Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Products | Clinical Tools | Education | Research Critical Care Nutrition Guidelines: Ali/ards Appropriate TUBE FEEDING patientS may include: Patients in the ICU who are intubated with Acute Lung Injury (ALI): PaO2/FiO2 <300mmHg or Acute Respiratory Distress Syndrome (ARDS): PaO2/FiO2 <200mmHg. n Any intubated patient with increased calorie and protein needs due to hypermetabolism associated with respiratory failure. ENTERAL FORMULA Selection Criteria: Concentrated formula, as fluid restriction may help to minimize fluid accumulation around the lungs, associated with pulmonary edema. n ENTERAL FORMULA OPTIONS Peptamen® af Provides: n n n Added long-chain omega-3 fatty acids plus an appropriate n6 to n3 ratio to help minimize the inflammatory cytokine production associated with n6 fatty acids. n n n n n n n Added antioxidants to help neutralize free radicals. n 1.2 calories 25% protein Peptide-based 50% mct epa & dha n6:n3 of 1.8:1 Antioxidant rich in vitamins a,c,e and minerals selenium and copper Added prebiotics Crucial® Provides: n n n n n n n n 1.5 calories 25% protein Peptide-based 50% mct epa & dha n6:n3 of 1.5:1 Antioxidant rich in vitamins a,c,e and minerals selenium and copper Added arginine High protein to help minimize loss of lean body mass during the acute phase response. n TUBE FEEDING CONSIDERATIONS Balanced peptide profile to help enhance protein absorption. n High arginine diet to help restore the immune system in potentially argininedeficient patients (if patient was not admitted with underlying infection). n n n Initiate as soon as hemodynamically stable, gastric or small bowel access is available, and no contraindications exist. Initiate slowly at full strength and advance as tolerated, with goal to meet at least 60% of needs enterally. Nestlé Nutrition has endeavored to include in this document such clinical information that it believes to be accurate and reliable as of the date of publication. Nestlé Nutrition makes no representation or warranty, express or implied, as to the accuracy or completeness of the information and shall have no liability relating to or resulting from the use of such information. The information contained in this document is not intended as a replacement for medical advice, standards of care, approved practices or policies of a particular physician and/or healthcare facility, all of which should be considered. See also: Al-Saady, NM, Balckmore CM, Bennett, ED. High fat, low carbohydrate enteral feeding lowers PaO2 and reduces the period of ventilation in artificially ventilated patients. Intensive Care Medicine 1989; 15: 290-295. Chin, R, Haponik, EF. Nutrition, Respiratory Function and Disease. Modern Nutrition in Health and Disease. Lea & Febiger: Philadelphia, 1994;1374-1390. Gadek, JE, DeMichele SJ, Karlstad MD, et al. Effect of enteral feeding with eicosapentaenoic acid, g-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Critical Care Medicine 1999; 27: 1409-1420. Hogg, J, Klapholz, A, Reid-Hector, J. Pulmonary Disease. In Gottschlich M, (ed), The Science and Practice of Nutrition Support, A Case-based Core Curriculum. Dubuque: Kendall/Hunt, 2002; 575-599. Meredith JW, et al. Visceral protein levels in trauma patients are greater with peptide diet than with intact protein diet. The Journal of Trauma. 1990; 30(7): 825-829. Mizock BA. Nutritional support in acute lung injury and ARDS. Nutrition and Clinical Practice 2001;16:319-328. McCarthy, MS, Deal LE. Nutritional Support in Respiratory Failure. Nutritional Considerations in the Intensive Care Unit. Dubuque: Kendall/Hunt, 2002; 187-197. Ochoa, Juan B et al. A Rational Use of Immune Enhancing Diets: When Should We Use Dietary Arginine Supplementation? Nutrition in Clinical Practice 2004;19:216-225. © 2007 Nestlé Nutrition. All trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland. ESSENTIALS OF CRITICAL CARE NUTRITION