What are the benefits and harms of nutritional support for hospitalized adults at nutritional risk?

2018 ◽  
Keyword(s):  
Nutritional Support ◽  
Nutritional Risk

scholarly journals Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 57
Author(s):  
Adam Brewczyński ◽  
Beata Jabłońska ◽  
Sławomir Mrowiec ◽  
Krzysztof Składowski ◽  
Tomasz Rutkowski
Keyword(s):  
Head And Neck ◽  
Nutritional Support ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Percutaneous Gastrostomy ◽  
Critical Weight ◽  
Oncological Treatment ◽  
Feeding Tubes ◽  
Hpv Status ◽  
Percutaneous Gastrostomy Tube

Malnutrition is a common problem in patients with head and neck cancer (HNC), including oropharyngeal cancer (OPC). It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor. It is also secondary to the oncological treatment of the basic disease, such as radiotherapy (RT) and chemoradiotherapy (CRT), as a consequence of mucositis with the dry mouth, loss of taste, and dysphagia. The severe dysphagia leads to a definitive total impossibility of eating through the mouth in 20–30% of patients. These patients usually require enteral nutritional support. Feeding tubes are a commonly used nutritional intervention during radiotherapy, most frequently percutaneous gastrostomy tube. Recently, a novel HPV-related type of OPC has been described. Patients with HPV-associated OPC are different from the HPV− ones. Typical HPV− OPC is associated with smoking and alcohol abuse. Patients with HPV+ OPC are younger and healthy (without comorbidities) at diagnosis compared to HPV− ones. Patients with OPC are at high nutritional risk, and therefore, they require nutritional support in order to improve the treatment results and quality of life. Some authors noted the high incidence of critical weight loss (CWL) in patients with HPV-related OPC. Other authors have observed the increased acute toxicities during oncological treatment in HPV+ OPC patients compared to HPV− ones. The aim of this paper is to review and discuss the indications for nutritional support and the kinds of nutrition, including immunonutrition (IN), in HNC, particularly OPC patients, undergoing RT/CRT, considering HPV status.

scholarly journals Nutritional Risk Screening and Assessment

2019 ◽  
Vol 8 (7) ◽  
pp. 1065 ◽  
Author(s):  
Emilie Reber ◽  
Filomena Gomes ◽  
Maria F. Vasiloglou ◽  
Philipp Schuetz ◽  
Zeno Stanga
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Nutritional Support ◽  
Nutritional Risk ◽  
Nutritional Management ◽  
Risk Screening ◽  
Care Plans ◽  
Patients At Risk ◽  
Nutritional Risk Screening

Malnutrition is an independent risk factor that negatively influences patients’ clinical outcomes, quality of life, body function, and autonomy. Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start a timely and adequate nutritional support. Nutritional risk screening, a simple and rapid first-line tool to detect patients at risk of malnutrition, should be performed systematically in patients at hospital admission. Patients with nutritional risk should subsequently undergo a more detailed nutritional assessment to identify and quantify specific nutritional problems. Such an assessment includes subjective and objective parameters such as medical history, current and past dietary intake (including energy and protein balance), physical examination and anthropometric measurements, functional and mental assessment, quality of life, medications, and laboratory values. Nutritional care plans should be developed in a multidisciplinary approach, and implemented to maintain and improve patients’ nutritional condition. Standardized nutritional management including systematic risk screening and assessment may also contribute to reduced healthcare costs. Adequate and timely implementation of nutritional support has been linked with favorable outcomes such as a decrease in length of hospital stay, reduced mortality, and reductions in the rate of severe complications, as well as improvements in quality of life and functional status. The aim of this review article is to provide a comprehensive overview of nutritional screening and assessment methods that can contribute to an effective and well-structured nutritional management (process cascade) of hospitalized patients.

scholarly journals Screening of Nutritional Risk and Nutritional Support in General Surgery Patients: A Survey from Shanghai, China

2015 ◽  
Vol 100 (5) ◽  
pp. 841-848 ◽  
Author(s):  
Zhen-Yi Jia ◽  
Jun Yang ◽  
Da-Nian Tong ◽  
Jia-Yuan Peng ◽  
Zhong-Wei Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
At Risk ◽  
Clinical Outcomes ◽  
Support Group ◽  
Complication Rate ◽  
Nutritional Support ◽  
Nutritional Risk ◽  
Complication Rates ◽  
Lower Complication ◽  
Risk Patients

To determine the prevalence of nutritional risk in surgical departments and to evaluate the impact of nutritional support on clinical outcomes. The nutritional risk in different surgical diseases and the different way of nutritional support on clinical outcomes in patients at nutritional risk remain unclear. Hospitalized patients from general surgical departments were screened using the Nutritional Risk Screening (NRS) 2002 questionnaire on admission. Data were collected on nutritional risk, complications, and length of stay (LOS). Overall, 5034 patients were recruited; the overall prevalence of nutritional risk on admission were 19.2%. The highest prevalence was found among patients with gastric cancer. At-risk patients had more complications and longer LOS than nonrisk patients. Of the at-risk patients, the complication rate was significantly lower and LOS was significantly shorter in the nutritional-support group than in the no-support group (20.9 versus 30.0%, P < 0.05). Subgroup analysis showed reduced complication rates and LOS only in patients with gastric cancer, colorectal cancer, and hepato-pancreato-biliary (HPB) cancer. Significantly lower complication rates relative to nonsupported patients were found among patients who received enteral nutrition or who received support for 5 to 7 days, or daily support entailing 16 to 25 kcal/kg of nonprotein energy. Different surgical diseases have different levels of nutritional risk. The provision of nutritional support was associated with a lower complication rate and a shorter LOS for gastric, colorectal, and HPB cancer patients at nutritional risk. The improper use of nutritional support may not improve outcomes for at-risk patients.

scholarly journals Effect of Early Nutritional Assessment and Nutritional Support on Immune Function and Clinical Prognosis of Critically Ill Children

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Jie Guo ◽  
Zixuan Jin ◽  
Yibing Cheng ◽  
Jun Su ◽  
Zheng Li ◽  
...  
Keyword(s):  
Immune Function ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Nutritional Risk ◽  
Critically Ill Children ◽  
Control Group ◽  
Clinical Prognosis ◽  
Experimental Group

The aim of this study was to study the effect of early nutritional assessment and nutritional support on immune function and clinical prognosis of critically ill children. 90 critically ill children at the same level of severity admitted to the pediatric intensive care unit (PICU) of our hospital (June 2019–June 2020) were chosen as the research objects and were equally separated into the experimental group and the control group by the random number table method. The children in the control group were admitted to the PICU according to the routine process, and the nutritional support was provided to the malnourished ones. After admission to the PICU, the children in the experimental group were given nutritional assessment, nutritional risk screening, and nutritional support according to the screening results. The PICU stay time and total hospitalization time of the experimental group were obviously shorter than those of the control group ( P < 0.05 ), the hospitalization expenses of the experimental group were obviously lower than those of the control group ( P < 0.05 ), the clinical outcomes and immune function of the experimental group were obviously better than those of the control group ( P < 0.05 ), and the nutrition indicators of the experimental group were obviously higher than those of the control group ( P < 0.05 ). Early nutritional assessment and nutritional support can effectively improve the immune function and reduce the incidence of adverse clinical outcomes of critically ill children, which are worthy of clinical application and promotion.

Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial

The Lancet ◽  
2019 ◽  
Vol 393 (10188) ◽  
pp. 2312-2321 ◽  
Author(s):  
Philipp Schuetz ◽  
Rebecca Fehr ◽  
Valerie Baechli ◽  
Martina Geiser ◽  
Manuela Deiss ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Nutritional Support ◽  
Randomised Clinical Trial ◽  
Nutritional Risk ◽  
Medical Inpatients

scholarly journals Metabolic hepatotropic regimens in programs of accompanying nutritional support for cancer patients with colorectal cancer and pancreatic cancer: Remaxol in structure of infusion and nutritional therapy

2020 ◽  
Vol 4 (38) ◽  
pp. 27-36
Author(s):  
L. N. Kostyuchenko ◽  
M. V. Kostyuchenko
Keyword(s):  
Colorectal Cancer ◽  
Pancreatic Cancer ◽  
Nutritional Support ◽  
Nutritional Therapy ◽  
Nutritional Risk ◽  
Metabolic Complications ◽  
Hematological Indices ◽  
Plasma Citrulline ◽  
The Relationship

Infusion-nutrient accompanying therapy provides prevention of metabolic complications and their nutrient correction in oncopatients with colorectal cancer (CRС) and pancreatic cancer.Material and methods. In patients with CRС and pancreatic cancer the effectiveness of detoxification alimentation was evaluated. Nutritional deficiency was specified by alimental-volemic diagnoses (AVD), nutritional risk-by NRI, sarcopenia by bioimedansometry. Hematological indices of intoxication (Krebs index, leukocyte index of intoxication) were calculated according to known formulas. Hepatological parameters (total protein, albumin, bilirubin, ALT, etc.) and the content of blood urea and creatinine, electrolytes were determined by conventional methods, the participation of the intestine in detoxification was monitored by plasma citrulline levels and activity of the intestinal microbiota. The severity of the condition was assessed by APACHE II, the quality of life by ECOG.Results. The relationship between indicators of homeostasis and endotoxicosis, as well as more positive dynamics in the application of detoxification regimens with the addition of Remaxol.Conclusion. In CRC T3–T4, it is advisable to use a combination of nutrient compositions with the addition of hepatotropic pharmaconutrients, in particular, Remaxol.

Comparative survey on nutritional risk and nutritional support between Beijing and Baltimore teaching hospitals

Nutrition ◽  
2008 ◽  
Vol 24 (10) ◽  
pp. 969-976 ◽  
Author(s):  
Xiaokun Liang ◽  
Zhu-Ming Jiang ◽  
Marie T. Nolan ◽  
David T. Efron ◽  
Jens Kondrup
Keyword(s):  
Nutritional Support ◽  
Nutritional Risk ◽  
Teaching Hospitals ◽  
Comparative Survey

Admission kidney function is a strong predictor for the response to nutritional support in patients at nutritional risk

2021 ◽  
Vol 40 (5) ◽  
pp. 2762-2771
Author(s):  
Annika Bargetzi ◽  
Nora Emmenegger ◽  
Simone Wildisen ◽  
Manuela Nickler ◽  
Laura Bargetzi ◽  
...  
Keyword(s):  
Kidney Function ◽  
Nutritional Support ◽  
Strong Predictor ◽  
Nutritional Risk
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