2702900
GI functions?
- Yes
- Enteral Nutrition
- Indications
- Not receiving nutritionaldemands (for 5-7 days by mouth)
- 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
- 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
- He shouldn't
- GI Surgery
Inflammatory disease
Pancreatitis
- GI Surgery
Inflammatory disease
Pancreatitis
- He doesn't want
- Anorexia
Bulimia
- Access
- Time?
- < 4 weeks
- Temporal access
- The gastric (Gold
standard) or
jejunal tube
- The gastric (Gold
standard) or
jejunal tube
- Temporal access
- > 4 weeks
- Permanent aceess
- - Percutaneous
endoscopic (GS)
- Gastrostomy
- Contraindications
-Morbid obesity
- Peritonitis -
Ascitis -
Nephrological
patients
- Contraindications
-Morbid obesity
- Peritonitis -
Ascitis -
Nephrological
patients
- Surgical gastrostomy
- Indications: - When
you perform other
abdominal surgery
- Contraindication
for endoscopy
- Indications: - When
you perform other
abdominal surgery
- Contraindication
for endoscopy
- - Percutaneous
endoscopic (GS)
- Gastrostomy
- Permanent aceess
- < 4 weeks
- Risk of bronco aspiration?
- Yes
- Jejunal
- Jejunal
- No
- Gastric
- Gastric
- Yes
- What formula?
- Polymeric
Oligomeric
Elemental
Energy 1 kCal/mL
- Patients who
need >
proteins:
- Undernutrition,
- catabolic
patients -
kidney with
dialysis
- Undernutrition,
- catabolic
patients -
kidney with
dialysis
- Patients who
need <
proteins
- Kidney
without
dialysis
- Kidney
without
dialysis
- Polymeric
Oligomeric
Elemental
Energy 1 kCal/mL
- Access
- Anorexia
Bulimia
- He can't
- Not receiving nutritionaldemands (for 5-7 days by mouth)
- Contraindications
- Peritonitis, GI tract
perforation, Incohesive
vomit, GI obstruction
GI ischemia GI bleeding
Hemodynamic
instability Pregnant
lady Hypovolemic
shock
Enterocutaneous
fistula
- Peritonitis, GI tract
perforation, Incohesive
vomit, GI obstruction
GI ischemia GI bleeding
Hemodynamic
instability Pregnant
lady Hypovolemic
shock
Enterocutaneous
fistula
- Benefits
- -Preserve
structure and
physiology
-Less
complications
-Maintain GAP
junctions
-Produce
hormones
and enzymes
-Maintain
micro biome
-MALT and
GALT (IgA)
-Trophism
- -Preserve
structure and
physiology
-Less
complications
-Maintain GAP
junctions
-Produce
hormones
and enzymes
-Maintain
micro biome
-MALT and
GALT (IgA)
-Trophism
- Indications
- Enteral Nutrition
- No
- Parenteral nutrition
- Indications
- 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
- 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
- Contraindications
- Functional GI trac
Hemodynamic instability
Less than 10 days
(transferrin)
- Functional GI trac
Hemodynamic instability
Less than 10 days
(transferrin)
- Access
- < 4 weeks
- Temporal access
- Central
- Subclavian
PICC
Yugular
Femoral
- Subclavian
PICC
Yugular
Femoral
- Peripheral
- Cephalic
Basilic
- Cephalic
Basilic
- Central
- Temporal access
- > 4 weeks
- Permanent access
- All central catheters
- All central catheters
- Permanent access
- < 4 weeks
- Indications
- Parenteral nutrition
- Complications Enteral and parenteral nutrition
- Mechanical
- Enteral: perforation,
laceration
Pneumo/hemo/quilotorax
Laceration of
vein/artery/heart
Obstruction Malposition
- Enteral: perforation,
laceration
Pneumo/hemo/quilotorax
Laceration of
vein/artery/heart
Obstruction Malposition
- Infectious
- Sepsis associated with catheter
Diarrhea
- Sepsis associated with catheter
Diarrhea
- GI complications
- Paralytic ileus,
atrophy
translocation
vomit diarrhea
distention pain
- Paralytic ileus,
atrophy
translocation
vomit diarrhea
distention pain
- Metabolic
- Glicemia changes
Electrolytic changes
< Tiamine, Mg, K, P
(Refeeding
syndrome) >
Osmolarity
- Glicemia changes
Electrolytic changes
< Tiamine, Mg, K, P
(Refeeding
syndrome) >
Osmolarity
- Mechanical
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