경장영양 지원의 역할 및 고려사항
Nutritional Considerations in Tube Feeding Patients
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Dysphagia patients who are damaged by stroke or various factors have a very high prevalence of malnutrition. Malnutrition affects medical complication and functional outcome in hospitalized patients. Early detection and ongoing management of malnutrition is important in rehabilitation for the dysphagia patients. Enteral nutrition is recommended in case of insufficient oral food intake. Most of all, it is important to determine nutrient needs, feeding regimen and methods according to patient’s condition. Nutrient requirements are based on nutritional status, degree of stress of disease or injury and physical activity levels. There is no change of energy expenditure after stroke itself. However the inflammatory response to acute ischemic stroke is seen in patients with or without evidence of infection. So the protein requirement is expected to be elevated in stroke patients. To obtain effective nutritional repletion, the tube fed patient must be carefully monitored the tolerance of formula, hydration status and adequacy of nutrition support. During transition from tube feeding to oral feeding, inadequate intake can aggravate patient’s malnutrition. So dysphagia patients are recommended to accompany tube feeding until safe and sufficient oral intake is possible. It is emphasized to monitor oral intake and nutritional status by a nutritionist. (JKDS 2011;1:85-89)
Abstract
Dysphagia patients who are damaged by stroke or various factors have a very high prevalence of malnutrition. Malnutrition affects medical complication and functional outcome in hospitalized patients. Early detection and ongoing management of malnutrition is important in rehabilitation for the dysphagia patients. Enteral nutrition is recommended in case of insufficient oral food intake. Most of all, it is important to determine nutrient needs, feeding regimen and methods according to patient’s condition. Nutrient requirements are based on nutritional status, degree of stress of disease or injury and physical activity levels. There is no change of energy expenditure after stroke itself. However the inflammatory response to acute ischemic stroke is seen in patients with or without evidence of infection. So the protein requirement is expected to be elevated in stroke patients. To obtain effective nutritional repletion, the tube fed patient must be carefully monitored the tolerance of formula, hydration status and adequacy of nutrition support. During transition from tube feeding to oral feeding, inadequate intake can aggravate patient’s malnutrition. So dysphagia patients are recommended to accompany tube feeding until safe and sufficient oral intake is possible. It is emphasized to monitor oral intake and nutritional status by a nutritionist. (JKDS 2011;1:85-89)
참고문헌 (18)
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