Nutrition in the hospitalized patient

被引:83
作者
Kirkland, Lisa L. [1 ]
Kashiwagi, Deanne T. [1 ]
Brantley, Susan [2 ]
Scheurer, Danielle [3 ]
Varkey, Prathibha [4 ]
机构
[1] Mayo Clin, Div Hosp Med, Rochester, MN USA
[2] Univ Tennessee, Med Ctr Knoxville, Dept Pharm, Knoxville, TN USA
[3] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA
[4] Mayo Clin, Dept Med, Rochester, MN USA
关键词
RESTING ENERGY-EXPENDITURE; TOTAL PARENTERAL-NUTRITION; CRITICAL-CARE MEDICINE; ENTERAL NUTRITION; REFEEDING SYNDROME; AMERICAN SOCIETY; CONSENSUS STATEMENT; SUPPORT THERAPY; ICU PATIENTS; MALNUTRITION;
D O I
10.1002/jhm.1969
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Almost 50% of patients are malnourished on admission; many others develop malnutrition during admission. Malnutrition contributes to hospital morbidity, mortality, costs, and readmissions. The Joint Commission requires malnutrition risk screening on admission. If screening identifies malnutrition risk, a nutrition assessment is required to create a nutrition care plan. The plan should be initiated early in the hospital course, as even patients with normal nutrition become malnourished quickly when acutely ill. While the Harris-Benedict equation is the most commonly used method to estimate calories, its accuracy may not be optimal in all patients. Calculating the caloric needs of acutely ill obese patients is particularly problematic. In general, a patient's caloric intake should be slightly less than calculated needs to avoid the metabolic risks of overfeeding. However, most patients do not receive their goal calories or receive parenteral nutrition due to erroneous practices of awaiting return of bowel sounds or holding feeding for gastric residual volumes. Patients with inadequate intake over time may develop potentially fatal refeeding syndrome. The hospitalist must be able to recognize the risk factors for malnutrition, patients at risk of refeeding syndrome, and the optimal route for nutrition support. Finally, education of patients and their caregivers about nutrition support must begin before discharge, and include coordination of care with outpatient facilities. As with all other aspects of discharge, it is the hospitalist's role to assure smooth transition of the nutrition care plan to an outpatient setting. Journal of Hospital Medicine 2013. (c) 2012 Society of Hospital Medicine
引用
收藏
页码:52 / 58
页数:7
相关论文
共 56 条
[1]   Re-feeding syndrome in head and neck - Prevention and management [J].
Ahmed, Sameh ;
Travis, Jane ;
Mehanna, Hisham .
ORAL ONCOLOGY, 2011, 47 (09) :792-796
[2]  
American Dietetic Association Evidence Library, CRIT ILLN
[3]  
American Society for Parenteral and Enteral Nutrition (A. S. P. E. N.) Board of Directors and Clinical Practice Committee, 2012, DEF TERMS STYL CONV
[4]   Comparison of Resting Energy Expenditure Prediction Methods With Measured Resting Energy Expenditure in Obese, Hospitalized Adults [J].
Anderegg, Brent A. ;
Worrall, Cathy ;
Barbour, English ;
Simpson, Kit N. ;
DeLegge, Mark .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 2009, 33 (02) :168-175
[5]   Nutrition Screening Tools for Hospitalized Patients [J].
Anthony, Patricia S. .
NUTRITION IN CLINICAL PRACTICE, 2008, 23 (04) :373-382
[6]  
ASPEN Board of Directors and the Clinical Guidelines Task Force, 2002, JPEN J Parenter Enteral Nutr, V26, p1SA
[7]  
Bankhead Robin, 2009, JPEN J Parenter Enteral Nutr, V33, P122, DOI 10.1177/0148607108330314
[8]  
Blackburn G L, 1977, JPEN J Parenter Enteral Nutr, V1, P11, DOI 10.1177/014860717700100111
[9]   Refeeding syndrome: Treatment considerations based on collective analysis of literature case reports [J].
Boateng, Akwasi Afriyie ;
Sriram, Krishnan ;
Meguid, Michael M. ;
Crook, Martin .
NUTRITION, 2010, 26 (02) :156-167
[10]   ESPEN Guidelines on Parenteral Nutrition: Surgery [J].
Braga, M. ;
Ljungqvist, O. ;
Soeters, P. ;
Fearon, K. ;
Weimann, A. ;
Bozzetti, F. .
CLINICAL NUTRITION, 2009, 28 (04) :378-386