Nutrition Support

• Fluid and electrolyte requirements.

• Calculate enteral and parenteral nutrition formulations.

Nutrition Support

• Pt can’t meet nutritional needs by normal oral ingestion of food for greater than 5 - 7 days.

NS Methods

• Add snack between meals

• Add high kcal or protein supplements at meals

• Enteral supplement via tube feeding

Two Types NS

• Enteral– still use the gut

• Parenteral– DO NOT use the gut– veins

Dx and NS

• Strong data for NS– Acute renal failure - ENS/PNS– Prolonged acute pancreatitis - ENS/PNS– Acute respiratory failure - ENS/PNS

Dx and NS

• Strong data for NS– Acute Crohn’s disease - PNS– Short bowel syndrome - PNS/ENS– Severely malnourished - ENS– Entercutaneous fistulas - PNS

Dx and NS

• Moderate data for NS– Acute alcoholic liver disease - ENS– Stable COPD and CF - ENS– Chronic Crohn’s - ENS– Acute ulcerative colitis - ENS/PNS

NS

• Figure 59-1 from Cecil’s here

• Selecting the route of nutritional support

Selecting route of nutritional support

• What questions to ask to determine route of NS?

• What happens if you don’t use the gut and it is functioning?

END NS General

• Questions?