FATORES ASSOCIADOS COM A PRESENÇA DE ANEMIA E DESNUTRIÇÃO EM PACIENTES HOSPITALIZADOS COM NUTRIÇÃO ENTERAL EXCLUSIVA: ESTUDO LONGITUDINAL

• Autor(a) principal: Jesus, Sibila Reck de
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional Universidade Franciscana
• Texto Completo: http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/604
• topic: Avaliação nutricional, Terapia de Nutrição Enteral, Micronutrientes, Necessidades nutricionais.; Nutritional assessment, Enteral Nutrition Therapy, Micronutrients, Nutritional needs.; Ciências da Saúde e da Vida

Introduction: Anemia and malnutrition have shown high prevalence in hospitalized patients in Brazil and abroad; therefore, it brings along serious consequences. The aim of the present study is to assess factors associated with anemia and malnutrition in hospitalized patients with exclusive enteral nutrition. Methodology: Data were collected in August 2016 at Santa Maria University Hospital, RS. The sample consisted of hospitalized individuals with exclusive enteral nutrition under at least 7-day follow up and at most 14-day hospitalization. Nutritional evaluation was performed and consisted of dietetics, anthropometric, biochemical examinations in hospital; iron, zinc, copper and vitamin C plasma levels. Three articles addressed the topic, one integrative review about the effects of intermittent and continuous enteral nutrition therapy on muscle mass gain; one cross-sectional article associating anemia and malnutrition in patients with exclusive enteral nutrition; and one longitudinal article evaluating the influence of enteral nutrition therapy on the nutritional status of hospitalized patients. A bibliographic search was carried out in the databases. ANOVA and Duncan's post hoc were conducted to assess the transversal article. The analysis of variance with repeated measures (ANOVA) and the Spearman correlation were applied to study the longitudinal study. Results: Based of the review on few studies mainly involving animals, the intermittent administration method may be the most recommended for muscle mass gain. The cross-sectional study showed that the patients were hospitalized due to anemia and malnutrition according to BMI and to protein depletion according to serum albumin. There was statistically significant correlation between low weight according to BMI and AMB (R = 0.74, p <0.001), AGB (R = 0.81, p <0.001), EMAP (R = 0.23; p = 0.046), and CP (R = 0.81, p <0.001). Hemoglobin levels were statistically associated with albumin severity in patients (p <0.05). The weight and BMI of adults decreased during hospitalization (P = 0.025), such result was associated with muscle mass loss, such as the losses in the thickness of abductor muscle of the thumb and in the circumference of the calf. Weight gain was observed in elderly during hospitalization. Although the prescribed kcalorie and protein values had a little drop from the administered amount, adequacy rated 90% in the first monitoring week and 88% in the second one. Copper intake and dietary iron enteral nutrition were above the values recommended by EAR, but they did not exceed the maximum daily–intake levels. There were significant positive correlations among copper and weight (R = 0.50, p = 0.002), AMBc (R = 0.41, p = 0.022), and AGB (R = 0.40, p = 0.026). Conclusions: The enteral nutrition therapy played an important role in nutritional status recovery, mainly in elderly patients, during hospital follow-ups. Anemia and malnutrition were recorded during patients’ follow-up. There were important correlations between albumin and hemoglobin, it evidenced strong association between anemia and malnutrition in these patients. Copper was particularly noteworthy among the analyzed micronutrients, and this result was associated with anemia and malnutrition in the studied sample. Therefore, the influence of cooper in hospitalized patients should be analyzed in depth