Fundamentals of Parental Nutrition Support Flashcards
(57 cards)
What are the results of malnutrition?
1) increased morbidity & mortality
2) impaired wound healing
3) organ failure
What is marasmus?
chronic condition from prolonged inadequate intake or use of protein & calories
- weight loss > 10% TBW
- wasting of somatic protein & adipose
- visceral protein conserved
What are the consequences of marasmus?
impaired muscle function
impaired cellular immunity
What is kwashiorkor?
condition resulting from inadequate protein intake
- wasting of visceral (some somatic) protein
- adipose conserved
How do kwashiorkor & marasmus compare in terms of mortality?
kwashiorkor has higher mortality
What usually brings about kwashiorkor?
usually secondary to trauma, infection, burns
Describe mixed marasmus/kwashiorkor.
condition of severe protein & calorie malnutrition
- somatic protein & adipose wasting
- reduced visceral protein synthesis
What are the causes of mixed marasmus/kwashiorkor
chronic illness
starvation
hypermetabolic stress
What are the consequences of mixed marasmus/kwashiorkor?
reduced immunity
reduced wound healing
What is the half-life of albumin?
18-20 days
What is the half-life of transferrin?
8-9 days
What is the half-life of pre-albumin?
2-3 days
What are the 3 major tissue that rely on glucose?
1) RBCs
2) Neurons
3) Renal cortex
Describe the body’s initial response to starvation.
Gluconeogensis via glycogen & protein
Describe the body’s response to starvation at 5 days.
Adipose is broken down to ketone bodies.
BMR is reduced
What are the ketone bodies synthesized from fat?
1) beta-hydroxybutyrate
2) acetoacetic acid
How do hormone levels change with starvation response?
1) decreased insulin
2) increased glucagon
3) increased epinephrine
What conditions result in hypermetabolism?
1) trauma
2) burn
3) head injury
4) sepsis
What is the metabolic response in hypermetabolism?
1) altered CHO metabolism via decreased insulin efficiency
2) increased lipid oxidation
3) increased protein turnover
4) net loss of protein & body mass
What condition would you expect, in what timeframe, in a hypermetabolic patient who was previously well nourished?
kwashiorkor in 5-7 days
What condition would you expect, in what timeframe, in a hypermetabolic patient who was previously malnourished?
mixed form in 3-5 days
What malnutrition condition usually occurs in hypermetabolic elderly patients?
mixed form (previously malnourished)
What are the implications on malnutrition on ICU admits?
1) increased length of stay
2) more complications
How are caloric requirements determined?
1) H-B equation w/ correction factor
2) Indirect calorimetry via metabolic cart study
