GI functions?

GI functions?

Yes
1. Enteral Nutrition
  1. Indications
    1. Not receiving nutritionaldemands (for 5-7 days by mouth)
      1. He can't
        Neurological diseases Swallow problems Cerebrovascular patients Alzheimer Coma Any disease that increased nutritional requirements: Burns, Sepsis, Oncological Any disease the patient can't prevent their airway
      2. He shouldn't
        GI Surgery Inflammatory disease Pancreatitis
      3. He doesn't want
        Anorexia Bulimia
        Access
        Time?
        < 4 weeks
        Temporal access
        The gastric (Gold standard) or jejunal tube
        > 4 weeks
        Permanent aceess
        - Percutaneous endoscopic (GS) - Gastrostomy
        Contraindications -Morbid obesity - Peritonitis - Ascitis - Nephrological patients
        Surgical gastrostomy
        Indications: - When you perform other abdominal surgery - Contraindication for endoscopy
        Risk of bronco aspiration?
        Yes
        Jejunal
        No
        Gastric
        What formula?
        Polymeric Oligomeric Elemental Energy 1 kCal/mL
        Patients who need > proteins:
        Undernutrition, - catabolic patients - kidney with dialysis
        Patients who need < proteins
        Kidney without dialysis
  2. Contraindications
    1. Peritonitis, GI tract perforation, Incohesive vomit, GI obstruction GI ischemia GI bleeding Hemodynamic instability Pregnant lady Hypovolemic shock Enterocutaneous fistula
  3. Benefits
    1. -Preserve structure and physiology -Less complications -Maintain GAP junctions -Produce hormones and enzymes -Maintain micro biome -MALT and GALT (IgA) -Trophism
No
1. Parenteral nutrition
  1. Indications
    1. Doesn't pr he won't achieve nutritional goal by enteral route for more than 7 days 1. Short Bowel syndrome 2. Preoperative 10 days before surgery with undernutrition 3. Abdominal sepsis 4. Chron's disease
  2. Contraindications
    1. Functional GI trac Hemodynamic instability Less than 10 days (transferrin)
  3. Access
    1. < 4 weeks
      1. Temporal access
        Central
        Subclavian PICC Yugular Femoral
        Peripheral
        Cephalic Basilic
    2. > 4 weeks
      1. Permanent access
        All central catheters
Complications Enteral and parenteral nutrition
1. Mechanical
  1. Enteral: perforation, laceration Pneumo/hemo/quilotorax Laceration of vein/artery/heart Obstruction Malposition
2. Infectious
  1. Sepsis associated with catheter Diarrhea
3. GI complications
  1. Paralytic ileus, atrophy translocation vomit diarrhea distention pain
4. Metabolic
  1. Glicemia changes Electrolytic changes < Tiamine, Mg, K, P (Refeeding syndrome) > Osmolarity

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	Erstellt von Liz Ge vor mehr als 9 Jahre