade de ConteÃdo) e as alteraÃÃes decorrentes das sugestÃes dos especialistas, obteve-se a segunda versÃo do protocolo formada por duas seÃÃes com 21 itens na primeira seÃÃo, distribuÃdos nos seis domÃnios, e 12 itens na segunda seÃÃo, distribuÃdos em seis domÃnios, e tambÃm com remodulaÃÃo dos itens apÃs anÃlise criteriosa das sugestÃes. Conclui-se, portanto, que foi possÃvel construir um protocolo de TNE e que o mesmo envolve e representa o conteÃdo do constructo que se pretende, pois o coeficiente de correlaÃÃo intraclasse foi α=0,83. Pode-se concluir que a versÃo final do protocolo Ã vÃlida para usar na prÃtica hospitalar.

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Cervo, Anamarta Sbeghen. "EVENTOS ADVERSOS EM TERAPIA NUTRICIONAL ENTERAL." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/7388.

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This study aims to determine the occurrence of adverse events related to the use of enteral nutrition in patients hospitalized at the University Hospital of Santa Maria (HUSM), based on the quality indicators. This is an exploratory study, longitudinal, descriptive study with a quantitative approach. Follow-up of 46 adult patients of both sexes aged was conducted from 18 years in the use of enteral nutritional therapy in the Intensive Care Unit and Adult Medical Clinic II, in the period January-May 2012. To collect the a semistructured data form with information about the identification data, sociodemographic and data quality indicators (inadvertent output, tube obstruction and received diet volume) was used. Among the patients treated there was a predominance of males (71.7%), aged between 41 and 80 years (69.6%), skin color / Caucasians (93.6%), single (51.1 %) with incomplete 1st grade (53.2%) and from Santa Maria (53.2%). The diagnoses had a higher frequency were related to neurological disorders (N = 18), respiratory (N = 12) and neoplastic (N = 12). The average number of days in which patients used the probe to enteral feeding was 18.5 days (SD = 8.6), minimum of three and maximum of 30 days. Among the reasons that led to the suspension of the diet are: pause for body care (N = 2, 2.4%), exams and procedures (N = 46, 54.8%), for nausea and vomiting (N = 29 , 34.5%) and delay in installation of new bottle for not available in the unit (N = 7, 8.3%). In the study period 39 inadvertent exits the probe and tube obstruction occurred, showing incidence rates of 4.6% and 2.1%, respectively. On average, patients stopped receiving 176.4 ml (± 117.8), with a median of 81.4 ml. 72 drugs administered by tube feeding of patients who used NE were also identified. We conclude that the use of quality indicators in nursing constitutes a useful tool to assess the quality of care.
Este estudo tem como objetivo verificar a ocorrência de eventos adversos relacionados ao uso de nutrição enteral em pacientes internados no Hospital Universitário de Santa Maria (HUSM), tendo por base os indicadores de qualidade. Trata-se de um estudo exploratório, longitudinal, descritivo, com abordagem quantitativa. Foi realizado acompanhamento de 46 pacientes adultos de ambos os sexos com idade a partir de 18 anos, em uso de terapia nutricional enteral, na Unidade de Terapia Intensiva Adulto e Clínica Médica II, no período de janeiro a maio de 2012. Para a coleta dos dados foi utilizado um formulário semiestruturado com informações sobre os dados de identificação, caracterização sociodemográfica e dados sobre os indicadores de qualidade (saída inadvertida, obstrução da sonda e volume recebido da dieta). Dentre os pacientes acompanhados houve predomínio do sexo masculino (71,7%), com faixa etária entre 41 e 80 anos (69,6%), de cor da pele/raça branca (93,6%), solteiros (51,1%), com 1º grau incompleto (53,2%) e procedentes de Santa Maria (53,2%). Os diagnósticos que apresentaram maior frequência estavam relacionados aos distúrbios neurológicos (N=18), respiratórios (N=12) e neoplásicos (N=12). A média de dias em que os pacientes utilizaram a sonda para alimentação enteral foi de 18,5 dias (DP= 8,6), mínimo de três e máximo de 30 dias. Dentre os motivos que levaram à suspensão da dieta estão: pausa para higiene corporal (N=2; 2,4%), realização de exames e procedimentos (N=46; 54,8%), por náusea e vômito (N=29; 34,5%) e demora na instalação de novo frasco por não haver disponível na unidade (N=7; 8,3%). No período avaliado ocorreram 39 saídas inadvertidas da sonda e uma obstrução da sonda, evidenciando taxas de incidência de 4,6% e 2,1%, respectivamente. Em média os pacientes deixaram de receber 176,4 ml (±117,8), com mediana de 81,4 ml. Também foram identificados 72 medicamentos administrados pela sonda de alimentação dos pacientes que fizeram uso de NE. Conclui-se que o uso de indicadores de qualidade na enfermagem se constitui em uma ferramenta útil para avaliar a qualidade da assistência.

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Sands, Joyce Ann 1958. "THE INCIDENCE OF PULMONARY ASPIRATION IN INTUBATED PATIENTS RECEIVING ENTERAL NUTRITION THROUGH WIDE- AND NARROW-BORE NASOGASTRIC FEEDING TUBES." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/276693.

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Castro, Melina Gouveia. "A influência da introdução de um programa de educação médica em terapia nutricional no desfecho dos pacientes em uma unidade intensiva." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-26102012-114000/.

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A terapia nutricional mostra-se de grande importância no tratamento do doente crítico, por apresentar impacto favorável em seu desfecho clínico. No entanto, até 70% dos pacientes em unidade de terapia intensiva podem não receber terapia nutricional adequada. Isso ocorre, em parte, pela falta de formação e de conhecimento dos profissionais de saúde sobre princípios de nutrição clínica. O objetivo do presente estudo foi avaliar o impacto da introdução de um programa de educação médica em terapia nutricional em uma unidade de terapia intensiva sobre a qualidade da terapia nutricional e os resultados clínicos de seus pacientes. O presente estudo foi desenvolvido em três fases distintas: 1) Pré-programa educacional (PP): 50 pacientes recém-admitidos em unidade de terapia intensiva foram selecionados consecutivamente para avaliação da qualidade da terapia nutricional a eles oferecida e seus desfechos clínicos, através de visitas periódicas. 2) Programa Educacional (PE): foram criados protocolos nutricionais específicos. Um programa de educação em terapia nutricional baseado nesses protocolos (palestras, workshops e discussões à beira leito) foi introduzido nessa unidade de terapia intensiva. 3) Pós-programa educacional (PO): a qualidade da terapia nutricional e os desfechos clínicos de um segundo grupo de 50 pacientes foram avaliados, utilizando-se a mesma metodologia da fase 1 (PP). Os marcadores utilizados para avaliação da qualidade da terapia nutricional foram: avaliação nutricional, adequação da oferta de energia, tempo de jejum e introdução de nutrição enteral precoce. Tempo de permanência na unidade de terapia intensiva e tempo de internação hospitalar foram registrados e avaliados como desfechos clínicos principais. Os pacientes da fase PP e PO não diferiram em idade, APACHEII, sexo, tipo de diagnóstico na admissão e avaliação nutricional. Observou-se redução no tempo de jejum (PP 3,8 dias ± 3,1 vs PO: 2,2 dias ± 2,6; p = 0,002), melhora na adequação calórica (PP 74,2% ± 33,3 vs PO 96,2 ± 23,8%; p <0,001) e aumento da indicação de nutrição enteral precoce (PP 24% vs PO 60%; p = 0,001) nos pacientes da fase PO, em comparação com os pacientes da fase PP. Além disso, o tempo de permanência na unidade de terapia intensiva foi menor (PP: 21,9 dias ± 15,2 vs PO: 12,2 dias ± 8,0; p <0,001) nos pacientes da fase PO, em comparação com os pacientes da fase PP. Não houve alteração significativa no tempo de internação hospitalar. A introdução de um modelo de educação em terapia nutricional em uma unidade de terapia intensiva melhorou a qualidade da terapia nutricional e diminuiu o tempo de permanência de seus pacientes
In critically ill patients, nutritional therapy favorably impacts clinical outcomes. However, up to 70% of patients in the intensive care unit do not receive adequate nutritional therapy, due, partially, to the lack of training and knowledge regarding nutrition principles among healthcare providers. The aim of this study was to evaluate the impact of a medical educational program in an intensive care unit on the quality of the nutritional therapy and clinical outcomes. The study protocol was developed among three distinct phases: 1) Pre-educational program (Pre-EP): 50 patients newly admitted to the intensive care unit were consecutively selected to assess their regular performed nutritional therapy and clinical end-points. 2) Educational program (EP): specific nutritional protocols were created and an education program (lectures, workshops and bedside discussions) were implemented. 3) Post educational program (Post-EP): a second group of 50 patients was enrolled and observed using the same phase 1 (Pre-EP) methodology. Nutritional therapy practice was evaluated through the application of specific quality indicators and the evaluation of nutritional therapy-related complications, considering as main markers the nutritional assessment, adequacy of energy requirement, duration of fasting and use of early enteral nutrition. Intensive care unit length of stay and hospital length of stay were recorded and measured as primary end-points. The Pre-EP and Post-EP patients did not differ in age, APACHEII, gender, admission diagnosis (surgery x medical) and nutritional assessment. Duration of fasting decreased (Pre-EP 3.8 days ±3.1 vs. Post-EP: 2.2 days ±2.6; p=0.002), the adequacy of nutritional therapy improved (Pre-EP 74.2% ±33.3 vs. Post-EP 96.2%±23.8; p<0.001) and enteral nutrition was earlier initiated (Pre-EP 24% vs. Post-E 60%; p=0.001). Intensive care unit length of stay also decreased (Pre-EP: 21.9 days±15.2 vs Post-EP: 12.2 days ±8.0; p<0.001). No changes were observed in hospital length of stay. Conclusion: Implementing a medical nutrition educational model in an intensive care unit improved the quality of nutritional therapy and decreased the length of stay of their patients

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Fell, John Michael Edgar. "Intestinal mucosal inflammation in paediatric Crohn's disease and its response to treatment with enteral nutrition." Thesis, Queen Mary, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272183.

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Duffy, Amanda. "Malnutrition, hospitalisation and enteral nutrition use in head and neck cancer patients: A retrospective study." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/18717.

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Purpose: The primary aim of this thesis was to analyse body mass index (BMI) and enteral nutrition (EN) use as predictors of weight change and hospital admissions during radiotherapy in patients with head and neck cancer (HNC). A secondary aim was to develop guidelines for the selection of appropriate nutritional interventions. Methods: A narrative literature review of nutritional interventions used during treatment of HNC was completed. A retrospective chart review of patients treated with radiotherapy for HNC between October 2012 and April 2014 was conducted. Data on each subject’s diagnosis, age, sex, treatment modality, EN use and BMI were examined for their association with weight changes and hospital admissions during treatment. Results: Eighty-three patients were included, mean age ±standard deviation was 61 ±11 years. Thirty-four percent had self-reported weight loss at diagnosis, and mean BMI was 26.2 ± 5.3 kg/m2. Mean weight change during treatment was -5.1 ± 6.2%. Ten patients used EN, with mean weight stabilisation during EN use (0.3 ± 5.1%). Higher presenting BMI, younger age and definitive radiotherapy ± chemotherapy predicted greater weight loss (p<0.05). Critical weight loss ≥ 5% was associated with a higher number of hospital admissions for nutrition reasons (n=10) (p=0.011) compared to those without critical weight loss (n=2). EN use was associated with a higher number of nutrition related admissions; however, it did not predict length of stay amongst those admitted. Conclusion: Critical weight loss during radiotherapy is a predictor of unplanned nutrition related hospital admissions. Higher BMI and younger age were associated with greater weight loss during radiotherapy, whilst EN assisted in weight preservation. A decision tool guiding patient selection for EN at the point of diagnosis warrants further investigation for its merits in minimising critical weight loss and hospital admissions during radiotherapy.

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Penniman, Elizabeth Pash. "The Effect of Early Enteral Nutrition on the Number of Mechanical Ventilation Days and Length of Stay in the Coronary Intensive Care Unit." University of Akron / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=akron1204755021.

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Figueredo, Luana Prado. "Complicações da Terapia Nutricional Enteral (TNE) e fatores associados em pacientes hospitalizados." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-21062011-152352/.

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Trata-se de um estudo observacional, retrospectivo, cujo objetivo foi descrever o perfil dos pacientes e características da Terapia Nutricional Enteral (TNE) bem como analisar as complicações dessa terapia e os fatores associados em pacientes adultos hospitalizados. O estudo constituiu-se de uma amostra de 214 pacientes internados, no período de 2008 e 2009, em um hospital universitário do Município de São Paulo. Os dados foram coletados dos prontuários e das fichas de avaliação nutricional, em um formulário elaborado para o estudo. Os resultados permitiram verificar que: 1 a-) em relação ao perfil dos pacientes e terapia nutricional enteral, houve predominância do sexo masculino (55,6%), com média de idade de 64,8 anos; internados em unidades de semi-intensiva e UTI (66,8%). b-) Referente à terapia nutricional enteral, a média de dias de nutrição enteral foi de 13,2 dias, e 43,5% dos pacientes receberam-na em até uma semana. Quanto à via de acesso enteral, predominaram as sondas nasoenterais (96,3%) e o método de administração contínuo da dieta (67,3%). 2-) em relação às complicações da TNE e os eventos observados - dos 214 pacientes da amostra, em 200 deles houve complicações durante o uso da nutrição enteral. Verificou-se a ocorrência de complicações: gastrointestinal (90,5%), metabólica (55,0%), mecânica (41,5%) e pulmonar (13,0%). Os eventos observados mais frequentes da complicação gastrointestinal foram: distensão abdominal (33,4%), constipação (17,5%) e alto volume residual gástrico (14,6%). Na complicação metabólica, o evento observado foi hiperglicemia (55,0%), com valor médio de 174,2 mg/dL. Os eventos observados predominantes da complicação mecânica foram: saída não programada da sonda enteral (70,5%), seguida de obstrução da sonda enteral (19,0%). Na complicação pulmonar, a aspiração pulmonar (13,0%) foi o evento observado. 5-) Quanto ao método de infusão houve associação significativa da infusão contínua com os seguintes eventos observados na complicação gastrointestinal: alto VRG (p=0,000), constipação (p=0,010), distensão abdominal (p=0,037). Na complicação mecânica, houve associação significativa com a infusão intermitente nos seguintes eventos: saída não programada da sonda enteral (p=0,005) e deslocamento da sonda enteral (p=0,040). 6-) Quanto à terapia medicamentosa, houve associação significativa da complicação metabólica (hiperglicemia) e o uso de sedativos/opioides (p=0,000) e drogas vasoativas (p=0,000). Este estudo demonstrou que as complicações coexistentes com a TNE são muito prevalentes nesta população (93,5%). Além disso, verificou-se que existe elevada ocorrência de eventos observados (617), sendo as complicações (400) que apresentaram intersecções significativas com outras variáveis acima descritas. Portanto, investigações das condições clínicas, as terapêuticas e os cuidados no uso da sonda enteral devem ser reiteradamente indicadas, sobretudo para os enfermeiros que são responsáveis pela administração e monitoramento da nutrição enteral.
This observational and retrospective study aimed to describe the profile of patients and the characteristics of the Enteral Nutrition Therapy (ENT), as well as to analyze the complications of this therapy and the associated factors in hospitalized adult patients. The study consisted of a sample of 214 patients, hospitalized between 2008 and 2009 at a university hospital in the city of São Paulo. Data were collected from medical records and of nutritional assessment sheets, using a form developed for the study. Results showed that: 1 a-) in relation to patient profiles and enteral nutrition therapy participants were predominantly male (55.6%), with an average age of 64.8 years, hospitalized in semi-intensive and intensive care units (66.8%); b-) Concerning enteral nutrition therapy, the average days of enteral nutrition was 13.2 days, and 43.5% of the patients received it for up to one week. As for the route of enteral access, nasoenteric feeding tube (96.3%) and continuous feeding administration (67.3%) were the most common. 2 -) regarding the complications of ENT and the observed events of the 214 patients of the sample, 200 had complications during the use of enteral nutrition. There was occurrence of gastrointestinal (90.5%), metabolic (55.0%), mechanical (41.5%) and pulmonary (13.0%) complications. The most frequently observed events among gastrointestinal complication were: abdominal distention (33.4%), constipation (17.5%) and high gastric residual volume (GRV) (14.6%). Among the metabolic complication, hyperglycemia (55.0%) was observed, with average of 174.2 mg/dL. The predominant events resulting from mechanical complication were unexpected withdrawal of enteral feeding tube (70.5%), followed by obstruction of enteral feeding tube (19.0%). As for pulmonary complication, pulmonary aspiration (13.0%) was the observed event. 5-) Concerning the method of infusion, there was significant association of continuous infusion with the following events observed in gastrointestinal complication: high GRV (p=0.000), constipation (p=0.010) and abdominal distension (p=0.037). Among the mechanical complication, there was significant association with intermittent infusion at the following events: unexpected withdrawal of enteral feeding tube (p=0.005) and displacement of enteral feeding tube (p=0.040). 6-) Regarding drug therapy, there was significant association of metabolic complication (hyperglycemia) and use of sedatives/opioids (p=0.000) and vasoactive drugs (p=0.000). This study evidenced that complications concomitant with ENT are very prevalent in this population (93.5%). Moreover, it was found that there is a high occurrence of observed events (617), with complications (400) presenting significant intersections with other variables described above. Therefore, research on the clinical conditions, treatments and care to the use of enteral feeding tubes should be constantly indicated, particularly for nurses who are responsible for the administration and monitoring of enteral nutrition.

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Mansfield, Allison N. "Nutrition Support Protocols and Early Feeding in the Intensive Care Unit." Bowling Green State University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1210191094.

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Dissertations / Theses on the topic 'Enteral nutrition'

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