Introduction to Nutrition Support

Overview

• Nutrition is fundamental to health, essential for survival, and aids in recovery and thriving.
• Nutrition care is both preventative and therapeutic.

Definition of Nutrition Support

• Nutrition Support: A method of feeding someone who cannot get enough nutrients from food to prevent significant unintentional weight loss.
• Includes Enteral Nutrition and Parenteral Nutrition.
• Defined by the American Society for Parenteral and Enteral Nutrition (ASPEN).

Types of Nutrition Support

1. Enteral Nutrition

• Enteral Nutrition (EN): Tube feeding delivering nutrients directly to the stomach or small intestine.
• Uses the gastrointestinal tract, not intravenous.
• Tubes can be inserted through the nose, mouth, or abdominal wall.
• Suitable for short-term (up to 6 weeks) or when the GI tract cannot be accessed through the oral/nasal cavity.

2. Parenteral Nutrition

• Parenteral Nutrition (PN): Intravenous delivery of nutrients directly into the bloodstream.
• Does not use the gastrointestinal tract.
• Common infusion sites: forearm, elbow, chest, neck.

Patient Assessment and Decision-Making

Stoplight Model for Nutrition Support

• Green Light: Patients eating well, no need for nutrition support.
  • Examples: Healthy individuals with non-eating related conditions.
• Yellow Light: Patients with limited ability to eat, needs assessment.
  • Examples: Cancer patients with decreased appetite, stroke patients.
• Red Light: Patients unable to eat at all, candidates for nutrition support.
  • Examples: Ventilator dependence, severe swallowing difficulty, GI obstructions.

Criteria for Nutrition Support

• Physical Assessment: Moderate to severe fat and muscle loss.
• Unintentional Weight Loss: Significant loss over varying time frames.
• Estimated Calorie Intake: Meeting less than 50% of estimated needs over a week or 75% over a month.

Decision Process

• Enteral vs. Parenteral Nutrition
  • Enteral: Preferred if the GI tract is functional ("If the gut works, use it").
  • Parenteral: Necessary when GI tract cannot perform essential functions.

Advantages of Enteral Nutrition

1. Gut stimulation and maintenance.
2. Lower risk of infection.
3. Fewer metabolic complications.
4. Cost-effective compared to Parenteral Nutrition.

Key Takeaway

• Always consider "If the gut works, use it" for choosing the type of nutrition support.