Recent evidence suggests that a negative protein balance secondary to severe disease
is associated with increased morbidity. A loss of total body protein is inevitable in
this scenario, even with an aggressive nutritional approach, primarily due to the
catabolism of skeletal muscle fibers. The ubiquitin-proteasome system is the primary
metabolic and biochemical mechanism involved in this process; paradoxically, this
system consumes adenosine triphosphate as its energy source. It is possible that a
neutral protein balance in these clinical situations is important for improving
outcomes and achieving the caloric goals estimated or measured by indirect
calorimetry. Recent studies have suggested that the use of higher protein
concentrations in nutritional therapy for critically ill patients may help to reduce
mortality. The purpose of this study was to review some of the nutrition therapy
principles related to protein metabolism, evaluate the main assertions of the
guidelines of specialty societies and review the recent studies that address these
issues using critical insights from the authors' clinical experience.
Pressure ulcer (PU) can be classified according to tissue impairment, etiology, healing time and tissue characteristics. Currently, it is the third type of adverse event most reported by the patient safety centers of health services in the country, according to the National Report of Incidents Related to Health Care. The classification and the identification of risk factors are essential for implementation of preventive and therapeutic actions in susceptible patients. Nutritional status is a fundamental piece for the prevention and development of PU, making it essential to integrate the interdisciplinary team in the prevention and treatment of PU, with a focus on quality, safety and patient experience. In this sense, the objective of this campaign is to disseminate knowledge, providing technical support for patient care and reducing PU rates. A mnemonic was developed with the word “CICATRIZATION”, in which each letter proposes steps that help in the identification of risk, assessment, treatment and monitoring of PU. Thus, the sequence of 12 steps established in this campaign is suggested as a measure to assist health professionals in this management
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