Complicaciones gastrointestinales de la nutrición enteral en el paciente crítico

Montejo, Juan Carlos; Jiménez, J.; Ordóñez, J.; Caparros, T; García, A.; Ortiz, Carlos Humberto; Lopez, Jorge

doi:10.1016/s0210-5691(01)79674-x

Cited by 23 publications

(13 citation statements)

References 57 publications

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“…The gastrointestinal complications seen during this study were infrequent and, in general, did not require withdrawal of nutrition. The incidence of diarrhea was clearly lower than that described for studies in adults [31–33], perhaps due to the good tolerance seen with the infant formulas and protein hydrolysates in small children [34]. Only two patients showed severe complications, necrotizing enterocolitis, which was related to hypoperfusion and sepsis by betalactamase‐positive gram‐negative bacteria in the postoperative period of cardiac surgery [35], causing the death of one of these patients.…”

Section: Discussionmentioning

confidence: 95%

The Use of Transpyloric Enteral Nutrition in the Critically Ill Child

Sánchez¹,

López‐Herce²,

Guerra³

et al. 2000

J Intensive Care Med

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To assess the use and complications of transpyloric enteral nutrition (TEN) in the critically ill child we evaluated prospectively all children who received TEN in a pediatric intensive care unit (PICU) of a tertiary university hospital. The type of nutrition used, its duration, medication administered, tolerance, gastrointestinal complications (vomiting, abdominal distension or excessive gastric residue, diarrhea, and pulmonary aspiration), nongastrointestinal complications, and mortality were assessed. A comparative analysis was made between the first 2 years of the study and the remaining period. Over a period of 4.5 years, 152 patients between the ages of 3 days and 17 years received TEN for a duration of 19 ± 32.3 days (range 1–240 days). Forty‐one patients received TEN during the first 2 years; 100 patients received TEN in the postoperative period after cardiac surgery (66%). One hundred seventeen patients (77%) received sedation and 65 (43%) received muscle relaxants, presenting no extra complications. Twenty‐four patients (15.8%) presented with gastrointestinal complications: abdominal distension and/or excessive gastric residue in 17 and diarrhea in 11. Gastrointestinal intolerance was associated with pulmonary infection (p < 0.05), altered hepatic function (p < 0.001), and hypokalemia or hypocalcemia (p < 0.05). Diarrhea was more frequent in patients with shock (p < 0.05), altered hepatic function (p < 0.05), excessive gastric residue (p < 0.001), and hypokalemia or hypocalcemia (p < 0.05). In the second study period, the number of patients on TEN and the doses of sedatives, muscle relaxants, and vasoactives were higher (p < 0.05), with no increase in the incidence of complications. TEN is a useful method of nutrition with few complications in the critically ill child.

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Section: Discussionmentioning

confidence: 95%

The Use of Transpyloric Enteral Nutrition in the Critically Ill Child

Sánchez¹,

López‐Herce²,

Guerra³

et al. 2000

J Intensive Care Med

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“…Incidence and density of incidence of the complications studied of enteral nutritional support Table 4. Incidence and density of incidence of the complications studied of parenteral nutritional support of constipation in patients receiving EN and it is speculated that besides the prior factors, alterations may be involved in intestinal motility as a consequence of the pathological process presented by patients 11 . For its treatment, fiber plays a determinant role, especially in those receiving prolonged EN.…”

Section: Discussionmentioning

confidence: 99%

Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

Ochoa

Giraldo

Aguilar³

et al. 2012

Colomb Med

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Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p = 0.363). For the enteral nutrition, the most significant complication was the removal of the catheter (14%), followed by diarrhea (8.3%); an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05). For parenteral nutrition, hyperglycemia was the complication of highest incidence (22.9%), followed by hypophosphatemia (12.5%); all complications were associated with the duration of the support (p < 0.05). Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an association with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits.

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“…El SN puede entenderse como el aporte de nutrientes por las vías enteral o parenteral con el objetivo de conseguir y/o conservar un estado nutricional apropiado en los pacientes que no pueden ser alimentados por vías convencionales. Ciertos factores como el riesgo/beneficio del tratamiento escogido para el paciente y la valoración de la función intestinal deben tenerse en cuenta en el instante de tomar la decisión del tipo de soporte a implementar en el paciente crítico [15][16][17][18][19] . Dicho SN puede dividirse en:…”

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Manejo de la anemia en el paciente crítico

Freire¹,

Zamora²,

Bautista³

et al. 2018

Enferm Inv

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La etiología de la anemia del paciente crítico se establece como multifactorial. Las pérdidas de sangre pueden causarse por cirugía, hemorragias, traumatismos, extracciones sanguíneas repetidas, entre otros factores que incluyen mecanismos inmunológicos. En ciertos casos, la aparición de la anemia del paciente crítico resulta anterior al ingreso en la unidad de cuidados intensivos y en otros se establece como un síntoma o comorbilidad de la patología médica o quirúrgica que ha provocado el ingreso, resultando uno de los principales factores de morbimortalidad en estos pacientes. Es, entonces, imprescindible dominar su etiopatogenia con el objetivo de su prevención, la realización de un diagnóstico correcto y la ejecución de un tratamiento apropiado con el fin de impedir o reducir sus efectos deletéreos. Este artículo se orienta a revisar el manejo y las metas del tratamiento antianémico del paciente crítico.

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Complicaciones gastrointestinales de la nutrición enteral en el paciente crítico

Cited by 23 publications

References 57 publications

The Use of Transpyloric Enteral Nutrition in the Critically Ill Child

The Use of Transpyloric Enteral Nutrition in the Critically Ill Child

Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

Manejo de la anemia en el paciente crítico

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