Nutrition Therapy

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The Nutrition Therapy is of central importance for our ability to handle diseases in general, infections, surgery and trauma in particular. The objective of the Nutrition Therapy is to maintain or improve the nutrition status by avoiding and treatment of malnutrition, maintaining body tissue and functioning plasma protein stores and to prevent macro- and micronutrient deficiency.

Nutritional support can be provided either orally (oral nutritional supplements) or through a feeding tube (Enteral Nutrition) or, when the digestive tract cannot be used, through an intravenous catheter that is inserted directly into the veins (Parenteral Nutrition).

The definitive type of nutrition therapy is largely depending on the patients condition, illness and needs. E.g. surgical patients in an ICU tend to have needs different from those patients undergoing anti-cancer treatment or chronic dialysis yet again need another nutritional support.

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Nutrition therapy

Processes in nutrition therapy

The field of Nutrition Therapy comprises all kinds of nutritional support from additions to normal oral diets for patients who do not or cannot eat sufficiently until complete parenteral nutrition regimes for patients who are unable to meet their nutritional needs by oral or enteral nutrition. Body reserves can normally make up for short fasting periods, however in already malnourished patients or patients at-risk of malnutrition even short periods without adequate nutrition present an additional hazard which could lead to a negative clinical outcome with increased morbidity and mortality.Depending on the populations, approximately 20-50% of hospitalized patients present with a state of malnutrition and thus need nutrition therapy. Generally speaking, two different approaches are available, the using the gastrointestinal system thus being referred to as enteral nutrition, the other bypassing the gastrointestinal system thus being referred to as parenteral nutrition. 

The definitive type of nutrition therapy is largely depending on the patients condition, illness and needs. E.g. patients on the ICU tend to have needs different from those a burn patient might have, and patients undergoing anti-cancer treatment or chronic dialysis yet again need another nutritional support. 

Prescription

Tools are available for the systematic screening of patients to assess whether they suffer from malnutrition or not. Depending on the result of the screening the physician decides upon the appropriate nutritional support and application route. Based on this he prescribes the nutritional regime.

Patient Access

To apply the nutrition solution, an access to the patient has to be established. The type of patient access is depending on the type of nutritional support and the patient’s condition: For enteral nutrition, a gastric or nasal tube might be applied or a percutaneous endoscopic gastrostomy (PEG) may be needed. For parenteral nutrition, a peripheral IV catheter, a central line or an implanted catheter (e.g. port or Hickman catheter) can be appropriate choices.

Preparation

Many enteral nutrition products are available as ready-to-use-products such as sip or tube feeds. Parenteral Nutrition solutions are offered in ready-to-mix bags, such as 2- or 3-chamber bags. Only vitamins or trace elements should be added. Some patients may need individually compounded IV nutrition. These admixtures can be prepared by a pharmacy or an industrial compounding service.

Application

The transfer of nutrition solutions from container to patient access requires, except for sip feeds, assembled systems of medical devices.
B. Braun helps you to set up your systems safely and provides concepts preventing medication errors. Safe and dedicated disposables avoid misconnections between enteral and IV-lines. Space GlucoseControl enables safe and reliable glucose levels in critical ill patients.

Discharge Management

Once the treatment of the patient in the hospital is finished, patients may have to stay on nutritional support, e.g. oncology or short bowl patients. Discharge management supports optimum continuous support and hand over to nursing services plus appropriate training of the care givers.
During the recovery process the patient is transfered from the intensive care unit to the ward and finally discharged from hospital to home. However, some patients still need further nutritional support after being discharged. In this case a qualified B. Braun Discharge Management ensures a smooth transition and hand over from the hospital to the nursing service which cares for the patient at home.