About 30% of all patients in hospital are undernourished. A large part of these patients are undernourished when admitted to hospital and in the majority of these, undernutrition develops further while in hospital (1).
Although malnutrition is common in chronically ill patients, this issue is often neglected. A simple screening of risk groups and a systematic nutrition therapy of these patients can prevent malnutrition. Therefore, the determination of the nutritional status should be part of each physical examination in order to identify risk patients, to evaluate their risk and to define an individual nutrition therapy.
There are a number of different valuable screening tools available, such as the NRS-2002 (Nutrition Risk Score) (2), the ‘MUST’(‘Malnutrition Universal Screening Tool’) (4) and the SGA (Subjective Global Assessment) (3).
‘MUST’ is designed to be used in adults in all care settings, to identify individuals who are malnourished or at risk of malnutrition (undernutrition). Furthermore ‘MUST’ can be used in patients in whom height and weight are not obtainable, as a range of alternative measures or criteria can be used. Please refer to BAPEN (www.bapen.org.uk) for further information.
The Subjective Global Assessment (SGA) (3) is a simple and reproducible method that can be performed at the patients bedside by physicians or other medical staff in order to assess the patients nutritional status. This method is applicable for both in-patients and out-patients.
Energy Expenditure Estimation (EE) – The human body needs energy to maintain body functions and for physical activity. These requirements can be measured via indirect calorimetry or estimated by the use of formulas like the Harris-Bendict formula.
(1) McWhirter J P, Pennington C R. Incidence and recognition of malnutrition in hospital. BMJ 1994; 308: 945–948
(2) J. KONDRUP,n S. P. ALLISON,y M. ELIA,z B.VELLAS,z M. PLAUTHy. ESPEN Guidelines for Nutrition Screening 2002 Clinical Nutrition (2003) 22(4): 415–421
(3) Detsky et al., JPEN 1987: 8-13
(4) THE .’MUST’. REPORT Nutritional screening of adults: a multidisciplinary responsibility, Please refer to the following link, www.bapen.org.uk
The App also included a Short Guide – Clinical Nutrition of the Adult: This is a practical guide about how to support your patients with adequate nutrition using B. Braun TPN (Total Parenteral Nutrion) solutions. There is a lot more to be found on our nutrition site, www.nutrition-partner.com.
The part Nutrition with Multi-Chamber-Bags contain information about the B.Braun Multi-Chamber bags for parenteral nutrition. Here you can learn more about the compositions, handling and design of the bag systems. An interactive bag calculator will give you in 2 steps (Choose nutritional requirements according to patient’s need/ Set patient’s body weight) a proposal for the recommended product. According to national laws, only medical professionals (e. g. doctors and pharmacists) are allowed to obtain this information. To enter it for the first time you need a DocCheck password.