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Terapia nutricional enteral em pacientes sépticos na unidade de terapia intensiva: adequa o às diretrizes nutricionais para pacientes críticos Enteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients  [cached]
Valeska Fernandes Pasinato,Marina Carvalho Berbigier,Bibiana de Almeida Rubin,Kamila Castro
Revista Brasileira de Terapia Intensiva , 2013,
Abstract: OBJETIVO: Avaliar a adequa o do manejo nutricional do paciente séptico a diretrizes de nutri o enteral para pacientes críticos. MéTODOS: Estudo de coorte prospectivo com 92 pacientes sépticos, idade ≥18 anos, internados em unidade de terapia intensiva, em uso de nutri o enteral, avaliados segundo diretrizes para pacientes críticos quanto à nutri o enteral precoce, adequa o calórica e proteica, e motivos para n o início da nutri o enteral precoce bem como de interrup o da mesma. Escores prognósticos, tempo de interna o, evolu o clínica e estado nutricional também foram analisados. RESULTADOS: Pacientes com idade média de 63,4±15,1 anos, predominantemente masculinos, diagnóstico de choque séptico (56,5%), tempo de interna o na unidade de terapia intensiva de 11 (7,2 a 18,0) dias, escores SOFA de 8,2±4,2 e APACHE II de 24,1±9,6 e mortalidade de 39,1%. Em 63% dos pacientes, a nutri o enteral foi iniciada precocemente. Cerca de 50% atingiu as metas calóricas e proteicas no 3o dia de interna o na unidade de terapia intensiva, percentual que foi reduzido para 30% no 7o dia. Motivos para início da nutri o enteral tardia foram complica es do trato gastrintestinal (35,3%) e instabilidade hemodinamica (32,3%). Procedimentos foram o motivo mais frequente para interrup o da nutri o enteral (44,1%). N o houve associa o entre a adequa o às diretrizes com estado nutricional, tempo de interna o, gravidade ou evolu o. CONCLUS O: Embora expressivo o número de pacientes sépticos que iniciaram a nutri o enteral precocemente, metas calóricas e proteicas no 3o dia da interna o foram atingidas apenas pela metade destes, percentual que diminui no 7o dia. OBJECTIVE: Evaluate the compliance of septic patients' nutritional management with enteral nutrition guidelines for critically ill patients. METHODS: Prospective cohort study with 92 septic patients, age ≥18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores, length of intensive care unit stay, clinical progression, and nutritional status were also analyzed. RESULTS: The patients had a mean age of 63.4±15.1 years, were predominantly male, were diagnosed predominantly with septic shock (56.5%), had a mean intensive care unit stay of 11 (7.2 to 18.0) days, had 8.2±4.2 SOFA and 24.1±9.6 APACHE II scores, and had 39.1% mortality. Enteral nutrition was initiated early in 63%
Adequa??o do suporte nutricional na terapia nutricional enteral: compara??o em dois hospitais
Nozaki, Vanessa Taís;Peralta, Rosane Marina;
Revista de Nutri??o , 2009, DOI: 10.1590/S1415-52732009000300004
Abstract: objective: the objective of this study was to assess the nutritional status of inpatients and compare the enteral feeding practices of two general hospitals in the metropolitan region of maringá (pr), brazil. methods: the study included 62 patients of both sexes on exclusive enteral feeding. the data were collected in two general hospitals. the energy requirements of the patients were estimated using the equations proposed by harris & benedict and the european society for clinical nutrition and metabolism recommendation. the nutritional status of the patients was determined by anthropometric assessment. results: high rates of malnutrition were found in both hospitals, especially when the mid-arm muscle area was used as the indicator of nutritional status. the energy prescription was adequate for 45.71% and 40.74% of the patients of hospitals 1 and 2, respectively. conclusion: inadequate enteral feeding associated with high rates of malnutrition was found in both hospitals. the data obtained in this study show that both enteral feeding services need improvements. standardization of enteral feeding practices and regular patient assessment are also needed.
Suprimento de micronutrientes, adequa??o energética e progress?o da dieta enteral em adultos hospitalizados
Luft, Vivian Cristine;Vieira, Diego de Matos;Beghetto, Mariur Gomes;Polanczyk, Carísi Anne;Mello, Elza Daniel de;
Revista de Nutri??o , 2008, DOI: 10.1590/S1415-52732008000500004
Abstract: objective: to asses the adequacy of enteral diet, in terms of micronutrients and energy and to identify factors that interfere in the progression of enteral diets prescribed to adults hospitalized in a high complexity general hospital. methods: from june 2004 to may 2005, adult patients hospitalized in a high complexity hospital, in southern brazil, were assessed in terms of enteral diet prescription and clinical characteristics. the characteristics of the enteral nutrition were assessed and compared with the recommended daily intakes, obtaining percentages of nutrient adequacy of the enteral diet. factors associated with energy prescription were identified by multiple linear regression. results: two hundred and thirty tube-fed patients were followed. the dietary reference intakes were satisfatory met for water-soluble vitamins (except for folic acid), fat-soluble vitamins (except for vitamin d) and minerals (except for calcium). the mean initial energy prescription was 24.0 kcal/kg/day (standard deviation=10.8, minimum and maximum values ranging from 4.3 to 69.2kcal/kg/day) and progressed to 28.4kcal/kg/day (standard deviation=11.8, minimum and maximum values ranging from 1.4 to 69.2kcal/kg/day).the recommendation of 25 to 35kcal/kg/day was prescribed to 32.6% of patients. forty or more kcal/kg/day was presuibed to 15.7% of the patients. only body mass index and the number of hospital stay days, adjusted to the energy prescribed at the beginning, were independently associated with the final energy prescription. conclusion: a small proportion of the prescriptions were adequate in terms of kcal/kg/day, and the progression of enteral diet occurs regardless of the clinical characteristics of the patients.
Impacto da adequa??o da oferta energética sobre a mortalidade em pacientes de UTI recebendo nutri??o enteral
Oliveira, Natália Sanchez;Caruso, Lúcia;Bergamaschi, Denise Pimentel;Cartolano, Flávia de Conti;Soriano, Francisco Garcia;
Revista Brasileira de Terapia Intensiva , 2011, DOI: 10.1590/S0103-507X2011000200011
Abstract: objective: to investigate the relationship between adequacy of energy intake and intensive care unit mortality in patients receiving exclusive enteral nutrition therapy. methods: observational and prospective study conducted during 2008 and 2009. patients above 18 years with exclusive enteral nutrition therapy for at least 72 hours were included. the adequacy of energy intake was estimated by the administered/prescribed ratio. non-conditional logistic regression was used to assess the relationship between predictive variables (adequacy of energy intake, apache ii, gender, age, and intensive care unit length of stay) and intensive care unit mortality. results: sixty-three patients (mean 58 years, 27% mortality) were included, 47.6% of whom received more than 90% of the energy prescribed (mean adequacy 88.2%). mean energy balance was -190 kcal/day. significant associations between death in the intensive care unit and the variables age and intensive care unit length of stay were observed, after removing the variables adequacy of energy intake, apache ii, gender and age during the modeling process. conclusion: in our study, adequacy of energy intake did not affect intensive care unit mortality. carefully followed enteral nutrition protocols, resulting in an administered/prescribed ratio above 70%, are apparently not sufficient to impact the mortality rates in the intensive care unit. therefore, it may not be necessary to achieve 100% of the targeted energy, considering the high frequency of enteral feeding interruptions due to gastrointestinal intolerance and fasting for tests and procedures. additional research is needed to identify the optimal energy intake for improved outcomes and reduced costs.
Prescri??o e uso de formulados para nutri??o enteral pelos Servi?os de Nutri??o Hospitalares do município de Campinas (SP)
Domene, Semíramis Martins álvares;Galeazzi, Maria Ant?nia Martins;
Revista de Nutri??o , 1997, DOI: 10.1590/S1415-52731997000200004
Abstract: tube feeding is a recognized means, for dietary management of a disease, successfully surpassing the limits of patients with impaired feeding. nevertheless, there is no local data about utilization of industrialized or domestic formulae by the hospital nutrition services. in order to evaluate the utilization of both industrialized and the domestic formulae, as well as the health professional involved with diet prescription, all hospitals located in the city of campinas, s?o paulo, brazil were interviewed. results show that enteral nutrition is a routine for most institutions, and there is no significant deference between the use of industrialized or domestic formulae. in campinas, the physician is responsible for the diet prescription, despite of the presence of a dietitian in the staff.
Complica??es gastrointestinais e adequa??o calórico-protéica de pacientes em uso de nutri??o enteral em uma unidade de terapia intensiva
Oliveira, Suzana Meira de;Burgos, Maria Goretti Pessoa de Araújo;Santos, Eduíla Maria Couto;Prado, Leila Virgínia da Silva;Petribú, Marina de Moraes Vasconcelos;Bomfim, Flávia Myrna Tenório de Sousa;
Revista Brasileira de Terapia Intensiva , 2010, DOI: 10.1590/S0103-507X2010000300009
Abstract: objective: to evaluate the prevalence of gastrointestinal complications and protein-calorie adequacy in critical patients using enteral nutrition therapy. methods: this was a retrospective study in the intensive care unit of the hospital das clinicas of the universidade federal de pernambuco involving analysis of nutritional records evaluating the most frequent gastrointestinal complications during the patients' hospitalization and protein-calorie supply requirements. it was considered offered, the volume and formula effectively received by the patient on the last hospitalization day. the spss version 13 software was used for statistical analysis. results: the sample consisted of 77 patients aged in average 54.7 ± 18.1 years who were predominantly female (54.5%). the diet offered was appropriate and all patients had some type of gastrointestinal complications, being high gastric residuals the most prevalent (39%), followed by constipation (36.4%). conclusion: despite the high prevalence of gastrointestinal complications, no mismatches were observed in protein-calorie intake. multidisciplinary approaches to these complications should be standardized in order to provide their early resolution.
Avalia o da adequa o do acervo da biblioteca regional de Rondonópolis da UFMT à bibliografia do curso de história

Evaluation the adequacy of the regional library of Rondonópolis UFMT the history course bibliography p. 293-312
A. O. M. Gusm?o,A. M.M. Souza,K. F. SOUZA,T. L. Deus
Revista ACB , 2009,

Abstract: Avalia a adequa o do acervo de livros da Biblioteca Regional de Rondonópolis à bibliografia das disciplinas do Curso de História. Utiliza o método descritivo e uma escala de avalia o qualitativa e outra quantitativa. Na avalia o qualitativa, detecta-se que 39,8% da bibliografia está presente no acervo, percentual considerado insatisfatório. Quanto à avalia o quantitativa, o resultado também foi considerado insatisfatório, porque a biblioteca possui em média 2,37 exemplares por título
Nutritional status and adequacy of enteral nutrition in pediatric cancer patients at a reference center in northeastern Brazil El estado nutricional y la adecuación de la nutrición enteral en pacientes de oncología pediátrica en un centro de referencia del noreste de Brasil  [cached]
J. Maciel Barbosa,F. Pedrosa,P. Coelho Cabral
Nutrición Hospitalaria , 2012, DOI: 10.3305/nh.2012.27.4.5869
Abstract: Introduction: Individualized nutritional support is important to pediatric cancer patients and should be integrated to the overall treatment of these patients. Objective: Analyze the nutritional status of cancer patients submitted to enteral nutrition (EN) and assess the adequacy of this form of nutrition. Methods: A case series study was carried out at the Pediatric Oncology Unit of the Institute of Integrative Medicine Professor Fernando Figueira (IMIP, Brazil, Recife-PE) between January and December 2009. Clinical and anthropometric data were obtained from medical charts and nutritional follow-up charts. Z scores for height for age, weight for age and body mass index for age indicators (H/A, W/A and BMI/A, respectively) were calculated using the AnthroPlus program. Caloric and protein requirements were calculated based on the recommendations of the Brazilian National Council of Oncologic Nutrition. Results: At the beginning of EN, 32.4% of the sample had short stature and 23.9% were underweight based on the BMI/A indicator. The assessment of EN adequacy demonstrated that 49.3% reached the caloric requirements and 76.1% reached the protein requirements, with maximal intakes of 65.6 Kcal/Kg/day and 1.95 g of protein/kg/day. Malnourished patients had greater mean Z scores for W/A and BMI/A at the end of EN, whereas no significant changes were found among patients with adequate nutritional status and significant reductions in these indicators were found among those with overweight or obesity. Conclusion: The patients either maintained or achieved a significant improvement in nutritional status, which demonstrates the importance of nutritional support and follow up during hospitalization. Introducción: El soporte nutricional individualizado se considera una terapia importante en oncología pediátrica y, como tal, debe integrarse en el tratamiento global de estos pacientes. Objetivo: Evaluar el estado nutricional de los pacientes sometidos a terapia de la nutrición enteral y la adecuación de la nutrición enteral (NE). Métodos: Una serie de casos realizado en la Oncología Pediátrica del Instituto de Medicina Integrativa Profesor Fernando Figueira (IMIP, Brasil, Recife-PE), entre los meses de enero a diciembre de 2009. Se obtuvieron los datos antropométricos y clínicos de los registros médicos y formularios para recibir asesoramiento nutricional. Los valores de puntuación Z de los indicadores de A/E, P/E y el IMC/E se calcularon utilizando el software AnthroPlus . Las necesidades calóricas y proteínas se calcularon de acuerdo con el Consenso Nacional de Nutr
FORMULATION DEVELOPMENT OF ENTERAL NUTRITION PRODUCTS
Mirajkar Reshma Nilesh,Patil Amol Vilas,Jamadar Shahaji Ambadas,Mirajkar Nilesh Sharadchandra
International Research Journal of Pharmacy , 2011,
Abstract: This review mainly deals with the Formulation Development of Enteral Nutrition Products. Nutrition plays an important role in the prevention and management of many diseases. Chronic illness is associated with many complications such as anorexia, hypermetabolism, malabsorption, atrophy of muscles, liver, kidney, gastrointestinal tract heart, and impaired cell mediated immunity, susceptibility to infection, poor wound healing, anaemia, death. Hence it is important to correct caloric and nutrient deficiencies whenever possible. The term enteral means “within or by the way of gastrointestinal tract”. The nutrition product given by enteral route called as enteral nutrition product. The different types of enteral nutrition are classified as Short term and long term enteral nutrition. Enteral tubes are made of PVC, Polyurethane etc. The selection of the enteral formula is patient specific thus its nutritional requirements, the ingredients used in it are taken into consideration. The classification of formulas is also done on the basis of the patient’s needs and ingredients used in it. The enteral feeds can be given in the form of solutions and powders which require reconstitution. The quality control test like Osmolality, pH, etc is also taken into consideration. Thus, the purpose here is to point out explicitly the formulation development of enteral nutrition products.
Identifica o de medicamentos "n o apropriados para crian as" em prescri es de unidade de tratamento intensivo pediátrica  [cached]
Carvalho Paulo R.A.,Carvalho Clarissa G.,Alievi Patrícia T.,Martinbiancho Jaqueline
Jornal de Pediatria , 2003,
Abstract: OBJETIVO: Avaliar a extens o do uso de medicamentos n o apropriados para crian as em prescri es de uma unidade de tratamento intensivo pediátrica (UTIP) terciária, de acordo com os padr es estabelecidos pela FDA. MéTODOS: Estudo transversal, observacional, baseado na avalia o das prescri es de todos os pacientes admitidos na UTIP do Hospital de Clínicas de Porto Alegre, no período de seis semanas consecutivas. Foram considerados idade, sexo, peso, doen a prévia, motivo de admiss o na UTIP, e PIM (pediatric index of mortality) dos pacientes, e todos os medicamentos prescritos e suas indica es, com as respectivas apresenta es, doses, freqüências e vias de administra o. O critério de adequa o na prescri o dos medicamentos seguiu a classifica o de aprova o da FDA, baseada no catálogo de informa es de medicamentos USP DI 2001, em três faixas etárias pediátricas. RESULTADOS: Os dados foram obtidos nos meses de julho e agosto de 2002, em diferentes dias, de seis semanas consecutivas, baseados nas prescri es de 51 pacientes em 54 admiss es de UTIP. A mediana de idade dos pacientes foi 10,5 meses, sendo 61% do sexo masculino. Dois ter os (65%) dos pacientes apresentavam doen a prévia, e 87% das admiss es ocorreram por motivos clínicos, sendo 57% por causas respiratórias. Foram registrados 747 itens de prescri o, com prevalências de 10,5% para medicamentos n o aprovados e 49,5% para medicamentos n o padronizados. A distribui o das prevalências de prescri o, tanto pela faixa etária quanto pelo nível de gravidade dos pacientes na admiss o (de acordo com as categorias de risco do PIM), nas três classes de medicamentos, n o mostrou diferen a estatística entre os grupos. CONCLUS O: A alta prevalência de prescri es com medicamentos n o apropriados para crian as confirma, também no nosso meio, o uso inadequado e inadvertido de medicamentos n o testados ou de apresenta es n o padronizadas para crian as em UTIP. Isso aponta para a necessidade de estimular a realiza o de estudos sobre qualidade, eficácia e seguran a de medicamentos para uso pediátrico.
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