Nutritional support

Nutritional support is a set of active measures to maintain an adequate intake of energy, nutrients, trace elements and vitamins .

Algorithm for administration of nutritional support[edit | edit source]

With good GIT function , enteral nutrition is given (sipping, nasogastric or nasojejunal tubes) ;
- if enteral nutrition is required for longer than 4–6 weeks, nutrition is introduced into the stoma (PEG) in bolus, intermittent or continuous form.
In case of poor GIT function, parenteral nutrition (total, supplementary) is given;
- short-term (up to 10 days) – peripheral application;
- long-term (over 10 days) – by central catheter.
Methods of administration:
- all-in-one;
- multiple bottles.
Components of enteral nutrition:
- carbohydrates - the basis is glucose (150 g/day);
- fat emulsions – 1–2 g/kg/day;
- essential AMC – Val, Leu, Ile, Phe, Try, Lys, Met, Thr.
Contraindications of enteral nutrition:
- sudden abdominal events (ileus conditions), toxic megacolon, severe abdominal infections, bleeding into the GIT;
- when applying fat emulsions there is a risk of hyperlipoproteinemia , fat embolism , shock , sepsis, DIC.

Diet therapy means adjusting the diet in order to influence the disease process, the so-called sparing diet:

mechanical examination – must not increase tone or peristalsis;
chemical investigation – its composition must not irritate the mucous membrane and increase secretion;
thermal protection - must not irritate the digestive tract thermally.

strict sparing diet – in an acute state, incomplete;
basic sparing diet – full of energy and biological value, served long-term;
sparing diet:
- special - tea, liquid nutritional, with strict fat restriction, diabetic;
- basic – liquid, mushy, sparing, with fat restriction, no residue;
- standardized – for pancreatitis, lactose intolerance, gluten, liver insufficiency.

A polysaccharide that has almost no nutritional value.
Intake should be 25-30 g per day (intake above 50 g may cause intestinal obstruction).
Diet with fiber content is indicated for all people who do not need to spare the digestive tract, it has a preventive effect against constipation, hemorrhoids, diverticulosis.
Soft (soluble) fiber - fruits, vegetables, nuts, legumes - hemicellulose, agar, pectins, mucus - absorbs excess water from the intestines, swells, binds toxic substances, increases the volume of stool and softens it.
Coarse (insoluble) fiber - cereals, woody plants - cellulose, lignin - increases the volume of intestinal contents, adjusts peristalsis, acts against constipation.

For more information see Parental nutrition (Paediatrics).

PASTOR, Jan. Langenbeck's medical web page [online]. ©2006. [cit. 14.11.2010]. <http://langenbeck.webs.com/interna.htm>.