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題名:重症病人腸胃道管灌常見合併症之預防
書刊名:護理雜誌
作者:王采芷吳淑芳 引用關係梁淑媛 引用關係童恒新林玉萍 引用關係
作者(外文):Wang, Tsae-jyyWu, Vivienne Shu-fangLiang, Shu-yuanTung, Heng-hsinLin, Yu-ping
出版日期:2012
卷期:59:4
頁次:頁18-23
主題關鍵詞:腸胃道管灌肺吸入腹瀉嘔吐代謝併發症Enteral feedingAspirationDiarrheaVomitingMetabolic complications灌食營養支持
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:3
  • 共同引用共同引用:0
  • 點閱點閱:112
營養支持是提供重症病人在面對疾病壓力與氧合所需能量的一種輔助性治療,可經由腸胃道管灌或非腸胃道方式提供給無法主動維持適當營養攝取的重症病人。腸胃道管灌比靜脈營養更能維持腸道完整性、有較低的感染併發症風險及營養治療費用,而早期的腸道營養支持,更被認為是一種可以減輕疾病嚴重度、減少合併症、縮短加護病房住院天數以及改善病人治療成效的積極治療策略,故重症病人之營養支持以腸胃道管灌為優先考量。然而,就像其他的治療一樣,腸胃道管灌也有其相關的危險性。護理人員應具備相關知識,以提供接受腸胃道管灌之重症病人適當的照護,因此,本文就腸胃道管灌臨床適應症、照護注意事項、常見合併症之評估與預防作深入介紹。其中照護注意事項包括:開始灌食的時機、確認灌食管路插入的位置、胃殘餘量的監測以及管路阻塞的預防與處置,而常見合併症主要介紹肺吸入、腹瀉、嘔吐、低血鈉與高血糖的評估與預防,上述實證知識可作為重症照護單位制訂灌食管路照護標準與規範及人員訓練之參考,並藉以提供病人適當的營養支持,進而促進病人的預後。
Nutritional support provides critically ill patients with energy and nutrients required to face the demands of their illness and stress. For those unable to ingest orally, enteral feeding rather than parenteral feeding is recommended, as the former better preserves gut integrity, reduces risk of infection, and costs less. Early enteral feeding in critically ill patients is also associated with decreased disease severity, reduced complications, and shortened length of stay. Risks associated with enteral feeding include aspiration, diarrhea, vomiting, hyponatremia, and hyperglycemia. This article reviews current knowledge on enteral feeding and addresses correct feeding tube placement, proper feeding sites, assessing and managing gastric residual volume, and preventing feeding tube occultation. We also review information related to identifying and controlling risk factors for enteral feeding complications such as aspiration, diarrhea, vomiting, hyponatremia, and hyperglycemia. Nurses can use this information to provide high quality care for enteral feeding patients and develop institutional protocols, guidelines, and standards of care for such patients in intensive care units.
期刊論文
1.Marik, P. E.,、Zaloga, G. P.(2001)。Early enteral nutrition in acutely ill patients: A systematic review。Critical Care Medicine,29(12),2264- 2270。  new window
2.Bourgault, A. M.、Ipe, L.、Weaver, J.、Swartz, S.、O'Dea, P. J.(2007)。Development of evidence-based guidelines and critical care nurses' knowledge of enteral feeding。Critical Care Nurse,27(4),17-29。  new window
3.Heyland, D. K.、Dhaliwal, R.、Drover, J. W.、Gramlich, L.、Dodek, P.(2003)。Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients。Journal of Parenteral and Enteral Nutrition,27(5),355-373。  new window
其他
1.Booker, K. J., Niedringhaus, L., Eden, B., & Arnold, J. S.(2000)。Comparison of 2 methods of managing gastric residual volumes from feeding tubes。  new window
2.Gramlich, L., Kichian, K., Pinilla, J., Rodych, N. J., Dhaliwal, R., & Heyland, D. K.(2004)。Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature。  new window
3.Heyland, D. K., Drover, J. W., MacDonald, S., Novak, F., & Lam, M.(2001)。Effect of postpyloric feeding on gastroesophageal regurgitation and pulmonary microaspiration: Results of a randomized controlled trial。  new window
4.Lien, H. C., Chang, C. S., & Chen, G. H.(2000)。Can percuta neous endoscopic jejunostomy prevent gastroesophageal reflux in patients with preexisting esophagitis?。  new window
5.Martindale, R. G., McClave, S. A., Vanek, V. W., McCarthy, M., Roberts, P., Taylor, B., ... the A.S.P.E.N. Board of Directors(2009)。Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition。  new window
6.McClave, S. A., DeMeo, M. T., DeLegge, M. H., DiSario, J. A., Heyland, D. K., Maloney, J. P., ... Zaloga, G. P.(2002)。North American summit on aspiration in the critically ill patient: Consensus statement。  new window
7.McClave, S. A., Lukan, J. K., Stefater, J. A., Lowen, C. C., Looney, S. W., Matheson, P. J., … Spain, D. A.(2005)。Poor validity of residual volumes as a marker for risk of aspiration in critically ill patients。  new window
8.Metheny, N. A.(2006)。Preventing respiratory complications of tube feedings: Evidence-based practice。  new window
9.Metheny, N. A.(2009)。Verification of feeding tube placement (American Association of Critical-care Nurses [AACN] practice alert。  new window
10.Metheny, N. A., Clouse, R. E., Chang, Y. H., Stewart, B. J., Oliver, D. A., & Kollef, M. H.(2006)。Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients: Frequency, outcomes, and risk factors。  new window
11.Metheny, N. A., & Titler, M. G.(2001)。Assessing placement of feeding tubes。  new window
12.National Patient Safety Agency(2011)。Patient Safety Alert NPSA/2011/PSA002: Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants。  new window
13.Peter, J. V., Moran, J. L., & Phillips-Hughes, J.(2005)。A meta-analysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients。  new window
14.Phang, J. S., Marsh, W. A., Barlows, T. G., & Schwartz, H. I.(2004)。Determining feeding tube location by gastric and intestinal pH values。  new window
15.Simpson, F., & Doig, G. S.(2005)。Parenteral vs. enteral nutrition in the critically ill patient: A meta-analysis of trials using the intention to treat principle。  new window
16.Spain, D. A.(2002)。When is the seriously ill patient ready to be fed?。  new window
17.Stroud, M., Duncan, H., Nightingale, J., & British Society of Gastroenterology(2003)。Guidelines for enteral feeding in adult hospital patients。  new window
18.US Food and Drug Administration, Center for Food Safety and Applied Nutrition(2003)。FDA public health advisory: Subject: Reports of blue discoloration and death in patients receiving enteral feedings tinted with the dye, FD&C blue no. 1。  new window
19.Williams, N. T.(2008)。Medication administration through entral feeding tubes。  new window
 
 
 
 
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