Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지

A Study on Nutritional Status, Biochemical Parameters, Lipid and Electrolytes Concentrations According to the Duration of Enteral Nutrition Tube-feeding

경장영양 기간에 따른 영양상태, 생화학적 지표, 지질 및 전해질 농도에 관한 연구

  • 이정화 (경희의료원 영양상담팀) ;
  • 조금호 (경희대학교 임상영양연구소) ;
  • 이봉암 (경희대학교 의과대학 신경외과) ;
  • 이선화 (네오딘 의학연구소) ;
  • 조여원 (경희대학교 동서의학대학원)
  • Published : 2002.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

The objective of this study was to investigate the nutritional status, biochemical parameters, lipid and electrolytes concentrations of the enteral nutrition patients according to the duration of enteral nutrition. Eighteen neurosurgery patients in the intensive care unit (ICU) at K University Hospital were subjected in this study. The duration of enteral nutrition was classified into under or over six month of period. Anthropometric, biochemical, clinical, and dietary assessments were performed. Patients' intakes of energy and protein were insufficient, from 82% to 95% of their requirements. Mid-arm muscle circumference (MAMC) and mid-am muscle area (MAMA) were significantly lower in patients over six months of enteral nutrition than those in patients under six months. The subjects were malnourished as indicated by nutrition-related parameters such as hemoglobin, albumin, total lymphocyte count (TLC), tricep skinfold thickness (TSF), mid-arm circumference (MAC), MAMC, and MAMA. Serum chloride level of the patients eve, six months of enteral nutrition was lower (94.7 $\pm$ 3.4 mmo1/1) significantly as compared to that of patients (99.3 $\pm$ 3.5 mmol/ 1) under six months. Urinary sodium and chloride levels were lower in the longer time of enteral nutrition patients than those of shorter period of enteral nutrition patients (p < .05). While serum phospholipid level was higher in the patients over six months of enteral nutrition, other blood biochemical parameters and electrolyte concentrations did not show any differences with the duration of enteral nutrition. Neurosurgery patients in the ICU undergoing long-term enteral nutrition tube-feeding were malnourished and had a variety of metabolic complications. The duration of enteral nutrition could affect the patients' nutritional status, biochemical parameters, and electrolytes balance. The patients who require nutritional support over an extended time need the continuous follow-up care and monitoring by the nutrition support team for laboratory, clinical, and nutritional assessments.

Keywords

References

  1. Perspect Appl Nutr v.2 Medical nutrition therapy and health-care reform : Strategies of the American Dietetic Association Johnson,R.;Tonore,M.;Gallagher,A.
  2. J Am Diet Assoc v.95 no.2 JCAHO standards: Development and relevance to dietetics practice Krasker,G.D.;Balogum,L.B. https://doi.org/10.1016/S0002-8223(95)00059-3
  3. J Am Diet Assoc v.86 Hospital maluntrition: A 33 - hospital screening study Kamath,S.K.;Lawler,M.;Smith,A.E.;Kalat,T.;Olson,R.
  4. The Korean Dietetic Association Fall Conference Study on the nutritional status of inpatients in Seoul area Soh,E.K.;Lee,S.M.;Kim,S.H.;Um.Y.R.;Kim,H.J.;Oh,H.O.;Kim,C.H.;Pack,Y.W.
  5. Korean J intenal Medicine v.35 Evaluation of Nutritional Medical Patiets Kim,Y.L.;Kim,H.M.;Lim,S.K.;Lee,H.C.;Huh,K.B.;Choi,E.J;Moon,S.J.
  6. The Korean Dietetic Association Fall Conference Nutritional status of the enteral nutrition patients in ICU and the occurance of diarrhea according to the kinds of enteral nutrition formulas and flow rate Lee,S.M.;Shin,S.J.
  7. J Food Science and Nutrition v.25 no.5 Evaluation of nutritional status of tube-feeding patients and the effect of enteral nutrition formula supplement Yoon,S.Y.;Kim,S.M.
  8. AJCN v.32 no.2 Hospital malnutrition . A prospective evaluation of general medical patients during the course of hospitalization Weinsier,R.L.;Hunker,E.M.;Krumdieck,C.L;Butterworth,C.E.Jr.
  9. Nutrition Support Dietetics, Core curriculum(2nd ed.) Gottschlich,M.M.;Matarese,L.E.;Shronts,E.P.
  10. Dietitian's Handbook of Enteral and Parenteral Nutrition Skipper,A.
  11. The Korean Dietetic Association Fall Conference The importance of nutrition support and screening the patients Lee,M.D.
  12. Enteral and Tube feeding. Clinical Nutrition v.1 The history of enteral nutrition Randall,H.T.;Rombeau,J.L.(ed.);Caldwell,M.D.(ed.)
  13. Contemporary Nutrition Support Practice, A Clinical Guide Laura,E.M.;Michele,M.G.
  14. Korean J Nutrition v.27 no.3 The Effect of Enteral Nutritional Support in Cancer Patients Moon,S.J.;Chong,Y.K.;Lee,J.H.;Kim,B.S.;Koh,E.H.;Chong,H.C.;Yun,J.S.;Jung,S.S.
  15. J Korean Surgical Society v.31 no.4 Clinical Experience of Enteral Nutrition with ELENTAL in Surgical Patients Lee,M.D.;Kim,I.C.;Kim,S.M.;Choi,Y.M.;Chang,S.T.
  16. J Am Geriat Soc v.33 Estimating stature from knee height for persons 60 to 90 years of age Chumlea,W.C.;Roche,A.F.;Steinbaugh,M.L.
  17. Nutritional Assessment and Support(4th ed.) Grant,A.;Dehoog,S.
  18. Korean J Nutrition v.28 no.1 Estimating stature and weight from Anthropometry for the Elderly Who are limited in Mobility Han,K.H.
  19. J Am diet Assn v.88 no.6 Prediction of body weight for the nonambulatory elderly from anthropometry Chumlea,W.C.;Guo,S.;Roche,A.F.
  20. Clinical Nutrition and Dietetics(2nd ed.) Zeman,F.J.
  21. Nutrition support dietetics core curriculum(2nd ed.) Neurologic Impairment Hester,D.D.
  22. Contemporary nutrition support practice, A clinical guide Nutrition support in neurologic impairment Hester,D.D.;Kjelde,J.A.
  23. Nutrition support theory and therapeutics Nutritional support for the critically ill Shikora,S.A.
  24. Clin Chem v.14 A New dye-binding technique using bromcresol purple for determination of albumin in serum Louderback,A.;Mealy,E.H.;Taylor,N.A.
  25. Selected methods of clinical chemistry v.9 Protein (total protein) in serum, urine, and cerebrospinal fluid: albumin in serum Peters,T.J.;Biamonte,G.T.;Doumas,B.T.;W.R.Faulkner(ed.);S.Meites(ed.)
  26. Ann Clin Biochem v.22 Measurement of blood glucose Burrin,J.M.;Price,C.P. https://doi.org/10.1177/000456328502200401
  27. Clin Chim Acta v.59 The Jaffe reaction: Identification of the coloured species Butler,A.R. https://doi.org/10.1016/0009-8981(75)90033-9
  28. Ion-selective electrodes Durst,R.A.
  29. Clin Chim Acta v.135 IFCC: IFCC methods for the measurement of catalytic concentration of enzymes. V: IFCC method for alkaline phosphatase Expert Panel on Enzymes https://doi.org/10.1016/0009-8981(83)90294-2
  30. Am J Clin Pathol v.45 Determination of serum calcium by means of orthocresolphthlein complexone Connerty,H.V.;Briggs,A.R. https://doi.org/10.1093/ajcp/45.3.290
  31. Anal Chim Acta v.16 Spectrophotometric determination of magnesium with 1-azo-2-hydrozy-3- (34-dimethylcarbox-anilido)-nap-thalene-1'-(2-hydroxybenzene) Mann,C.K.;Yoe,J.H. https://doi.org/10.1016/S0003-2670(00)89905-5
  32. Clin Chem v.29 Revision of the 1963 semidine HCL standard method for inorganic phosphorous Garber,C.C.;Miller,R.C.
  33. Clin Chem v.33 Standardization of lipid, lipoprotein, and apolipoprotein measurements Cooper,G.R.;Myers,G.L.;Smith,S.J.;Sampson,E.J.
  34. Tietz textbooks of clinical chemistry(2nd ed.) Burtis,C.A.;Ashwood,E.R.
  35. Clin Chem v.24 Cholesterol in high-density lipoprotein: Use of $Mg^{2+}$/dextran sulfate in its enzymic measurement Finley,P.R.;Schifman,R.B.;Williams,R.J.
  36. Clin Chem v.18 Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge Friedewald,W.T.;Levy,R.I.;Fredrickson,D.S.
  37. Diabetes Res Clin Prac v.10 no.2 Frequency of atherogenic risk factor in japanese obese children Yamajaki,K.;Murata,M. https://doi.org/10.1016/0168-8227(90)90166-Q
  38. Clin Chem v.18 Enzymatic kinetic rate and end-point analyses of substrate, by use of a GeMSAEC fast analyzer Tiffany,T.O.;Jansen,J.M.;Burtis,C.A.
  39. J Biol Chem v.158 The colorimetric determination of creatinine by the Jaffe reaction Bonsnes,R.W.;Taussky,H.H.
  40. J Korean Society of Critical Care Medicine v.2 no.13 Nutritional Support in the Clinical III Patients Chung,S.S.
  41. JPEN v.6 no.5 Body weight measurement of patients receiving nutritional support Guenter,P.A.;Moore,K.;Crosby,L.O.;Buzby,G.P.;Mullen,J.L. https://doi.org/10.1177/0148607182006005441
  42. NCP v.9 no.5 Clinical applications of enteral nutrition Kudsk,K.A.
  43. J Korean Dietetic Association v.1 no.1 A study on Nutritional status and Support in Critically ill patients Choi,M.S.;Kim,J.N.
  44. The 12th Autumn Meeting of the Korean Society of Surgical Metabolism and Nutrition Study on the enteral nutrition support and nutritional status in the intensive care unit Park,E.K.;So,E.J.;Kim,C.N;Lim,H.S.
  45. J Korean Society for Medical Nutritional Science v.1 no.2 Malnutrition and Nutrition assessment of Inpatients Kim,Y.H.
  46. J Am Diet Assoc v.93 no.12 Nutrition screening and assessment: current practices and dietitian's leadership roles Foltz,M.B.;Schiller,M.R.;Ryan,A.S. https://doi.org/10.1016/0002-8223(93)92240-X
  47. JADA v.93 no.1 Hospital-associated malnutrition: a reevaluation 12 years later Coats,K.G.;Morgan,S.L.;Bartolucci,A.A.;Weinsier,R.L. https://doi.org/10.1016/0002-8223(93)92126-I
  48. JPEN v.11 Immunological function and nutritional assessment Dominioni,L.;Dionigi,R. https://doi.org/10.1177/014860718701100509
  49. J Korean dietetic Association v.5 no.1 Relationship of Nutritional Status at the Time of Admission to Length of Hospital Stay (LOS) and Mortality: A Prospective Study Based on Computerized Nutrition Screening Kim,Y.H.;Seo,A.R.;Kim,M.K.;Lee,Y.M.
  50. Clin Sci v.22 Inter-relation of calcium and magnesium absorption Alcock,N.;Macintyre,I.
  51. J Nutr v.80 Mineral utilization in the rat. I. Effects of varying dietary ratios of calcium, magnesium and phosphorus Forbes,R.M.
  52. J Nutr v.118 Influence of dietary clicium: phosphorus ration on mineral excretion and nephrocalcinosis in female rats Hoek,A.C.;Lemmens,A.G.;Mullink,J.W.M.A.;Beynen,A.C.
  53. Ann Rev Nutr v.8 Magnesium in health and disease Shills,M.E. https://doi.org/10.1146/annurev.nu.08.070188.002241
  54. Biol Trace Elem Res v.1 Magnesium (and trace substance) deficiencies in the pathogenesis of cancer Seelig,M.S. https://doi.org/10.1007/BF02778831
  55. Clin Sci v.28 The mechanism of renal calcification induced by magnesium deficiency in the rat Heaton,F.W.;Anderson,C.K.
  56. J Nutr Sci Vitaminol v.44 Diminished kidney function and nephrocalcinosis in rats fed a magnesium deficient diet Kikuchi,T.;Matsuzaki,H.;Sato,S.;Kajita,Y.;Chiba,H.;Tsuchiya,H.;Masuyama,R.;Uehara,M.;Suzuki,K.;Goto,S. https://doi.org/10.3177/jnsv.44.515
  57. Journal of ARAHE v.9 no.1 The contents of calcium and phosphorus in Korean and Chinese enteral solutions and estimated daily intakes of patients undergoing long term enteral nutrition Cho,K.H.;Kang,S.A.;Kim,E.S.;Kim,H.C.;Lee,Y.N.;Chen,J.D.
  58. Recommended dietary allowances for Koreans(7th revision) The Korean Nutrition Society
  59. Anesth Analg v.91 no.5 Hypermagnesemia in a pediatric patient Harker,H.E.;Majcher,T.A. https://doi.org/10.1097/00000539-200011000-00022
  60. Pediatrics v.105 no.2 Fatal hypermagnesemia in a child treated with megavitamin/megamineral therapy McGuire,J.K.;Kulkarni,M.S.;Baden,H.P. https://doi.org/10.1542/peds.105.2.e18
  61. Rev Clin Esp v.183 no.6 Hypomagnesemia in non-oliguric acute renal failure treated by parenteral nutrition. Study of its mechanism of action Lopez Martinez J.;Castrillo Garcia J.M.;Rapado Errasti A.;Perez Picouto F.;Caparros Fernandez De Aguilar T.
  62. New Horiz v.42 no.2 Should we supplement magnesium in critically ill patients? Olerich,M.A.;Rude,R.K.
  63. Am J Clin Nutr v.47 no.3 Mineral loss in the parenteral nutrition patient Lipkin,E.W.;Ott,S.M.;Chesnut CH 3rd;Chait,A.
  64. Endocr J v.47 Growth and metabolic disturbances in a patient with total parenteral nutrition: a case of hypercalciuric hypercalcemia Ikema,S.;Horikawa,R.;Nakano,M.;Yokouchi,K;Yamazaki,H.;Tanaka,T.;Tanae,A. https://doi.org/10.1507/endocrj.47.SupplMarch_S137
  65. Annals of Nutrition & Metabolism, 17th International Congress of Nutrition The excessive calcium intake and unbalance of calcium and phosphorus intake of patients using enteral nutrition in Korea and China Cho,K.H.;Kim,E.S.;Kang,S.A.;Kim,H.C.;Lee,Y.N.;Chen,J.D.
  66. J Parenter Enteral Nutr v.12 no.1 Hyperphosphatemia from lipid emulsion in a patient on total parenteral nutrition Vernon,W.B.;Atkins,J.M.;Stewart,R.D. https://doi.org/10.1177/014860718801200184
  67. Intensive Care Med v.12 no.4 Hypochloruria associated with hypovolemia Parini,M.
  68. Present Knowledge in nutrition(6th ed.) Luft F.C. Sodium;Chloride;Potassium;Brown,M.L.(ed.)
  69. Recommended Dietary Allowances(10th) National Research Council, Food and Nutrition Board
  70. The Autuman Meeting of the Korean Nutrition Society Insufficient potassium and exessive sodium of enteral nutrition in Korea and China Cho,K.H.;Kim,E.S.;Kang,S.A.;Lee,Y.N.;Kim,S.Y.;Chen,J.D.
  71. Food Technology and Nutrition v.6 Encyclopaedia of Food Science Macrae,R.;Robinson,R.K.;Sadler,M.J.
  72. J Appl Physiol v.80 Changes in insulin action and GLUT-4 with 6days of inactivity in endurance runners Vukovich,M.D.
  73. Acta Physiol Scand v.616 Carbohydrate and lipid metabolism after 20 days of bed rest Yanagibori,R.