ESPEN Guidelines on Enteral Nutrition: Cardiology and Pulmonology

Anker, Stefan D.; Morser, John; Pedersen, Preben Ulrich; Raguso, Comasia A.; Cicoira, Mariantonietta; Dárdai, E; Laviano, Alessandro; Ponikowski, Piotr; Schols, A.M.W.J.; Becker, Heinrich F.; Böhm, M.; Brunkhorst, Frank M.; Vogelmeier, C. Franz

doi:10.1016/j.clnu.2006.01.017

Cited by 136 publications

(92 citation statements)

References 65 publications

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“…Nutritional support should be given to patients with the pulmonary cachexia phenotype, preferably in combination with a rehabilitation programme. Nutritional specialists choose the type and content of the nutritional therapy based on the assessment of energy requirements of the patient, residual oral intake, and the possibility of oral or enteral food intake, which are always preferred over parenteral intake 93,94 . Antibiotic therapy (ABT) may have a positive effect during stable disease in selected phenotypes: in patients with an increased production of phlegm -bronchitic phenotype; in patients with frequent exacerbations; and also in the COPD with bronchiectasis.…”

Section: Additional Components Of the Standard Treatmentmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

Koblížek

Chlumský²,

Zindr³

et al. 2013

BIOMED PAP

125

116

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Section: Additional Components Of the Standard Treatmentmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: Official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care

Koblížek

Chlumský²,

Zindr³

et al. 2013

BIOMED PAP

125

116

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“…Surgery ESPEN guidelines on enteral nutrition: surgery including organ transplantation 4.1 Encourage patients who do not meet their energy needs from normal food to take ONS during the pre-operative period (C) 6.0 Before transplantation, in undernutrition, use additional ONS (C) Anker et al (67) Chronic heart failure and chronic obstructive pulmonary disease ESPEN guidelines on enteral nutrition: cardiology and pulmonology 1.3 (Heart failure) Enteral nutrition (by means of ONS or tube feeding) is recommended in cardiac cachexia to stop or reverse weight loss (C) 2.5 (Chronic obstructive pulmonary disease) Frequent small amounts of ONS are preferred to avoid postprandial dyspnoea and satiety and to improve compliance (B) Volkert et al (68) Geriatrics ESPEN guidelines on enteral nutrition: geriatrics 2.1 In patients who are undernourished or at risk of undernutrition use oral nutritional supplementation to increase energy, protein and micronutrient intake, maintain or improve nutritional status and improve survival (A) 2.2 In the frail elderly use ONS to improve or maintain nutritional status (A) 2.4 In geriatric patients after hip fracture and orthopaedic surgery use ONS to reduce complications (A) 2.7 In demented patients ONS or tube feeding may lead to an improvement of nutritional status 2.7 In early and moderate dementia consider ONS -and occasionally tube feeding -to ensure adequate energy and nutrient supply and to prevent undernutrition (C) 2.10 Oral nutritional supplements, particularly with high protein content, can reduce the risk of developing pressure ulcers (A) *Levels of evidence: 1 + + , high-quality meta-analyses, systematic reviews of randomised controlled trial (RCT) or RCT with a very low risk of bias; 1 + , well-conducted meta-analyses, systematic reviews or RCT with a low risk of bias; 2 + + , high-quality systematic reviews of case-control or cohort studies, high-quality case-control or cohort studies with a very low risk of confounding bias; 2 + , well-conducted case-control or cohort studies with a low risk of confounding bias. 3, case reports; 4, expert opinion.…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Encouraging appropriate, evidence-based use of oral nutritional supplements

Stratton

Elia

2010

Proc. Nutr. Soc.

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With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be > £13 · 10 9 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1 % (about £99 · 10 6 , 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multinutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0 . 56 (95% CI 0 . 41, 0 . 77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

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“…Rehabilitation outcome has been shown to be poor in malnourished patients with stroke, 4 chronic heart failure, 5 chronic obstructive pulmonary disease, 5 and a variety of other diseases. It has therefore been suggested the relationship between nutritional supplementation and rehabilitation from hospital-associated deconditioning is an important area of research.…”

Section: Malnutrition Often Occurs In Disabled Patientsmentioning

confidence: 99%