ISSN:0884-5336    

DOI:10.1177/0115426592007005203

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

The tremendous variability in resting energy expenditure makes efforts to predict caloric requirements difficult. Indirect calorimetry has provided a valuable tool in assessing energy expenditure, evaluating the way in which the body uses nutrient fuel, and designing nutritional regimens that best fit the clinical condition of the patient. The many indirect calorimetric instruments available vary in their application to clinical nutrition. The best metabolic studies are achieved by controlling the testing environment, accounting for the many clinical factors that may affect measurements, and eliminating potential sources for error. Although indirect calorimetry would seem to reduce the likelihood of complications from overfeeding, its greatest effect may be in cost savings by avoiding unnecessary nutritional support and in providing a means for clinical research.

ISSN:0884-5336    

DOI:10.1177/0115426592007005207

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700504

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700505

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Providing nutrition support may be costly to hospitals under the prospective payment system. A nutrition support team, however, can be effective in controlling costs. To demonstrate the importance of the nutrition support team and to quantify the potential cost savings that can be achieved, a retrospective review of the effect of our team on hospital costs was conducted for the 12‐month period of October 1989 to September 1990. The team supervises but does not regulate the use of total parenteral nutrition (TPN). During this time period, 176 patients received TPN. In 14 patients, the use of TPN was inappropriate, representing $65,349 in excess costs. After the cost of providing enteral nutrition to these patients (estimated at $2,430) was deducted, a net loss of $62,919 occurred. Nutrition support team action saved an additional $45,186 in hospital charges when recommendations to discontinue TPN were eventually heeded. Nutrition support team approval before TPN is initiated would achieve cost savings.

ISSN:0884-5336    

DOI:10.1177/0115426592007005227

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Nutrition support is recognized as an important cofactor in altering morbidity and mortality of hospitalized patients. Paramount in delivering proper nutrition support is the accurate determination of baseline metabolic and nutritional status, thus influencing necessary protein requirements. After nutritional intervention, routine laboratory monitoring is used to measure the efficacy and to reassess metabolic stress level. Accurate determination of nitrogen excretion (and nitrogen balance) remains the standard in prescribing and monitoring the protein and nutritional treatment regimen. This article examines nitrogen excretion determinations in the clinical setting, including proper collection techniques, laboratory measurements, and analyses and their effect upon nitrogen balance studies.

ISSN:0884-5336    

DOI:10.1177/0115426592007005231

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

The selection of a nutrition support regimen should be the product of a logical, stepwise process. After an appropriate candidate is selected, the integrity and function of the gastrointestinal tract must be assessed to determine if nutrients can be administered enterally or must be given by vein. The anticipated length of therapy will help determine the type of feeding access. Long‐term nutrition support requires permanent access, such as a percutaneously or surgically placed feeding tube for enteral nutrition or a tunnelled catheter or implanted port for parenteral nutrition. Formula selection for enteral nutrition, providing adequate liver and renal function, depends largely on the patient's ability to assimilate intact nutrients. The primary decision in parenteral formula selection is whether to provide the macronutrients as a mixed fuel system. The ultimate goal of nutrition support is to make a smooth transition to oral feedings while maintaining adequate nutritional intake.

ISSN:0884-5336    

DOI:10.1177/0115426592007005239

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700509

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/0115426592007005246

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/0115426592007005252

出版商:Sage Publications    

年代:1992

数据来源: WILEY