Mr. Maddox has not eaten since his surgery. He was started on clear liquids several days ago but has taken in very little. Using the ASPEN guidelines, justify his requirement for nutrition support
What will be an ideal response?
• Mr. Maddox is a candidate for enteral nutrition support because he has had inadequate PO intake greater than 7 days and it is expected that this will continue. Also, it is important that he meets his nutritional needs at this time because he is s/p major surgery and is in a hypermetabolic state during sepsis and organ failure. Because he has no major injury to his GI tract, it is safe to administer the enteral feeding through an NG tube to the stomach for short-term use (<30 days).
• He is currently hemodynamically stable after experiencing hypotension immediately post-op.
• Nutrition support can be beneficial for this patient because it can preserve gut function, support immune function, and decrease episodes of bactremia and infection.
- Macronutrient, total fluid, electrolyte, and mineral content should to be considered.
- Formulas that are concentrated with minimal fluid load are desired.
- Flushes may not be tolerated well and must be monitored with fluid status.
- With CRRT, a standard, high-protein formula would be best.
• Once Mr. Maddox meets 60% of his needs through oral intake, weaning from EN can ensue.
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