Critical Care Flashcards
(42 cards)
Goal reach 80% TF goal x
48 hrs
pSBO what enteral tube to use
feed distally, and decompress proximally
Ileus
takes a mix of fluid/nutrients and air to make BS
TF factors for pts with aspiration risk include:
HOB 30-40 degrees, slow continuous rate, prokinetics, post pyloric
Diarrhea
investigate cause (drug/infectious), antidiarrheals/fiber
Best outcomes with TF providing this amt
33-65%
Acute pancreatitis with EN
proximal feeds do not exacerbate, reduces mortality
Distal Jtube used for
obstruction UGI, pancreatic rest, suppression of pancreatitis
Mild-Moderate Trauma –resume po 3-5 days
No Nutrition support
Severe Trauma (burns 20% BSA or MOSF), anticipate no po 5-10 days
YES Nutrition support
Cascade
SIR-neuroendocrine and cytokine response to maintain O2 delivery
SIR catabolic state
store substrates,increase insulin, inc HR, minute vent
Increase GI blood flow with
presence luminal nutrients
Nutrients effect lumin
Dextrose: inc bld flow, improve gut dysfx, AA: amplify injury, Glutamine: enhance neutrophil fx and prevent damage, IVF: ?
Primary Nutrition Support plan for trauma, surgery and burn with intact GI
EN
Early Feeding
within 2 hrs of injury to 5 days
G tubes predisposed to (may cause)
aspiration/PNA
Aspiration seen with these tubes
G/J despite low residuals
Advocate for J tubes
Dec GE regurg, dec rate vent assoc PNA, Inc nutrient delivery, short time to get to TF goal
Fewer post-op infections with this type of feeds
EN, preserved GI immunity, mucosal barrier function, dec pulmonary infections in trauma pts
Uncomplicated Malnutrition markers
normal visceral proteins
Hyperglycemia with PN may cause
negative outcomes
Gastric and Colorectal Cancer significant dec post-op intra abdomenal abscesses with
Pre-operative EN
Post-op PN highest M/M over how long
over 14 days
