Nutrition Assessment in Critically Ill Patients课件.ppt

Nutrition Assessment in Critically Ill Patients;Introduction;Nutrition assessment;A.S.P.E.N. Guidelines;Veterans Administration Cooperative Group study of perioperative parenteral nutrition using serum albumin level and the ratio of current weight to usual weight successfully stratifies operative morbidity and mortality ;uses markers of the inflammatory response in combination with nutrition assessment parameters predict infectious complications and death ;evaluates abnormalities in food intake, digestion and absorption, strength and activity, and body composition developed by Detsky et al predicts nutrition-related complications in certain populations, such as? surgical patients? trauma good sensitivity and specificity Its applicability to critically ill patients? Its role in the assessment of responses to nutrition support?;Objective of this study;Materials and Methods;using a standard form performed by a trained independent physician food intake and complaints such as vomiting, diarrhea, and loss of weight within 24 hours of admission;遗涩梦锈秤绰墒管书吝搐张靠单刚莱伦驾眺何篆雄惫锗根粪返蓬练桶借糜Nutrition Assessment in Critically Ill Patients课件Nutrition Assessment in Critically Ill Patients课件;TSF and MAC (mid-arm circumference) on admission Performed by a trained independent physician Mean of 3 measurements (to the nearest 0.1 cm) Height, weight, body mass index (BMI) Mid-arm muscle circumference (MAMC) MAMC (cm) = MAC (cm) – (TSF [mm] × 0.3142);4–8 mm: borderline fat stores 3 mm or less: severe depletion;Enteral feeding (NG tube) ? commercial formulas based on patient’s need Parenteral nutrition regimen? continuous infusion via a jugular vein ;APACHE II score (Acute Physiology and Chronic Health Evaluation) SAPS II (Simplified Acute Physiologic Score; calculated from 17 measurable clinical and biological parameters determined during the first 24 hours after admission) Biochemical parameters:? CBC, lymphocyte count ? serum levels of total protein, albumin, BUN,  creatini