University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

489

Pages:

2
Author:

Mariam A.

Relationship between the immune system and the nutritional status 1. Nutritional status and the immune response:  Malnutrition: malnutrition is common in patients with GI malignancies undergoing cancer related surgeries. - Studies report malnutrition in 19 to 50% of surgical patients.  Impact on immune response poor nutritional status adversely affects the immune response. - Surgery itself induces a significant stress response which can further impair immune function.  Reversed immune suppression: clinical research suggests that post-operative infections may result from immune suppression. - Specialized nutritional support can partially reverse the immune suppression, regardless of the nutritional status. 2. Impact of nutritional status on morbidity:  Post-operative outcomes: nutritional status significantly influences various post-operative status.  Morbidity: malnourished patients are at a higher risk of complications after surgery.  Hospital length of stay: poor nutrition status prolongs hospital stay.  Mortality: malnutrition contributes to increased mortality risk. 3. Immunonutrition (IMN):  This involves specialised nutritional support designed to enhance the immune response.  Recent meta-analysis has shown that IMN is associated with reduced post-operative complications in GI surgery.  Peri-operative administration of IMN appears to the preferred strategy for reducing infectious complications, anastomotic leaks, surgical site infections and hospital length of stay. Nutritional Support Indications and Routes Indications for nutritional support      Patient who cannot eat. Patient who should not eat. Patients who will not eat. Patient who cannot eat enough. All severely malnourished patients on hospital admission. This includes: - Patients with a BMI of less than 18.5 kg/m^2. - Unintentional weight loss greater than 10% within the last 3 to 6 months. -   BMI less than 20 kg/m^2 and unintentional weight loss greater than 5% within the last 3 to 6 months. Moderately malnourished patients who because of their physical illness are not expected to eat for more than 5 days. Normally malnourished patients expected not to eat for more than 5 days or expected to eat less than half their intake fore more than 8 to 10 days. Routes for nutritional support Oral nutritional support Enteral tube feeding Parenteral nutrition  Providing  Delivers nutrients  Provides nutrients adequate directly into the intravenously nutrients GIT via a tube. (directly into the through regular Such as bloodstream). foods or oral nasogastric tube,  Reserved for supplements. nasoenteric, patients with  Suitable for gastrostomy or severe patients who can jejunostomy. malnutrition, gut swallow and  Indicated when dysfunction or tolerate oral oral intake is inability to tolerate intake. insufficient or not enteral feeding.  Includes feasible.  Required central modified diets,  Commonly used venous access. fortified foods, in hospitalised  Used when the and oral patients or those enteral routes are nutritional with impaired contraindicated or supplements. swallowing. insufficient.