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Apezetxea A, Carrillo L, Casanueva F, de la Cuerda C, Cuesta F, Irles JA, Virgili MN, Layola M, Lizán L. Rasch analysis in the development of the NutriQoL® questionnaire, a specific health-related quality of life instrument for home enteral nutrition. J Patient Rep Outcomes 2017; 2:25. [PMID: 29888746 PMCID: PMC5976679 DOI: 10.1186/s41687-018-0050-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/24/2018] [Indexed: 11/18/2022] Open
Abstract
Background Home enteral nutrition (HEN) is a therapeutic method used in patients who are unable to ingest the required amounts of nutrients but retain a functional gastrointestinal tract. The objective of this study was to compose a specific questionnaire for measuring health-related quality of life (HRQoL) in HEN patients irrespective of their underlying condition and HEN route of administration. Methods Literature review, focus groups and semi-structured interviews were used to propose an initial version of the questionnaire which was answered by 165 participants. The responses were analyzed using the Rasch methodology. Firstly, the appropriateness of response options was assessed. Then, the differential item functioning (DIF) was evaluated. Finally, the item fit statistics, infit and outfit, were determined. Results Rasch analysis was performed on the responses given to the 43 items included in the initial questionnaire. Four items were excluded because more than 50% of respondents answered that the situation proposed did not apply to them. Seven items that showed overlapping and disordered categories were also removed. Pairwise DIF analysis were performed in subgroups defined by underlying disease and administration route. Eleven items presented DIF and were eliminated from the questionnaire. Finally, four items were deleted after analyzing the fit statistics, three of which did not fit the Rasch model and one did not belong to either of the dimensions. The final version of NutriQoL® includes 17 items. Conclusions NutriQoL® is a useful instrument to assess the HRQoL of HEN patients with any disease and any administration route.
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Affiliation(s)
| | - Lourdes Carrillo
- Centro de Salud Victoria de Acentejo, Santa Cruz de Tenerife, Spain
| | - Felipe Casanueva
- Department of Medicine, Universidad de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago (CHUS); CIBER de Fisiopatologia Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, Santiago de Compostela, Spain
| | | | | | | | - Maria Nuria Virgili
- Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Luis Lizán
- Outcomes'10, Universitat Jaume 1, Parc Cientific, Tecnologic i Empresarial, Edificio Espaitec 2, Campus del Riu Sec, Avenida Sos Baynat s/n, 12071 Castellon de la Plana, Castellon Spain.,Departamento de Medicina, Universidad Jaime I, Campus Riu Sec, Avenida Sos Baynat s/n, 12071 Castellón de la Plana, Spain
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Cuerda MC, Apezetxea A, Carrillo L, Casanueva F, Cuesta F, Irles JA, Virgili MN, Layola M, Lizán L. Reliability and Responsiveness of NutriQoL ® Questionnaire. Adv Ther 2016; 33:1728-1739. [PMID: 27469466 DOI: 10.1007/s12325-016-0384-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION NutriQoL® (Nestlé Health Science, Vevay, Switzerland) is a questionnaire developed to assess the health-related quality-of-life (HRQoL) of patients with home enteral nutrition (HEN) irrespective of their underlying condition and route of administration. The aim of this work is assessing the questionnaire's reliability and responsiveness to change. METHODS Two cohorts of patients with HEN and their primary caregivers were enrolled to assess reliability and responsiveness, respectively. All participants had to be 18 years of age or older, without mental deterioration (≤3 or 4 errors in the Pfeiffer's test) and with sufficient functional status (>40 points on Karnovsky's performance status scale). When the patients' ability to respond to the questionnaire was impaired due to underlying disease, their caregivers answered on their behalf. NutriQoL was administered in two and three visits to reliability and responsiveness cohorts, respectively. Test-retest reliability and internal consistency were assessed by the intra-class correlation coefficient (ICC) and the Cronbach's α, respectively. Responsiveness was evaluated by standardized effect size and standardized response mean between basal visit and third visit. Finally, the minimal clinically important difference (MCID) was estimated. RESULTS A total of 54 and 86 participants were recruited to the reliability and responsiveness cohort, respectively. Thirty-five caregivers were selected to assess the inter-observer reliability. ICC values confirmed the good reproducibility level (ICC >0.75) of the questionnaire in both "physical functioning and activities of daily living" and "social life" domains and total score. The assessment of internal consistency in both domains of the questionnaire showed good internal consistency in visit 2. ICC showed the excellent agreement level between caregiver and patient in the global NutriQoL score. Finally, patients classified as having a minimal change in their health reported a mean (standard deviation) MCID in NutriQoL score of 0.63 (11.51). CONCLUSION NutriQoL is a reliable and unique instrument to measure the HRQoL in HEN patients. NutriQoL detects changes in the health status of the patient. Nevertheless, further research is needed to determine the full extent of the questionnaire responsiveness.
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Cuerda MC, Apezetxea A, Carrillo L, Casanueva F, Cuesta F, Irles JA, Virgili MN, Layola M, Lizan L. Development and validation of a specific questionnaire to assess health-related quality of life in patients with home enteral nutrition: NutriQoL ® development. Patient Prefer Adherence 2016; 10:2289-2296. [PMID: 27853360 PMCID: PMC5104289 DOI: 10.2147/ppa.s110188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Home enteral nutrition (HEN) is indicated in patients with a functional gastrointestinal tract but who are unable to meet their nutritional requirements with normally consumed foodstuffs. HEN allows patients to remain in their social and family environment, thus reducing complications and costs associated with hospital admission, while increasing health-related quality of life (HRQoL). HRQoL in patients with HEN is mainly evaluated by generic instruments, which are not sensitive enough to identify certain specific patient-related outcomes of HEN. OBJECTIVE To develop a specific instrument to measure HRQoL in patients receiving HEN whose results allow interpretation regardless of the underlying disease and nutritional support administration route: the NutriQoL® questionnaire. MATERIALS AND METHODS The development of the NutriQoL entailed a literature review, focus groups with experts, semistructured interviews with patients, an assessment of face validity and feasibility, and Rasch analysis conducted on data from a sample of 141 patients and 24 caregivers. RESULTS Of the 52 items initially proposed on the basis of the literature review, expert focus group, and semi-structured interviews with patients and caregivers, 17 items were finally selected through the development process to make up the final version of the NutriQoL, as well as a visual analog scale for global HRQoL scoring. The selected items were evaluated as adequate for frequency, importance, and clarity. Furthermore, they have been shown to be independent of the underlying condition and HEN administration route. CONCLUSION A new instrument for measuring the HRQoL of patients with HEN in Spain has been developed, whose results are independent of the underlying condition and administration route. The next step will be the validation of the questionnaire to ensure that the instrument is valid, reliable, and sensitive to health status changes in patients, to be used periodically in usual clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Luis Lizan
- Outcomes’10, Universitat Jaume 1, Castellon, Spain
- Correspondence: Luis Lizan, Outcomes’10, Universitat Jaume 1, Science, Technology and Business Park, Espaitec 2 Building, Campus of Riu Sec, Avenida Sos Baynat s/n, 12071 Castellon, Castellon, Spain, Tel +34 964 86 8781, Email
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Apezetxea A, Cuerda C, Virgili N, Irles JA, Cuesta F, Casanueva F, Carrillo L, Layola M, Lizán L. Health Related Quality of Life in Patients Receiving Home Enteral Nutrition in Spain Assessed By A Specific Questionnaire: Nutriqol®. Value Health 2014; 17:A518. [PMID: 27201614 DOI: 10.1016/j.jval.2014.08.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - C Cuerda
- Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - N Virgili
- Hospital Bellvitge, Barcelona, Spain
| | - J A Irles
- Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
| | - F Cuesta
- Hospital San Carlos, Madrid, Spain
| | - F Casanueva
- Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - L Carrillo
- Centro de Salud Victoria de Acentejo, Santa Cruz de Tenerife, Spain
| | - M Layola
- Nestle health science, Barcelona, Spain
| | - L Lizán
- Outcomes'10, Castellon, Spain
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Cuerda C, Virgili N, Irles JA, Cuesta F, Apezetxea A, Casanueva F, Carrillo L, Layola M, Lizán L. Responsiveness and Minimal Clinically Important Difference of A Specific Health Related Quality of Life (Hrqol) Questionnaire for Home Enteral Nutrition (Hen) Patients: Nutriqol® Questionnaire. Value Health 2014; 17:A575. [PMID: 27201929 DOI: 10.1016/j.jval.2014.08.1935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Cuerda
- Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - N Virgili
- Hospital Bellvitge, Barcelona, Spain
| | - J A Irles
- Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
| | - F Cuesta
- Hospital San Carlos, Madrid, Spain
| | | | - F Casanueva
- Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - L Carrillo
- Centro de Salud Victoria de Acentejo, Santa Cruz de Tenerife, Spain
| | - M Layola
- Nestle health science, Barcelona, Spain
| | - L Lizán
- Outcomes'10, Castellon, Spain
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Olveira G, García-Luna PP, Pereira JL, Rebollo I, García-Almeida JM, Serrano P, Irles JA, Muñoz-Aguilar A, Molina MJ, Tapia MJ. Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition. NUTR HOSP 2013; 27:1837-49. [PMID: 23588430 DOI: 10.3305/nh.2012.27.6.6076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 08/07/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND & AIMS By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. METHODS Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. RESULTS We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. CONCLUSIONS This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.
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Affiliation(s)
- G Olveira
- Servicio de Endrocrinología y Nutrición, Hopital Regional Universitario Carlos Haya, Málaga, España.
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Wanden-Berghe C, Pérez de la Cruz A, Lobo Tamer G, Calleja Fernández A, Gómez Candela C, Zugasti Murillo A, Apezetxea Celaya A, Torres Corts A, Moreno Villarés JM, de Luis D, Penacho MÁ, Laborda L, Burgos R, Irles JA, Cuerda Compes C, Virgili Casas MN, Martínez Olmos MA, García Luna PP. [The registry of home artificial nutrition and ambulatory of the Spanish Society of Parenteral and Enteral Nutrition; SWOT analysis]. NUTR HOSP 2012; 27:1357-60. [PMID: 23165586 DOI: 10.3305/nh.2012.27.4.5912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 04/23/2012] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evidence by means of a SWOT-R analysis performed by an expert consensus the most worrying characteristics of the register on Home-based and Outpatient Artificial Nutrition. MATERIAL AND METHODS SWOT-R analysis with expert consensus. We requested the participation of the active members of the NADYA group within the last 5 years with the premise of structuring the SWOT-R based on the characteristics of the NADYA registry from its beginning. RESULTS 18 experts from hospitals all over Spain have participated. The internal analysis seems to be positive, presenting the registry as having important resources. The external analysis did not show a great number of threats, there are very potent factors, "the voluntariness" of the registry and the "dependence on external financing". The opportunities identified are important. The recommendations are aimed at stabilizing the system by decreasing the threats as one of the main focus of the strategies to develop as well as promoting the items identified as opportunities and strengths. CONCLUSIONS The analysis shows that the NADYA register shows a big potentiality for improvement. The proposed recommendations should be structured in order to stay on the track of development and quality improvement that has characterized the NADYA register from the beginning.
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Frías L, Puiggròs C, Calañas A, Cuerda C, García-Luna PP, Camarero E, Rabassa-Soler A, Irles JA, Martínez-Olmos MA, Romero A, Wanden-Berghe C, Laborda L, Vidal A, Gómez-Candela C, Penacho MA, Pérez de la Cruz A, Lecha M, Luengo LM, Suárez P, de Luis D, García Y, Parés RM, Garde C. [Home enteral nutrition in Spain: NADYA registry in 2010]. NUTR HOSP 2012; 27:266-9. [PMID: 22566332 DOI: 10.1590/s0212-16112012000100035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 11/02/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2010. MATERIAL AND METHODS We retrieved the data of the patients recorded from January 1st to December 31st 2010. RESULTS We registered 6,591 patients (51% males) with 6,688 episodes of HEN, from 32 hospitals. Mean age in those younger than 14 yr (4%) was 1 ± 2 yrs (m ± SD) and 69,9 ± 17,8 yrs in those older than 14 yr. The length of HEN was longer than 2 yrs in 76% of the patients. The most frequent underlying disease was neurological disorders 42%, followed by cancer 28% (mostly head and neck cancer 18%). We had information related to the enteral access route in only 626 cases (9,4%), 51% of them used nasogastric tubes, 27% gastrostomies, 10% oral route and 3% jejunostomies. Only 251 episodes were closed during the year, mostly due to patient death 57% and progress to oral diet 14%. The activity level was limited in 29% of the patients and 39% of them were bed- or chairridden. Total or partial help was needed by 68% of the patients. The hospitals and the private pharmacies delivered the enteral formula in 63% and 34% of the cases, respectively. The hospitals and the primary care centres delivered the disposables in 83% and 16% of the cases, respectively. CONCLUSIONS The results of the 2010 HEN registry are similar to those published in previous years regarding the number and characteristics of the patients. We continue finding problems in the entrance of data referred to the enteral access route and the closing of the episodes.
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Affiliation(s)
- L Frías
- Unidad de Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España
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Gallardo R, Irles JA, Almeida González CV. [Usage profile of different parenteral support options in acute and chronic care facilities]. Farm Hosp 2011; 36:240-9. [PMID: 22118761 DOI: 10.1016/j.farma.2011.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 06/01/2011] [Accepted: 06/12/2011] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE To evaluate the use of parenteral, enteral, and mixed nutrition in one acute and one chronic hospital. DESIGN Retrospective, non-randomised, observational study. STUDY SITES: South Seville Health Area: Acute Hospital (H1) and Chronic Hospital (H2) with 447 and 84 beds, respectively. We analysed all episodes of artificial nutrition administered in a 6-month period. Exclusion criteria included: age <18 years, oral supplements, and peripheral nutrition. RESULTS Artificial nutrition was used in a total of 568 episodes: 406 were enteral nutrition, 162 were parenteral nutrition, constituting 4.95%, 3.54% and 1,41% of all hospitalisations, respectively. Enteral nutrition was more common at H2 hospital (n=219, 15.5/100 hospitalisations) and parenteral nutrition was more commonly used at H1 (n=155, 6.96/100 hospitalisations), with the ICU providing the majority of treatments (43.8%). Mixed nutritional support was used in 68 patients (0.59% of all cases), and was most commonly used in the surgery department (n=32, P<.001). The most commonly used enteral formula was the special diabetes diet; 41.2% at H1 and 46.6% at H2. Patient mortality with enteral nutrition was 37% at H1, 63% at H2, and was correlated with age (OR=1.025, 95% CI: 1.006-1.046, P<.05), male sex (OR=1.612, 95% CI: 1.023-2.540, P<.05), and time in ICU (OR=49.379, 95% CI: 11.971-203.675, P<.01). CONCLUSIONS Enteral nutrition was more frequently used in both the acute and chronic hospitals. Parenteral nutrition and mixed nutritional support were used almost exclusively at the acute hospital.
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Affiliation(s)
- R Gallardo
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
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Wanden-Berghe C, Puiggrós JC, Calañas A, Cuerda C, García-Luna PP, Rabassa-Soler A, Irles JA, Romero A, Martínez-Olmos MA, Camarero E, Lecha M, Gómez-Candela C, Vidal A, Laborda L, Zapata A, Luengo LM, Pérez de la Cruz A, Penacho MA, De Luis D, Parés RM, García Y, Suárez P, Sánchez-Migallón JM, Apezetxea A, Matía P, Martínez C, Martí E, Garde C, Muñoz A, Cánovas B, Bobis MA, Ordóñez J. [The Spanish Home Enteral Nutrition registry of the year 2009: from the NADYA-SENPE group]. NUTR HOSP 2010; 25:959-963. [PMID: 21519767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Accepted: 09/18/2010] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVE To describe the Home Enteral Nutrition Characteristics (HEN) recorded by the group NADYA-SENPE during 2009. MATERIAL AND METHOD collection and analysis of the data voluntary recorded in the HEN registry from the NADYA-SENPE group from January 1st to December 31st. RESULTS 6.540 HEN patients were registered, 5.11% more than the previous year and 6,649 episodes (3,135 in women, 47,93%) from 32 different hospitals. 6,238 of them (95,38%) were over 14 years. The mean age of the patients under 14 yr was 3,67 ± 2,86 and it was 72,10 ± 16,89 in those over 14 yr group. The base illness registered more frequently was the neurological disorders in 2,732 (41,77%) patients, followed by cancer patients in 1,838; 28,10%. The enteral access route was registered in 1,123 (17,17%) of the episodes, being more frequent the administration by nasogastric tube 562 (50,04%). The mean length of nutritional treatment by episode was 323 days (10,77 months). 606 episodes of HEN ended, being the principal reasons for discontinuing treatment the patient death in 295 (48,68%) occasions. The transition to oral feeding occurred in 219 (36,14%) cases. Patients maintained normal activity in 2162 (32,55%) HEN episodes and 2,468 (37,13%) cases were living "bed-couch". The level of dependence was "total" in 2,598 (39,07%) of the episodes recorded. The nutritional formula was provided by the hospital in 4,183 (62,91%) cases and by the reference pharmacy in 2,262 (el 34,02%). Consumables were provided by the hospital in 3,531 (53,11%) cases. CONCLUSIONS The number of HEN patients recorded increased from the year 2008, continuing the gradual growth increase since the start of registration. The characteristics of the patients remain in the same profile as in previous years.
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Affiliation(s)
- C Wanden-Berghe
- Universidad CEU Cardenal Herrera, Hospital General Universitario de Alicante, Elche, España.
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Pedrón-Giner C, Puiggrós C, Calañas A, Cuerda C, García-Luna PP, Irles JA, Romero A, Rabassa-Soler A, Camarero E, Martínez-Olmos MA, Lecha M, Penacho MA, Gómez Candela C, Parés RM, Zapata A, Laborda L, Vidal A, Pérez de la Cruz A, Luengo LM, de Luis D, Wanden-Berghe C, Suárez P, Sánchez-Migallón JM, Matía P, García Y, Martí E, Muñoz A, Martínez C, Bobis MA, Garde C, Ordóñez J, Cánovas B. [Spanish home enteral nutrition (HEN) registry of the year 2008 from the NADYA-SENPE group]. NUTR HOSP 2010; 25:725-729. [PMID: 21336427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 06/17/2010] [Indexed: 05/30/2023] Open
Abstract
AIM To present the results of the Spanish home enteral nutrition (HEN) registry of the year 2008 from the NADYA-SENPE group. MATERIAL AND METHODS We recorded the HEN registry data from January 1st to December 31st 2008. RESULTS The number of patients registered in this period was 6206 (51% male) with up to 6,279 episodes of HEN, from 31 Spanish hospitals. Most of the patients (95%) were older than 14 yr. Mean age was 4.83±3.29 yr in the children group, and 70.75±18.14 yr in the adult group (older than 14 yr). Neurological disorders (39%) and cancer (27%) were the two most prevalent diagnoses. The oral route was the most frequently used (43,4%), followed by nasogastric tube (40,4%), and gastrostomy tube (14,7%). Mean length of treatment was 305,36 days (10 months). The principal reasons for discontinuing treatment were death (43%) and progress to oral diet (40%). Only 33% of the patients had a normal activity level, being limited in different grades in the rest of the patients. Most of the patients required partial (25%) or total help (38%). The enteral formula was provided by the hospital in 65% of the cases and by private pharmacies in 32%. The disposables were provided by the hospital (82,4%) and primary care services (17,2%). CONCLUSIONS The number and the age of the patients registered have increased comparing to previous years, with little variations in the rest of analyzed variables. The increase in the length of treatment could reflect misreporting of the weaning process in the registry.
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Luengo Pérez LM, Chicharro ML, Cuerda C, García Luna PP, Rabassa Soler A, Romero A, Irles JA, Penacho MA, Camarero E, Martínez Olmos MA, Calañas A, Parés RM, Lecha M, Gómez Candela C, Zapata A, Pérez de la Cruz A, Luis DD, Wanden-Berghe C, Cantón A, Laborda L, Matía P, Martí E. [National registry of home enteral nutrition in Spain 2007]. NUTR HOSP 2009; 24:655-660. [PMID: 20049367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Accepted: 02/09/2009] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To communicate the results from the registry of Home-Based Enteral Nutrition of the NADYASENPE group in 2007. MATERIAL AND METHODS We included every patient in the registry with home enteral nutrition any time from January 1st to December 31st of 2007. RESULTS The number of patients with home enteral nutrition in 2007 was 5,107 (52% male) from 28 different hospitals. 95.4% of them were 15 yr or older, with a mean age of 67.96 +/- 18.12, and 4.2 +/- 3.38 among patients aged 14 yr or less. The most common underlying diseases were neurological (37.8%) and neoplastic diseases (29.3%). Enteral nutrition was administered p.o. in most patients (63.5%), followed by nasogastric tube (25.9%), while gastrostomy was only used in 9.2%. The mean time in enteral nutrition support was 9.4 months and the most common reasons for withdrawal were death (58.7%) and switching to oral intake (32%). Activity was limited in 31.4% of patients and 36.01% were house-bound. Most patients needed partial (26.51%) or total (37.68%) care assistance. Enteral formula was provided by hospitals to 69.14% of patients and by pharmacies to 30.17% of them, while disposable material was provided by hospitals to 81.63% and by Primary Care to the remaining patients. CONCLUSIONS In 2007, there has been an increase of more than 30% of patients registered with home enteral nutrition comparing with 2006, without any big difference in other data, but a higher proportion of patients with enteral nutrition p.o.
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Affiliation(s)
- L M Luengo Pérez
- Unidad de Nutrición Clínica y Dietética, Hospital Universitario Infanta Cristina, Badajoz, España
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Alvarez J, Del Río J, Planas M, García Peris P, García de Lorenzo A, Calvo V, Olveira G, Irles JA, Piñeiro G. [SENPE-SEDOM document on coding of hospital hyponutrition]. NUTR HOSP 2008; 23:536-540. [PMID: 19132260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 09/12/2008] [Indexed: 05/27/2023] Open
Affiliation(s)
- J Alvarez
- Sociedad Española de Nutrición Parenteral y Enteral (SENPE), España.
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Cuerda C, Chicharro ML, Frías L, García Luna PP, Cardona D, Camarero E, Penacho MA, Calañas A, Parés RM, Martínez Olmos MA, Zapata A, Rabassa Soler A, Gómez Candela C, Pérez de la Cruz A, Lecha M, Luis DD, Luengo LM, Wanden-Berghe C, Laborda L, Matía P, Cantón A, Martí E, Irles JA. [Registry of home-based enteral nutrition in Spain for the year 2006 (NADYA-SENPE Group)]. NUTR HOSP 2008; 23:95-99. [PMID: 18449443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 01/10/2008] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To communicate the results obtained from the registry of Home-Based Enteral Nutrition (HBEN) of the NADYA-SENPE group for the year 2006. MATERIAL AND METHODS Recompilation of the data from the HBEN registry of the NADYA-SENPE group from January 1st to December 31st of 2006. RESULTS During the year 2006, 3,921 patients (51% men) from 27 hospital centers were registered. Ninety-seven percent were older than 14 years. The mean age for those < 14 years was 4.9 +/- 3.9 (m +/- SD) and in those > or = 14 years, it was 68.5 +/- 18.2 years. The most common underlying disease was neurological pathology (42%), followed by cancer (28%). Enteral nutrition was administered p.o. in 44% of the patients, through nasogastric tube in 40%, gastrostomy in 14%, and jejunostomy in 1%. The average time of nutritional support was 8.8 months. The most common reasons for ending the therapy were patient's death (54%) and switching to oral feeding (32%). Thirty-one percent of the patients presented a limited activity and 40% were confined to bed/coach. Most of the patients required partial (25%) or total (43%) care assistance. The nutritional formula was provided by the hospital in 62% of the cases and from the reference pharmacy in 27%. The fungible material was provided by the hospital in 80% of the cases and by primary care in the remaining patients. CONCLUSIONS Although the number of registered patients is slightly higher than that from the last years, there are no important changes in the patients characteristics, or way of administration and duration of enteral nutrition.
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Affiliation(s)
- C Cuerda
- Unidad de Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España.
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15
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Grau TG, Bonet A, Miñambres E, Piñeiro L, Robles A, Irles JA, Acosta J, Lopez J. Efficacy of glutamine dipeptide-supplemented total parenteral nutrition in critically ill patients: a prospective, double-blind randomized trial. Crit Care 2008. [PMCID: PMC4088517 DOI: 10.1186/cc6367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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16
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Puiggrós C, Chicharro ML, Gómez-Candela C, Virgili N, Cuerda C, Gómez-Enterría P, Ordóñez J, Moreno JM, Penacho MA, Pérez de la Cruz A, Alvarez J, Luengo LM, Irles JA, Wanden-Berghe C, de Luis D, Rodríguez-Pozo A, Garde C, Pedrón C, Gómez L, Cànovas B. [Spanish Registry of Home-based Parenteral Nutrition during 2006 (NADYA-SENPE Group)]. NUTR HOSP 2008; 23:6-11. [PMID: 18372940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 12/30/2007] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To report the data of the Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE working group for the year 2006. METHODOLOGY We compiled the data from the on-line registry introduced by the responsible Units for the monitoring of HPN from January 1st to December 31st 2006. RESULTS 103 patients with HPN were registered (47 males and 56 females), belonging to 19 hospitals. Average age for the 91 patients older than 14 years old was 53.3 +/- 14.9 years old, and that for the 12 patients under 14 years old was 2 +/- 0 years old. Most frequent pathology was neoplasm (29%), followed by intestinal motility disorders (13%). The reason for HPN provision was short bowel syndrome (40%), intestinal obstruction (22%), and malabsorption (21%). Tunneled catheters were mostly used (45%), followed by implanted port-catheters (32%). Catheter related infections were the most frequent complications, with a rate of 0.85 episodes / 10(3) days. HPD was provided for more than two years in 50% of the cases. By the end of 2006, 70.9% of the patients remained active; exitus was the most frequent reason to end HPN (53%). Complementary oral or enteral nutrition was provided to 52% of the patients. 48% of the patients had a normal activity level, and a 55% were autonomous. PN formula was supplied by the hospital in 82% of the cases, while this number was 78% for fungible materials. 27% of the patients were eligible for intestinal transplant. CONCLUSIONS We observe an increase in registered patients with respect to previous years, with a very different prevalence among regions. Neoplasia remains as the main pathology since 2003. We observe a decrease in catheter-related infections with respect to the 2004-2005 period.
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Affiliation(s)
- C Puiggrós
- Unidad de Soporte Nutricional, Hospital Universitario Vall d'Hebron, Barcelona, España.
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17
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Polo R, Gómez-Candela C, Miralles C, Locutura J, Alvarez J, Barreiro F, Bellido D, Câncer E, Cánoves D, Domingo P, Estrada V, Fumaz CR, Galindo MJ, García-Benayas T, Iglesias C, Irles JA, Jiménez-Nacher I, Lozano F, Marqués I, Martínez-Alvarez JR, Mellado MJ, Miján A, Ramos JT, Riobo P. Recommendations from SPNS/GEAM/SENBA/SENPE/AEDN/SEDCA/GESIDA on nutrition in the HIV-infected patient. NUTR HOSP 2007; 22:229-43. [PMID: 17416041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
OBJECTIVE to make recommendations on the approach to nutritional problems (malnutrition, cachexia, micronutrient deficiency, obesity, lipodystrophy) affecting HIV-infected patients. METHODS these recommendations have been agreed upon by a group of expertes in the nutrition and care of HIV-infected patients, on behalf of the different groups involved in drafting them. Therefore, the latest advances in pathophysiology, epidemiology, and clinical care presented in studies published in medical journals or at scientific meetings were evaluated. RESULTS there is no single method of evaluating nutrition, and diferent techniques--CT, MRI, and DXA--must be combined. The energy requirements of symptomatic patients increase by 20-30%. There is no evidence to support the increase in protein or fat intake. Micronutrient supplementation in only necessary in special circumstances (vitamin A in children and pregnant woman). Aerobic and resistance excercise is beneficial both for cardiovascular health and for improving lean mass and muscular strength. It is important to follow the rules of food safety at every stage in the chain. Therapeutic intervention in anorexia and cachexia must be tailored, by combining nutritional and pharmacological support (appetite stimulants, anabolic steroids, and, in some cases, testosterone). Artificial nutrition (oral supplementation, enteral or parenteral nutrition) is safe and efficacious, and improves nutritional status and response to therapy. In children, nutritional recommendations must be made early, and are a necessary component of therapy. CONCLUSION appropriate nutritional evaluation and relevant therapeutic action are an essential part of the care of HIV-infected patients.
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Affiliation(s)
- R Polo
- Plan Nacional sobre el Sida, España
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18
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Planas M, Lecha M, García Luna PP, Parés RM, Chamorro J, Martí E, Bonada A, Irles JA, Boris MA, Cardona D, Zamarrón I, Calañas AJ, Rodríguez A, Camarero E, Pérez de la Cruz A, Mancha A, De Luis Román D, Cos A, Luengo LM, Jiménez M, Bayo P, Goenaga MA. [National registry of Home Enteral Nutrition in 2003]. NUTR HOSP 2006; 21:71-4. [PMID: 16562816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
GOAL To communicate the information available by the NADYA-SENPE Working Group from patients on Home Enteral Nutrition (HEN) in our country during the year 2003. MATERIAL AND METHODS The data were collected through a closed questionnaire included in the web site of the Working Group (www.nadya-senpe.com) available only by the authorized users. Variable included were: epidemiological information, the indication to prescribe this treatment, the access path, the specific nutritional formula used, the treatment duration, the complications and hospital readmission related to the nutritional treatment, the follow-up and the quality of life. RESULTS We register 3,858 patients that belong to twenty-one hospitals. Mean age from those adults 66.2 +/- 18.9 years, and from those younger than 14, 6.0 +/- 4.3 years. Neurological and neoplasic diseases were the diagnostics more frequents (38.9% and 37.4%, respectively). Oral nutrition was the preferential rout used for the enteral nutrition (54.7%) followed by naso-enteral tube (26.6%), and only in 17.6% we used ostomy tubes. Polymeric was the enteral formula mainly utilized (80.1%). The mean time on HEN was 6.6 +/- 4.3 months; the 28.8% of patients stayed in the treatment for less than 3 months, 21.2 % between 3 and 6 months, and 50.0% more than 6 months. Patients were followed mainly by Nutritional Support Unit from the reference hospital (73.1%). While the reference hospital supplies the material (62.4%), reference hospital pharmacy (46.8%) and public pharmacies (32.0%) provides the enteral formula. Complications related to enteral nutrition included change of enteral tube (44.5%), gastrointestinal complications (30.5%), mechanical complications (21.7%), and the metabolic one (3.3%). These complications were followed by 0.02 hospitalizations/patient. At the end of the year, 54.7% of patients were in the HEN programme, and in 35.2 % HEN was finish due to accept oral conventional alimentation (49.2%) or by deceased of patients (40.9%). While 26.6% of the patients were confined to bed or armchair, 19.7 % no or light discapacity degree was observed. CONCLUSIONS We found a persistence of these treatment in our country. Neurological and neoplasic diseases were the more frequent diagnosis in patients analysed. The high prevalence of cancer patients could be the main cause of oral access for enteral nutrition. Change of enteral tube was the more frequent complication observed during this treatment.
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Affiliation(s)
- M Planas
- Unidad de Nutrición y Dietética, Hospital Universitario Vall d'Hebron, Barcelona, España.
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19
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Planas M, Lecha M, García Luna PP, Chamorro J, Zamarrón I, Parés RM, Bonada A, Cardona D, Jiménez M, Irles JA, Boris MA, Rodríguez A, Calañas AJ, Camarero E, Martí E, Pérez de la Cruz A, Mancha A, Gómez Enterría P, de Luis D, Muñoz A, Bayo P, Luengo LM. [The year 2002 national registry on home-based enteral nutrition]. NUTR HOSP 2005; 20:254-8. [PMID: 16045127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
GOAL To communicate the information available by the NADYA-SENPE Working Group from patients on Home Enteral Nutrition (HEN) in our country during the year 2002. MATERIAL AND METHODS The data were collected through a closed questionnaire included in the web site of the Working Group (www.nadya-senpe.com) available only by the authorized users. Variable included were: epidemiological information, the indication to prescribe this treatment, the access path, the specific nutritional formula used, the treatment duration, the complications and hospital readmission related to the nutritional treatment, the follow-up and the quality of life. RESULTS We register 3967 patients that belong to twenty-one hospitals. Mean age from those adults 69.2 +/- 19.2 years, and from those younger than 14, 5.6 +/- 4.1 years. Neurological and neoplasic diseases were the diagnostics more frequents (39.2% and 34.6%, respectively). Oral nutrition was the preferential rout used for the enteral nutrition (53.6%) followed by naso-enteral tube (30.6%), and only in 15.8% we used ostomy tubes. Polymeric was the enteral formula mainly utilized (81.5%). The mean time on HEN was 5.8 +/- 4.4 months; the 35.7% of patients stayed in the treatment for less than 3 months, 22.4% between 3 and 6 months, and 41.6% more than 6 months. Patients were followed mainly by Nutritional Support Unit from the reference hospital (75.3%). While the reference hospital supplies the material (65.7%), reference hospital pharmacy (43%) and public pharmacies (37.3%) provides the enteral formula. Complications related to enteral nutrition included change of enteral tube (29.7%), mechanical complications (22.9%), gastrointestinal complications (22.9%), and the metabolic one (9.2%). These complications were followed by 0.02 hospitalizations/patient. At the end of the year, 49.3% of patients were in the HEN programme, and in 41.5% HEN was finish due to accept oral conventional alimentation (47.3%) or by deceased of patients. While 31.8% of the patients were confined to bed o armchair, 17.8% no o light discapacity degree was observed. CONCLUSIONS We found a persistence of these treatment in our country (96.5 patients/million inhabitants. Neurological and neoplasic diseases were the more frequent diagnosis in patients analysed. The high prevalence of cancer patients could be the main cause of oral access for enteral nutrition. Change of enteral tube was the more frequent complication observed during this treatment.
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Affiliation(s)
- M Planas
- Unidad de Nutrición Clínica, Hospital 12 de Octubre Ctra. de Andalucía, km. 5,400 28041, Madrid
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20
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Planas M, Castellà M, García Luna PP, Parés RM, Chamorro J, Camarero E, Calañas AJ, Bonada A, Irles JA, Adrio G, Jiménez M, Bobis MA, Rodríguez A, Pérez de la Cruz A, Gómez Enterría P, Zamarrón I, Cos A, Mancha A, Martínez I, Martí E, de Luis D, Virgili N, Moreno JM, Luengo LM, de la Cuerda C, Forga MT, Goenaga MA, Carrera JA, Garde C, Ordóñez J, Pedrón C. [Home Enteral Nutrition: National Registry 2001]. NUTR HOSP 2004; 19:145-9. [PMID: 15211722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
GOAL The NADYA-SENPE Working Group analyzed the registered data of patients on Home Enteral Nutrition (HEN) in our country, during year 2001. MATERIAL AND METHODS The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient's quality of life and progress. All data were processed and analyzed by the coordinating team. RESULTS Twenty two hospitals participated and 3,458 patients, aged 5.6 +/- 4.0 y for those younger than 14 y, and 67.1 +/- 19.5 y for those older than 14 y, were enrolled. Of these patients, 43.4% were diagnosed with neurological diseases and 33.5% with cancer. The mean time on HEN was 6.5 +/- 4.5 months. Oral nutrition was the preferential route (54.5%), followed by nasoenteral tube (32.3%), and in 13.3% ostomy tubes were placed. Polymeric was the formula composition mainly used (85.9%). Patients were followed (71.1%) by the hospital reference Nutritional Support Unit. The complications related to nutrition included mainly the gastrointestinal (0.16 complications/patient), and the mechanical one (0.15 complications/patient). At the end for the year, 48.3% of the patients were in the HEN program, and in 33.3% HEN was finish due to different reasons. In 22.9% of the patients no, o light, discapacity degree was found. CONCLUSIONS Neurological diseases and cancer were the more frequent diagnoses in HEN patients. Oral access was the higher feeding route due, probably, to the high prevalence of cancer patients. In spite of the elevated prevalence of neurological diseases, a few number of patients, as previous years, were feed with ostomy tube. Due to the few complications observed, HEN is a safe treatment in our country.
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Affiliation(s)
- M Planas
- Unidad de Nutrición, Hospital Universitario Vall d'Hebrón, Passeig Vall d'Hebrón, 119-129, 08035 Barcelona.
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21
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Planas M, Castellá M, García Luna PP, Chamorro J, Gómez Candela C, Carbonell MD, Irles JA, Jiménez M, Morejón E, Pérez de la Cruz A, Bobis MA, Rodríguez Pozo A, Adrio G, Salas J, Calañas AJ, Gómez Enterría P, Mancha A, Martí Bonmatí E, Martínez I, Celador A, Camarero E, Tusón C, Carrera JA. [Enteral nutrition at home: National register for the year 2000]. NUTR HOSP 2003; 18:34-8. [PMID: 12621810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
GOAL Once again, the NADYA-SENPE Working Group analysed the registered data of Home Enteral Nutrition (HEN) in our country, during the year 2000. MATERIAL AND METHODS The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient's quality of life and progress. All data were processed and analysed by the co-ordinating team. RESULTS Twenty two hospital participated and 2,986 patients, aged 65.1 +/- 19.7 years, were enrolled. Of these patients, 41.2% were diagnosed with neurological diseases and 33.3% with cancer. The mean time on HEN was 6.3 +/- 4.4 months. Oral nutrition was the preferential route (50.8%), followed by nasoenteral tube (30.5%), and in 17.4% ostomy tubes were placed. Polymeric was the formula composition mainly used (83.2%). Patients were followed (70.1%) by the hospital reference Nutritional Support Unit. The complications related to nutrition included the gastrointestinal (0.25 complications/patient), the mechanical one (0.19 complications/patient), and the metabolic (0.007 complications/patient). Feeding tube need to be replaced 0.3 times/patient/year. The readmission rate, for nutritional problems, was observed in 0.03 patients. At the end of the year, 54.9% of the patients were in the HEN program, and in 30.3% HEN was finish due to different reasons. In 21.9% of the patients no, o light, discapacity degree was found. CONCLUSIONS Related to previous years, there is an increment in the number of enrolled patients. Neurological diseases and cancer were the more frequent diagnoses in HEN patients. Oral access was the higher feeding route due, probably, to the high prevalence of cancer patients. In spite of the elevated prevalence of neurological diseases, a few number of patients were feed with ostomy tube. Finally, due to the few readmission rate and complications, HEN is a safe treatment in our country.
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Affiliation(s)
- M Planas
- Unidad de Nutrición, Hospital Universitario Vall d'Hebrón, Barcelona
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Lozano F, Gómez-Mateos J, Irles JA, Meléndez B, Martin E. Fulminant septic shock in AIDS patients caused by disseminated cryptococcosis. Eur J Clin Microbiol Infect Dis 1999; 18:151-2. [PMID: 10219583 DOI: 10.1007/s100960050246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- F Lozano
- Department of Infectious Diseases, Hospital Universitario de Valme, Seville, Spain
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Barranco F, Lesmes A, Irles JA, Blasco J, Leal J, Rodriguez J, Leon C. Cardiopulmonary resuscitation with simultaneous chest and abdominal compression: comparative study in humans. Resuscitation 1990; 20:67-77. [PMID: 2171119 DOI: 10.1016/0300-9572(90)90088-v] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To assess the efficacy of the simultaneous application of chest and abdominal compression (SCAC) in cardiopulmonary resuscitation (CPR), we performed a prospective study on 18 patients shortly after cardiac arrest. Three different CPR procedures were carried out consecutively: (1) Standard CPR; (2) CPR interposed with abdominal compression (IAC-CPR); and (3) SCAC-CPR. Standard CPR was repeated at the end of each sequence. Thoracic aortic and right atrial pressures were recorded during maneuvers and no vasoactive drugs were administered. Systolic aortic pressures were 39.02 +/- 21 mmHg, 63.6 +/- 21 mmHg and 94.04 +/- 21 mmHg during standard CPR, IAC-CPR and SCAC-CPR, respectively (P less than 0.001). There was no evidence of intra-abdominal injury in the eight autopsies performed. We have reached the conclusion that the use of SCAC-CPR on humans does produce greater intravascular pressure and we recommend this technique as a possible alternative to standard CPR.
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Affiliation(s)
- F Barranco
- Department of Intensive Medicine, Virgen de Valme Universitary Hospital, Seville, Spain
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