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      The impact of the introduction of a clinical nutrition unit in a hospital: a retrospective observational study Translated title: El impacto de la implantación de una unidad de nutrición clínica en un hospital: estudio observacional retrospectivo

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          Abstract

          Abstract Objectives: the study describes the evolution over the years of the use of artificial nutrition, in particular after the introduction of a dedicated Clinical Nutrition and Dietetic Service. Methods: a single-center, retrospective observational study performed with data collected from 2014 to 2019 at the Regional Hospital of Locarno, Switzerland. Results: from 2014 to 2019, there has been an increase in the number of patients identified as being at risk of malnutrition. We observed a reduction in the use of parenteral nutrition in all services, especially after the introduction of the dedicated Clinical Nutrition and Dietetic Service. There would seem to be a switch from enteral to oral nutrition with increased use of oral nutritional supplements. Conclusions: the introduction of a dedicated Clinical Nutrition and Dietetic Service in the care of patients with nutritional issues would seem to reduce the use of artificial invasive nutrition, despite an increase in the number of patients identified as being at risk of malnutrition.

          Translated abstract

          Resumen Objetivos: el estudio describe la evolución a lo largo de los años del uso de la nutrición artificial, en particular después de la introducción de un Servicio de Nutrición Clínica y Dietética dedicado. Métodos: estudio observacional retrospectivo de un solo centro realizado con datos recopilados de 2014 a 2019 en el Hospital Regional de Locarno, Suiza. Resultados: del 2014 al 2019 ha habido un aumento en el número de pacientes identificados en riesgo de desnutrición. Observamos una reducción en el uso de la nutrición parenteral en todos los servicios, especialmente después de la introducción del Servicio de Nutrición Clínica y Dietética dedicado. Parecería haber un cambio de nutrición enteral a oral con un mayor uso de suplementos nutricionales orales. Conclusiones: la introducción de un Servicio de Nutrición Clínica y Dietética dedicado a la atención de pacientes con problemas nutricionales parecería reducir el uso de la nutrición artificial invasiva, a pesar del aumento en el número de pacientes identificados con riesgo de desnutrición.

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          ESPEN guideline: Clinical nutrition in surgery.

          Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e.g. for cancer, and of those developing severe complications despite best perioperative care. From a metabolic and nutritional point of view, the key aspects of perioperative care include: • integration of nutrition into the overall management of the patient • avoidance of long periods of preoperative fasting • re-establishment of oral feeding as early as possible after surgery • start of nutritional therapy early, as soon as a nutritional risk becomes apparent • metabolic control e.g. of blood glucose • reduction of factors which exacerbate stress-related catabolism or impair gastrointestinal function • minimized time on paralytic agents for ventilator management in the postoperative period • early mobilisation to facilitate protein synthesis and muscle function The guideline presents 37 recommendations for clinical practice.
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            ESPEN guidelines on nutritional support for polymorbid internal medicine patients

            Polymorbidity (also known as multimorbidity) - defined as the co-occurrence of at least two chronic health conditions - is highly prevalent, particularly in the hospitalized population. Nonetheless, clinical guidelines largely address individual diseases and rarely account for polymorbidity. The aim of this project was to develop guidelines on nutritional support for polymorbid patients hospitalized in medical wards.
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              Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: secondary analysis of a prospective randomised trial

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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                October 2022
                : 39
                : 5
                : 1101-1105
                Affiliations
                [4] Locarno orgnameOspedale Regionale di Locarno orgdiv1Service of Nephrology. Ente Ospedaliero Cantonale orgdiv2Department of Internal Medicine Switzerland
                [1] Locarno orgnameOspedale Regionale di Locarno orgdiv1Department of Internal Medicine. Ente Ospedaliero Cantonale orgdiv2Clinical Nutrition and Dietetics Switzerland
                [2] Locarno orgnamePrivate Medical Office orgdiv1Private Medical Office Switzerland
                [3] Locarno orgnameEnte Ospedaliero Cantonale. Ospedale Regionale di Locarno orgdiv1Institute of Pharmacological Sciences of Southern Switzerland orgdiv2Hospital Pharmacy Switzerland
                Article
                S0212-16112022000800019 S0212-1611(22)03900500019
                10.20960/nh.04033
                5ad37795-6f58-4222-8ca9-07354627e94a

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 11 January 2022
                : 29 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 5
                Product

                SciELO Spain

                Categories
                Original Papers

                Parenteral nutrition,Suplemento nutricional oral,Nutrición enteral,Nutrición parenteral,Malnutrición,Nutritional team,Oral nutritional supplement,Enteral nutrition,Malnutrition,Equipo nutricional

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