engleski

Case report: Nutrition support of malnutrition

Hospital malnutrition is an insidious problem which is responsible for many complications. Sepsis, shock, multiple traumas, is often associated with altered metabolism characterized by severe catabolism, wasting of the lean body mass and immune dysfunction. Critically ill patients are frequently hypermetabolic with increased nutritional requirements, and are exposed to the risk of underfeeding. Methodology: The case report presents the case of 18 years old patient which stayed 35 days in the intensive care unit before he came in University hospital Dubrava, and whose nutritional support failed. On admission in University hospital Dubrava he was underweight, malnourished (including calorie malnutrition and protein malnutrition). He underwent a comprehensive nutritional assessment which included anthropometric measurements, dietary intake and biochemical variables. Results and discussion: After 33 days nutrition support which includes: high energy and protein enteral feeding (hospital made diet: energy 60- 75 kcals/kg/day ; proteins 1, 5-2g/kg/day ; carbohydrates 8-9 g/kg/day ; fats 2-2, 5 g/kg/day) with antioxidant micronutrients, maltodextrin, enteral nutrition products, goat milk, olive and fish oil supplementation, there was significant improvement in patients nutritional status. Biochemical parameters were observed ; there was improvement in the serum albumin levels (Initial-35 g/L ; After 33 days-42 g/L), total protein (Initial-63 g/L ; After 33 days- 70 g/L) CRP (Initial-19, 3 mg/L ; After 33 days- 1, 8 mg/L), HDL -c (Initial-1, 25 mmol/L ; After 33 days-1, 28 mmol/L).There was significant improvement in anthropometrics measurements: body weight (Initial-53 kg ; After 33 days- 63 kg), BMI (Initial-14, 5 ; After 33 days- 18) , (triceps skin fold Initial-20 mm ; After 33 days- 23 mm). Conclusion: This case report illustrates the success of nutritional management. Nutrition support is one of the mainstays in the management of these critically ill patients and is aimed at minimizing these complications .The patient progressed from enteral feeding to normal nutrition and discharged on 30th post operative day.

malnutrition, clinical nutrition, critically ill patients

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