Nutrition

Specialized Nutrition Support

search

Specialized Nutrition Support, Nutrition Support

  • Evaluation
  1. See Subjective Global Assessment of Nutritional Status
  2. See Lab Markers of Malnutrition
  • 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. Impaired bowel function (e.g. short bowel syndrome)
    2. Severe prolonged hypercatabolic state
    3. Severe protein-calorie Malnutrition (due to a treatable condition)
    4. Prolonged bowel rest (e.g. Inflammatory Bowel Disease exacerbation)
  • Types
  1. Enteral Nutrition
    1. Prefererred form of nutritional support
  2. Peripheral Parenteral Nutrition (PPN)
  3. Total Parenteral Nutrition (TPN)
  • Evaluation
  • Nutritional requirements
  1. Calories
    1. Adults: 25-35 kcal/kg/day
    2. Child >5 years: 1500 kcal/day for weight of 20kg, then 25 kcal/day per each additional kg above 20 kg
  2. Protein
    1. Adults: 0.8 to 1.5 g/kg/day
    2. All Children and infants, as well as those adults in hypercatabolic or protein losing states require higher protein intake
  3. Linoleic Acid
    1. Dose: 2-4% of total calories should be in this form to prevent essential Fatty Acid deficiency
  • Prcautions
  1. Refeeding Syndrome risk
    1. Start refeeding at one third or less of nutritional needs and gradually increase every 5-7 days
  • References
  1. Kulick (2011) Am Fam Physician 83(2): 173-83 [PubMed]