Long Term Nutrition Support

The initial goal of nutritional support in the surgical patient is to prevent or reverse the catabolic effects of disease or injury. This article addresses the clinical application of nutritional support once the patient is stabilized and the initial injury contained. Long-term nutritional support usually refers to transition from the acute hospital setting into a long-term chronic care setting or the patient's home. The ability to transition nutrition therapy is the result of innovations in central venous catheters, enteral catheters, nutrient formulations, and infusion pumps and the availability of dedicated home health industry. However, in considering a patient for home nutritional support, one of the most important criteria is the availability of strong family support systems.

The indications for long-term nutrition support, specifically for home, include any patient who is unable to meet nutrient requirements by oral intake to avert the consequences of malnutrition. In the United States, cancer patients represent the most frequent use (>40%) of home parenteral and enteral nutrition support. Inflammatory bowel disease is the second most common reason for home parenteral

Table 1 Body fuel reserves in a 70-kg man

Component

Mass (kg)

Energy (kcal)

Days available

Water and minerals

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