II. Defintions

  1. Nutritional Support Therapy
    1. Formulated enteral or parenteral nutrients given to Restore nutritional status
  2. Enteral Nutrition
    1. Gastrointestinal Tract delivery of Nutritional Support
  3. Parenteral Nutrition
    1. Intravenous delivery of Nutritional Support

III. Indications

  1. No food intake secondary to underlying condition (adjusted for malnourishment at baseline)
    1. Adults: 5-7 days
    2. Children: 3-5 days
    3. Infants: 1-3 days
  2. Specific conditions
    1. See Nutrition in the Intensive Care Unit
    2. Impaired bowel function (e.g. short bowel syndrome)
    3. Severe prolonged hypercatabolic state
    4. Severe Protein-calorie Malnutrition (due to a treatable condition)
    5. Prolonged bowel rest (e.g. Inflammatory Bowel Disease exacerbation)

IV. Types

  1. Enteral Nutrition
    1. Prefererred form of Nutritional Support
  2. Peripheral Parenteral Nutrition (PPN)
  3. Total Parenteral Nutrition (TPN)

V. Evaluation: General Evaluation

  1. See Subjective Global Assessment of Nutritional Status
  2. See Lab Markers of Malnutrition
  3. See Nutrition in the Intensive Care Unit
  4. Hospitalized Patient Nutrition Assessments
    1. Malnutrition Screening Tool
      1. https://static.abbottnutrition.com/cms-prod/abbottnutrition-2016.com/img/Malnutrition%20Screening%20Tool_FINAL_tcm1226-57900.pdf
    2. Nutrition Risk Screening
      1. https://www.mdcalc.com/nutrition-risk-screening-2002-nrs-2002
    3. Short Nutritional Assessment Questionnaire
      1. https://www.fightmalnutrition.eu/toolkits/summary-screening-tools
  5. Nutrition Care Process Framework (Registered Dietitian Nutritionist)
    1. Anthropometric measurement
    2. Biochemistry results and other test results
    3. Food and nutrition history
    4. Related Patient Medical history (including significant comorbidities)
    5. Nutrition focused physical exam

VI. Evaluation: Nutritional requirements

  1. Calories
    1. Child >5 years: 1500 kcal/day for weight of 20kg, then 25 kcal/day per each additional kg above 20 kg
    2. Adults: 25-35 kcal/kg/day
    3. Adults: Mifflin-St Jeor Equation (KCals/day or RMR)
      1. Males = 9.99 * wtKg + 6.25 * htCm - 4.92 * ageY + 5
      2. Females = 9.99 * wtKg + 6.25 * htCm - 4.92 * ageY -161
  2. Protein
    1. Adults: 0.8 to 1.5 g/kg/day
    2. Higher Protein indications
      1. All Children and infants, as well as those adults in hypercatabolic or Protein losing states
      2. Bariatric Surgery (1 to 1.5 g/kg/day using Ideal Body Weight)
      3. Hemodialysis (1.2 to 1.5 g/kg/day)
      4. Critical Illness (1.2 to 2.0 g/kg/day)
      5. Obesity (2 to 2.5 g/kg/day)
      6. Pressure Ulcer (1.2 to 1.5 g/kg/day)
      7. Respiratory Disease (1.2 to 1.6 g/kg/day to maintain; increase to 1.6 to 2.0 for repletion)
  3. Fluid
    1. Fluid 1 ml/kcal OR
    2. Fluid 1500 ml per BSA (m2) OR
    3. Age based
      1. Age 16 to 30 years old: 35 to 40 ml/kg
      2. Age 31 to 54 years old: 30 to 35 ml/kg
      3. Age 55 to 65 years: 30 ml/kg
      4. Age >65 years: 25 ml/kg
  4. Other nutrients
    1. Linoleic Acid
      1. Dose: 2-4% of total calories should be in this form to prevent Essential Fatty Acid deficiency

VII. Prcautions

  1. Refeeding Syndrome risk
    1. Start refeeding at one third or less of nutritional needs and gradually increase every 5-7 days

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Related Studies

Ontology: Nutritional Support (C0242739)

Definition (MEDLINEPLUS)

Nutritional support is therapy for people who cannot get enough nourishment by eating or drinking. You may need it if you

  • Can't swallow
  • Have problems with your appetite
  • Are severely malnourished
  • Can't absorb nutrients through your digestive system

You receive nutritional support through a needle or catheter placed in your vein or with a feeding tube, which goes into your stomach.

Definition (NCI) Administration of essential nutrients to a patient utilizing methods other than oral feedings.
Definition (MSH) The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include FLUID THERAPY which normalizes body fluids to restore WATER-ELECTROLYTE BALANCE.
Definition (NIC) Interventions to modify or maintain nutritional status
Concepts Therapeutic or Preventive Procedure (T061)
MSH D018529
SnomedCT 278906000
English Support, Nutritional, Nutrition Support, Nutritional Therapy, Nutritional Care, Nutrition Therapy, nutrition support, support nutritional, support nutrition, care nutritional, Artificial hydration and nutrition, Nutritional support, Nutritional support (regime/therapy), nutritional support, nutritional care, support, nutritional, Nutritional support (procedure), Nutritional Support
Swedish Näringstillskott
Czech nutriční podpora, Nutriční podpora
Finnish Ravintolisä
Japanese 栄養補助, エイヨウホキュウ, 栄養補給
French Soutien nutritionnel, Support nutritionnel, Traitement nutritionnel symptomatique
Croatian Not Translated[Nutritional Support]
Polish Odżywianie sztuczne
Norwegian Ernæringstilskudd, Næringstilskudd
Dutch nutritionele ondersteuning, Voeding, kunstmatige
German Nahrungsersatz, Nahrungszufuhr
Hungarian Táplálék támogatás
Italian Supporto nutrizionale, Sostentamento nutrizionale
Portuguese Suporte nutricional, Apoio Nutricional
Spanish Apoyo nutricional, apoyo nutricional (procedimiento), apoyo nutricional (régimen/tratamiento), apoyo nutricional, Apoyo Nutricional