Nutritional recommendations in hematopoietic stem cell transplantation

Comparação de métodos de avaliação nutricional empregados no acompanhamento de pacientes submetidos a transplante de células-tronco hematopoéticas alogênico

“…[17][18][19][20][21] Entre os pacientes estudados, este valor representaria entre 1.575 a 1.816 Kcal entre as mulheres e 1.398 a 1.614 Kcal entre os homens. Porém, encontramos a média de consumo energético de 1.073 Kcal e 1.543 Kcal entre mulheres e homens, respectivamente, ficando em 89% do GEB/HB pelas mulheres e 113% do GEB/HB pelos homens.…”

“…A quantidade de proteína recomendada está entre 1,3 e 2g/kg. 17,20,21 Em nosso estudo encontramos a média de 0,53 g de proteína/kg, 40% do valor mínimo recomendado, entre as mulheres e 0,65 g de proteína/kg entre homens, 50% do valor mínimo recomendado.…”

“…16 Apesar disso, muitos protocolos utilizam o IMC como parâmetro, tanto para o início quanto para o fim, do uso de NPT. 20,23,25 O %PP também é utilizado como parâmetro para o uso de suporte nutricional. 11,17,20 As medidas de circunferência do braço, da dobra cutânea triciptal e circunferência muscular do braço foram analisadas pelo teste t para amostras pareadas (Tabela 3).…”

Nutritional support in patients with GVHD of the digestive tract: state of the art

“…When the volume of diarrhoea has decreased (typically to o500 mL/day), oral food is restarted, but certain foods may be better tolerated than others. 19,37,43 General guidelines of the Seattle Cancer Care Alliance recommend specific upgrade diets for patients with GVHD-DT, with limited amounts of fats, fibre, lactose, acidic items and GI irritants, which are stepwise introduced. 19 Only one prospective study investigated effects of this stepwise upgrade diet in 18 patients with GVHD-DT; in this study, the stepwise upgrade diet was compared with a historic control cohort (n ¼ 17) receiving nil by mouth and TPN, for effects.…”

“…11,49 Expert opinions and reviews (level D) on nutritional support in SCT recommend 1.8-2.5 g/kg/day in case of malnutrition and severe complications (that is, GVHD), and 1.5-1.8 g/kg/day if no severe malnutrition and only mild complications are present. 43,47 Micronutrients As patients with GVHD-DT experience nutritional and metabolic derangements, requirements for micronutrients might alter, and so does micronutrient status. Due to diarrhoea, malabsorption and inadequate food intake, GVHD-DT patients are at high risk of being in a deficient state for electrolytes and vitamins.…”