Outcomes of the implementation of an enteral nutrition algorithm in children and adolescents with cancer

ObjectiveThis study aimed to describe the algorithm and the global results after its implementation. MethodsThis was a randomized clinical trial done with malnourished cancer patients. Follow-up followed an algorithm and patients with mild malnutrition were randomized to receive store-bought or home...

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Detalhes bibliográficos
Autores: GARÓFOLO, Adriana, Santos MAIA, Priscila, PETRILLI, Antonio Sérgio, ANCONA-LOPEZ, Fábio
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Recursos:Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS)
Repositorio:Revista de Nutrição
Idioma:portugués
OAI Identifier:oai:ojs.periodicos.puc-campinas.edu.br:article/9407
Acesso em linha:https://periodicos.puc-campinas.edu.br/nutricao/article/view/9407
Access Level:acceso abierto
Palavra-chave:Algorithm
Neoplasms
Enteral nutrition
Nutritional support
Algoritmo
Neoplasias
Nutrição enteral
Terapia nutricional
Descrição
Resumo:ObjectiveThis study aimed to describe the algorithm and the global results after its implementation. MethodsThis was a randomized clinical trial done with malnourished cancer patients. Follow-up followed an algorithm and patients with mild malnutrition were randomized to receive store-bought or homemade oral supplementation. The patients were reassessed after three, eight and twelve weeks. Depending on how the group supplemented with store-bought supplements responded, the supplementation was either continued orally, by tube-feeding or discontinued. The group receiving homemade supplementation either continued on it if the response was positive or received store-bought oral supplementation if the response was negative. Theseverely malnourished patients either received store-bought supplementation by feeding tube or orally, or it was discontinued if an adequate nutritional status was reached. The patients’ responses to supplementation were determined by weight-for-height Z-scores, body mass indices, triceps skinfold thicknesses and circumferences. ResultsOne hundred and seventeen out of 141 patients completed the first three weeks; 58 were severely malnourished and 59 were mildly malnourished. The nutritional status of 41% of the severely malnourished patients and 97% of the mildly malnourished patients receiving store-bought supplement orally improved. The nutritional status of 77% of the mildly malnourished patients receiving homemade supplement orally also improved. Of the 117 patients, 42 had to be tube-fed; of these, 23 accepted and 19 refused tube feeding and continued taking store-bought supplement orally. Consumption of store-bought supplement was higher in tube-fedpatients than in orally-fed patients. Consumption also increased as orally-fed patients became tube-fed. Store-bought supplements given by tube improved nutritional status, showing a positive association between duration of tube feeding and nutritional status. ConclusionStore-bought oral supplements improved the nutrient intake of malnourished patients, especially those who were mildly malnourished. The results also suggest that store-bought supplements given by tube improve nutritional status, especially as duration of tube feeding increases.