This past week I attended to the largest meeting in nutrition support in Argentina (and probably in Latin America) organized by the Argentinean Asociation of Enteral and Parenteral Nutrition (AANEP). It was held in Buenos Aires and it was a great place to be to connect with colleagues and to hear from the best of the bests professionals in nutrition support. Some of the highlights were:
- One question, one test for nutrition screening (Dr. Peter Soeters): “How much weight have you lost in the past 6 months? Now give me a handshake” Functional tests like handgrip strength are good tools.
- There is no specific diet for diverticulosis. Many patients have symptoms because of concomitant irritable bowel syndrome (IBS). “Ispaghula” is a type of fiber that helps to alleviate diarrhea and constipation in IBS
- Clinical Practice Guidelines for acute pancreatitis (AANEP): Consider enteral nutrition as the first choice to feed. Gastric feeds are possible, using standard formulas. Do not give arginine nor probiotics
- Liver failure: do not limit proteins! No benefit has been shown in encephalopathy
- When implementing early enteral nutrition: don’t forget your patient. Be cautious, watch for distention, pain, acidosis, NG output, hemodinamic changes. Optimize enteral nutrition delivery to limit the use of supplemental parenteral nutrition, which may increment risk of infections /mortality (Dr. Martindale).
- Oral intake assessment: choose a method to estimate oral intake. Then, improve hospital menus to optimize intake and decrease waste. Good gastronomy in the hospital can also improve overall patient satisfaction with the hospital stay.
- Health care professionals (and the patient) can benefit using tools from marketing and business science.
- Use of protocols to improve outcomes (Dr. Heyland)
- All critically ill adult patients should receive enteral and/or parenteral glutamine (Dr. Paul Wischmeyer)
- Never limit proteins in acute renal failure in critically ill to prevent patient from renal replacement therapy. There is no need/benefit of enteral renal formulas.
And many other things ... Stay tunned for upcoming meetings organized by AANEP and FELANPE (Federacion Latinoamericana de Nutricion Clinica y Metabolismo)
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