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ISSN 1684-1824 (Electronic)

2019, Number 5

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Rev Méd Electrón 2019; 41 (5)

Precocious nutritional intervention in elder people with communityacquired pneumonia

García ÁPJ

Language: Portugués
References: 37
Page: 1166-1177
PDF size: 128.04 Kb.


ABSTRACT

Introduction: nutrition has a capital importance in the evolution of in-patients. Malnutrition prevalence ranges from 30 % to 60 % of the admitted patients.
Objective: to evaluate the impact on mortality and the short time complications of the precocious nutritional intervention.
Materials and methods: a case control study was carried out with all patients who entered the Emergency Intensive Care Unit with the diagnosis of community-acquired pneumonia associated to malnutrition in the Military Hospital “Dr, Carlos J. Finlay” from November 2017 to May 2018.
Results: the average age was 80.73 ± 9.01 years. 46 % were female patients. Global mortality was 26 %. 69 % of patients had complications. The group of study showed a higher survival (7 deads and 29 survivors) than the control one where there were 12 deads and 24 survivors (2=0.18). Table 2 shows that there are differences between groups according to the complications found. The difference between groups was remarkable in relation to the quantity of patients with diarrhea. The incidence was higher both in the group of survivors (8) and in the group of dead peoples(3) of the control group. On the other hand, hyperglycemia was much higher in the group of study (11) but without striking on mortality (2= 0.03). Table 3 shows strong evidence relating deficient nutritional status to a worth evolution. Among the deceased patients only 1 had a nutritional status classified as slightly malnutrition, but among the 22 deceased, 14 had severe malnutrition.
Conclusions: the nutritional status at admission negatively strikes on short term mortality, and mixed precocious nutritional strategy does not reduce that aspect. However it does reduce the number of complications, though it was associated to a higher incidence of hyperglycemia without striking on mortality.


REFERENCES

  1. INFOMED. Historia de la Neumonía. INFOMED. [Internet]; 2013 [citado 19/12/2013]. Disponible en: http://articulos.sld.cu/neumologia/2013/03/01/historiade- la-neumonia/

  2. Lara Aguayo P, Rojas Amezcua M, de la Fuente Martos C, et al. Neumonía adquirida en a comunidad. In: Fotoletra SA, editor. Tratado de Medicina Intensiva. Barcelona, España: Elsevier; 2017. p. 659.

  3. Saiz L, Garjón J, Gorricho J, et al. Validation and incidence of community-acquired pneumonia in patients with type 2 diabetes in the BIFAP database. Epidemiol Infect. 2017;145(14):3056-64. Citado en PubMed:PMID:28854991.

  4. Bess Contanten S. Anuario estadistico de la Salud.Cuba 2016 [Internet].La Habana:MINSAP[citado 01/09/2017]; 2016. Disponible en: http://files.sld.cu/dne/files/2016/04/Anuario_2015_electronico-1.pdf

  5. Ryo S, Kanda M, Ito S, et al. The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set. Ann Surg Oncol. 2018;26(2):456- 464. Citado en PubMed:PMID:30565044.

  6. Pelegrina-Cortés BM, Bermejo L, López-Plaza B, et al. Nutritional Composition Assessment of 3000 Individualized Parenteral Nutrition Bags in a Tertiary Referral Hospital: Current Prescribing Patterns. Nutrients. 2018;10(8):1079. Citado en PubMed:PMID:30104490.

  7. Sánchez-Muniz F, Culebras-Fernández J. Artificial Nutrition, a multidisciplinary task. The role of the Nutrition journals in its diffusion.Farm Hosp. 2018;42(3):93-94. Citado en PubMed: PMID:29730978.

  8. Lindroos E, Saarela R, Suominen M, et al. Burden of Oral Symptoms and Its Associations With Nutrition, Well-Being, and Survival Among Nursing Home Residents. J Am Med Dir Assoc. 2018;20(5):537-543. Citado en PubMed:PMID30541688.

  9. Shiraishi A, Yoshimura Y, Wakabayashi H, et al. Impaired oral health status on admission is associated with poor clinical outcomes in post-acute inpatients: A prospective cohort study. Clin Nutr. 2018 Nov 30. pii: S0261-5614(18)32553-6. Citado en PubMed: PMID:30538050.

  10. Fan M, Wang Q, Fang W, et al. Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury: Effects on Immune Function, Nutritional Status and Outcomes. Chin Med Sci J. 2016;31(4):213-220. Citado en PubMed: PMID:28065217.

  11. Harvey S, Parrott F, Harrison D, et al. Trial of the route of early nutritional support in critically ill adults.N Engl J Med. 2014 Oct 30;371(18):1673-84. Citado en PubMed: PMID: 25271389

  12. Van Blarcom A, McCoy M. New Nutrition Guidelines: Promoting Enteral Nutrition via a Nutrition Bundle.Crit Care Nurse. 2018 Jun;38(3):46-52. Citado en PubMed: PMID:29858195.

  13. Pu H, Doig G, Heighes P, et al. Early Enteral Nutrition Reduces Mortality and Improves Other Key Outcomes in Patients With Major Burn Injury: A Meta-Analysis of Randomized Controlled Trials. Crit Care Med. 2018;46(12):2036-2042. Citado en PubMed: PMID:30222632.

  14. Takenoshita S, Kondo K, Okazaki K, et al. Tube feeding decreases pneumonia rate in patients with severe dementia: comparison between pre- and post-intervention. BMC Geriatr. 2017 Nov 21;17(1):267. Citado en PubMed: PMID:29157223.

  15. Su S, Sun R, Liu R,et al. Effect of enteral nutrition time on pH value of gastric juice and ventilator-associated pneumonia in critically ill patient. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Aug;30(8):768-770. Citado en PubMed;PMID:30220279.

  16. Tian F, Heighes P, Allingstrup M,et al. Early Enteral Nutrition Provided Within 24 Hours of ICU Admission: A Meta-Analysis of Randomized Controlled Trials.Crit Care Med. 2018;46(7):1049-56. Citado en PubMed;PMID:29629984.

  17. Lewis S, Schofield-Robinson O, Alderson P, et al. Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit.Cochrane Database Syst Rev. 2018 Jun 8;6:CD012276. Citado en PubMed;PMID:29883514.

  18. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient. J Parenter Enter Nutr. 2016;40(2):159-211. Citado en PubMed:PMID:26773077.

  19. Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36:623-650. Citado en PubMed: PMID:28385477.

  20. Brisard L, Le Gouge A. Impact of early enteral versus parenteral nutrition on mortality in patients requiring mechanical ventilation and catecholamines: study protocol for a randomized controlled trial.Trials. 2014;15:1186. Citado en PubMed:PMID:25539571.

  21. Fan M, Wang Q, Fang W, et al. Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury: Effects on Immune Function, Nutritional Status and Outcomes.Chin Med Sci J. 2016 Nov 20;31(4):213-220. Citado en PubMed: PMID:28065217.

  22. Yu H, Tang C, Feng W, et al. Early Enteral Nutrition Versus Parenteral Nutrition After Resection of Esophageal Cancer: a Retrospective Analysis.Indian J Surg. 2017 Feb;79(1):13-18. Citado en PubMed; PMID:28331260.

  23. Valdés-Suárez O. Nutrición en el neurocrítico. Rev Cubana de Med Intensiva y Emergencias[Internet].2018[citado 12/12/2018];17(Supl1):41-50. Disponible en: https://www.revmie.sld.cu/index.php/mie/article/view/445

  24. Omorogieva A. The Challenges of Home Enteral Tube Feeding: A Global Perspective. Nutrients. 2015 Apr 08;7(4):2524-38. Citado en PubMed:PMID: 17456215.

  25. Takenoshita S, Kondo K, Okazaki K, et al. Tube feeding decreases pneumonia rate in patients with severe dementia: comparison between pre- and post-intervention.BMC Geriatr. 2017 Nov 21;17(1):267. Citado en PubMed; PMID:29157223.

  26. Chen F, Xu C, Zhang C. Effect of indwelling nasointestinal tube for enteral nutrition support in patients with severe craniocerebral trauma undergoing mechanical ventilation. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Jan;30(1):57-60. Citado en PubMed; PMID:29308759.

  27. Nordin N, Kamaruzzaman S, Chin A, et al. A descriptive study of nasogastric tube feeding among geriatric inpatients in Malaysia: utilization, complications, and caregiver opinions.J Nutr Gerontol Geriatr. 2015;34(1):34-49. Citado en Pub Med; PMID:25803603.

  28. Yagmurdur H, Leblebici F. Enteral nutrition preference in critical care: fibreenriched or fibre-free? Asia Pac J Clin Nutr. 2016 Dec;25(4):740-746.Citado en PubMed;PMID:27702716.

  29. Zhao R, Wang Y, Huang Y, et al. Effects of fiber and probiotics on diarrhea associated with enteral nutrition in gastric cancer patients: A prospective randomized and controlled trial. Medicine (Baltimore). 2017 Oct;96(43):e8418. Citado en PubMed;PMID:29069041.

  30. Brooke J, Maidstone K. Enteral Nutrition in Dementia: A Systematic Review.Nutrients. 2015 Apr 03;7(4):2456-68. Citado en PubMed;PMID:20726643.

  31. Chelkeba L, Mojtahedzadeh M, Mekonnen Z. Effect of Calories Delivered on Clinical Outcomes in Critically Ill Patients: Systemic Review and Meta-analysis.Indian J Crit Care Med. 2017 Jun;21(6):376-390. Citado en PubMed;PMID:28701844.1

  32. Villalobos-Gámez JL, Lara-Ramos C, Domínguez-Rivas Y, et al. Nitrogenous content in parenteral nutrition: A four-year experience in a general hospital. critically-ill patient specificity. Nutr Hosp. 2017;34(3):555. Citado en PubMed;PMID:28627189.

  33. Mazaki T, Ishii Y, Murai I. Immunoenhancing enteral and parenteral nutrition for gastrointestinal surgery: a multiple-treatments meta-analysis.Ann Surg. 2015 Apr;261(4):662-9. Citado en PubMed;PMID:25405556.

  34. Cho J, Kim K, Cho H, et al.Nutritional risk index as a predictor of mortality in acutely decompensated heart failure.PLoS One. 2018 Dec 14;13(12). Citado en PubMed;PMID:30550609.

  35. Nakao M, Muramatsu H, Arakawa S, et al. Immunonutritional status and pulmonary cavitation in patients with tuberculosis: A revisit with an assessment of neutrophil/lymphocyte ratio.Respir Investig. 2018 Oct 24. pii: S2212-5345(18)30243- 0. Citado en PubMed;PMID:30528689.

  36. Russell M, Wischmeyer P. Supplemental Parenteral Nutrition: Review of the Literature and Current Nutrition Guidelines.Nutr Clin Pract. 2018 Jun;33(3):359- 369.Citado en PubMed;PMID:29878557.

  37. Hanachi M, Bohem V, Bemer P, et al. Negative role of malnutrition in cell-mediated immune response: Pneumocystis jirovecii pneumonia (PCP) in a severely malnourished, HIV-negative patient with anorexia nervosa.Clin Nutr ESPEN. 2018 Jun;25:163-165. Citado en PubMed;PMID:29779813.




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