Outcomes of the implementation of an enteral nutrition algorithm in children and adolescents with cancer

• Autor(a) principal: GARÓFOLO, Adriana
• Data de Publicação: 2023
• Outros Autores: Santos MAIA, Priscila, PETRILLI, Antonio Sérgio, ANCONA-LOPEZ, Fábio
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista de Nutrição
• Texto Completo: https://periodicos.puc-campinas.edu.br/nutricao/article/view/9407
• topic: Algorithm; Neoplasms; Enteral nutrition; Nutritional support; Algoritmo; Neoplasias; Nutrição enteral; Terapia nutricional

ObjectiveThis study aimed to describe the algorithm and the global results after its implementation. MethodsThis was a randomized clinical trial done with malnourished cancer patients. Follow-up followed an algorithm and patients with mild malnutrition were randomized to receive store-bought or homemade oral supplementation. The patients were reassessed after three, eight and twelve weeks. Depending on how the group supplemented with store-bought supplements responded, the supplementation was either continued orally, by tube-feeding or discontinued. The group receiving homemade supplementation either continued on it if the response was positive or received store-bought oral supplementation if the response was negative. Theseverely malnourished patients either received store-bought supplementation by feeding tube or orally, or it was discontinued if an adequate nutritional status was reached. The patients’ responses to supplementation were determined by weight-for-height Z-scores, body mass indices, triceps skinfold thicknesses and circumferences. ResultsOne hundred and seventeen out of 141 patients completed the first three weeks; 58 were severely malnourished and 59 were mildly malnourished. The nutritional status of 41% of the severely malnourished patients and 97% of the mildly malnourished patients receiving store-bought supplement orally improved. The nutritional status of 77% of the mildly malnourished patients receiving homemade supplement orally also improved. Of the 117 patients, 42 had to be tube-fed; of these, 23 accepted and 19 refused tube feeding and continued taking store-bought supplement orally. Consumption of store-bought supplement was higher in tube-fedpatients than in orally-fed patients. Consumption also increased as orally-fed patients became tube-fed. Store-bought supplements given by tube improved nutritional status, showing a positive association between duration of tube feeding and nutritional status. ConclusionStore-bought oral supplements improved the nutrient intake of malnourished patients, especially those who were mildly malnourished. The results also suggest that store-bought supplements given by tube improve nutritional status, especially as duration of tube feeding increases.