Nutrition Support

1. Nutrition Support • Fluid and electrolyte requirements. • Calculate enteral and parenteral nutrition formulations.

2. Nutrition Support • Pt can’t meet nutritional needs by normal oral ingestion of food for greater than 5 - 7 days.

3. NS Methods • Add snack between meals • Add high kcal or protein supplements at meals • Enteral supplement via tube feeding

4. Two Types NS • Enteral • still use the gut • Parenteral • DO NOT use the gut • veins

5. Dx and NS • Strong data for NS • Acute renal failure - ENS/PNS • Prolonged acute pancreatitis - ENS/PNS • Acute respiratory failure - ENS/PNS

6. Dx and NS • Strong data for NS • Acute Crohn’s disease - PNS • Short bowel syndrome - PNS/ENS • Severely malnourished - ENS • Entercutaneous fistulas - PNS

7. Dx and NS • Moderate data for NS • Acute alcoholic liver disease - ENS • Stable COPD and CF - ENS • Chronic Crohn’s - ENS • Acute ulcerative colitis - ENS/PNS

8. NS • Figure 59-1 from Cecil’s here • Selecting the route of nutritional support

9. Selecting route of nutritional support

10. What questions to ask to determine route of NS? • What happens if you don’t use the gut and it is functioning?

11. END NS General • Questions?