Miksi letkuruokinta ei onnistu? - Duodecim

Kirjallisuutta
Adam S, Batson S. A study of problems associated with the delivery of
enteral feed in critically ill patients in five ICUs in the UK. Intensive
Care Med 1997;23:261–6.
Basse L, Hjort Jakobsen D, Billesbolle P, ym. A clinical pathway to accelerate
recovery after colonic resection. Ann Surg 2000;232(1):51–7.
Beattie TK, Anderton A. Bacterial contamination of enteral feeding
systems due to faulty handling procedures – a comparison of a
new system with two established systems. J Human Nutr Dietics
1998;11:313–21.
Bengmark S. Progress in perioperative enteral tube feeding. Clin Nutr
1998;17:145–52.
Benya R, Damle P, Mobarhan S. Diarrhea complicating enteral feeding
after liver transplantation. Nutr Rev 1990;48(3):148–52.
Braga M, Bozzetti F, Dionigi P. Parenteral and enteral feeding in hospitals
in Italy: a national survey. Clin Nutr 1994;13:153–60.
Braga M, Gianotti L, Vignali A, ym. Artificial nutrition after major abdominal
surgery: impact of route of administration and composition
of the diet. Crit Care Med 1998;26:24–30.
Brinson RR, Kolts BE. Hypoalbuminemia as an indicator of diarrheal
incidence in critically ill patients. Crit Care Med 1987;15(5):506–9.
Bruun LI, Bosaeus I, Bergstad I, Nygaard K. Prevalence of malnutrition in
surgical patients: evaluation of nutritional support and documentation.
Clin Nutr 1999;18:141–7.
Castrén M, Mäkeläinen A. Enteraalinen ravitsemus. Duodecim 1999;115:
583–94.
Cresci GA, Moore J, Martindale RG. Do critically ill patients receive prescribed
and adequate nutrition intervention? Clin Nutr 1999;
18(S1):167.
Guenter PA, Settle RG, Perlmutter S, ym. Tube feeding-related diarrhea
in acutely ill patients. JPEN 1991;15(3):277–80.
Demetriades H, Botsios D, Kazantzidou D, ym. Effect of early postoperative
enteral feeding on the healing of colonic anastomoses in
rats. Comparison of three different enteral diets. Eur Surg Res
1999;31(1):57–63.
Duggan C, Nurko S. »Feeding the gut»: The scientific basis for continued
enteral nutrition during acute diarrhea. J Pediatr 1997;131:
801–8.
Edington J, Boorman J, Durrant ER, ym. Prevalence of malnutrition on
admission to four hospitals in England. Clin Nutr 2000;19(3):191–
5.
Hamvas J, Pap A. The role of jejunal feeding in the treatment of acute
necrotizing pancreatitis and in recurrence of chronic pancreatitis
with severe necrosis. Orv Hetil 1998;139(16):945–9.
Heimburger DC, Sockwell DG, Geels WJ. Diarrhea with enteral feeding:
prospective reappraisal of putative causes. Nutrition 1994;10(5):
329–36.
Homann HH, Kemen M, Fuessenich C, ym. Reduction in diarrhea incidence
by soluble fiber in patients receiving total or supplemental
enteral nutrition. JPEN 1994;18(6):486–90.
Kandil HE, Oper FH, Switzer BR, Heitzer WD. Marked resistance of normal
subjects to tube-feeding-induced diarrhea: the role of magnesium.
Am J Clin Nutr 1993;57:73–80.
McClave SA, Sexton LK, Spain DA, ym. Enteral tube feeding in the
intensive care unit: factors impeding adequate delivery. Crit Care
Med 1999;27:1252–6.
McWhirter JP, Pennington CR. Incidence and recognition of malnutrition
in hospital. BMJ 1994;308:945–8.
Metheny N. Preventing pulmonary complications during enteral feeding
in the critically ill. Program manual Aspen 18th Clinical Congress,
Jan 30 – Feb 2, 1994;318–22.
Montejo JC. Enteral nutrition-related gastrointestinal complications in
critically ill patients: a multicenter study. Crit Care Med 1999;
27(8):1447–53.
Nuutinen L, Alahuhta S. Tehostetun ravitsemushoidon ravitsemussuunnitelma.
Duodecim 1999;115:574–82.
Patchell CJ, Anderton A, Holeden C, ym. Reducing bacterial contamination
of enteral feeds. Arch Dis Child 1998;78:166–8.
Payne-James JJ, Rana SK, Bray MJ, ym. Retrograde (ascending) bacterial
contamination of enteral diet administration systems. JPEN
1992;16(4):369–73.
Raff T, German T, Hartmann B. The value of early enteral nutrition in
the profylaksis of stress ulceration in the severely burned patient.
Burns 1997;23:313–8.
Rollins H. Tube Feeding-luento. 22nd Espen Congress 9.–13. syyskuuta
2000.
Scheinin B, Asantila R, Orko R. The effect of bupivacaine and morphine
on pain and bowel function after colonic surgery. Acta Anesthesiol
Scand 1987;31:161–4.
Singh G, Ram RP, Khanna SK. Early postoperative enteral feeding in
patients with nontraumatic intestinal perforation and peritonitis.
J Am Coll Surg 1998;187(2):142–6.
Taylor SJ, Fettes SB, Jewkes C, ym. Prospective, randomized, controlled
trial to determine the effect of early enhanced enteral nutrition
on clinical outcome in mechanically ventilated patients suffering
head injury. Crit Care Med 1999;21(11):2525–31.
Mitä opin
MAARET CASTRÉN, LT, osastonlääkäri
m.castren@kolumbus.fi
HUS:n ensihoitoyksikkö
Agricolankatu 15
00530 Helsinki
1. Mitkä seuraavista taudeista ovat enteraalisen
ravitsemuksen aloituksen indikaatioita?
a) Vaikea palovamma
b) Vaikea haimatulehdus
c) Peritoniitti
d) Vaikea kallovamma
2. Enteraalisesti ravittu potilas saa tarvitsemastaan
energiamäärästä käytännössä keskimäärin
a) 80 %
b) 70 %
c) 60 %
d) 50 %
3. Letkuruokintapotilailla suolen peristaltiikkaa
parantaa
a) Dopamiini
b) Epiduraalipuudutus
c) Metoklopramidi
d) Tehokas kivunlievitys opiaateilla
4. Enteraalinen ravitsemus tulee keskeyttää, jos
a) Potilaalle tehdään haavarevisio
b) Potilaalle tulee ripuli
c) Residuaali on 200 ml nenämahaletkusta
aspiroitaessa
d) Suoliäänet eivät kuulu
5. Enteraalinen ravitsemus toteutuu parhaiten, jos
a) Hoitosuunnitelma on olemassa ja sitä noudatetaan
b) Hoitohenkilökunnan tietoa ravitsemuksesta
lisätään koulutuksella
c) Se aloitetaan vasta muutaman vuorokauden
kuluttua sairastumisesta
d) Ravintoa annetaan jatkuvana infuusiona
Oikeat vastaukset sivulla 1260
Miksi letkuruokinta ei onnistu?
1239