GI functions?

Liz Ge
Mind Map by Liz Ge, updated more than 1 year ago
Liz Ge
Created by Liz Ge over 6 years ago
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GI FUNCTIONS

Resource summary

GI functions?
  1. Yes
    1. Enteral Nutrition
      1. Indications
        1. Not receiving nutritionaldemands (for 5-7 days by mouth)
          1. He can't
            1. Neurological diseases Swallow problems Cerebrovascular patients Alzheimer Coma Any disease that increased nutritional requirements: Burns, Sepsis, Oncological Any disease the patient can't prevent their airway
            2. He shouldn't
              1. GI Surgery Inflammatory disease Pancreatitis
              2. He doesn't want
                1. Anorexia Bulimia
                  1. Access
                        1. Time?
                          1. < 4 weeks
                            1. Temporal access
                              1. The gastric (Gold standard) or jejunal tube
                            2. > 4 weeks
                              1. Permanent aceess
                                1. - Percutaneous endoscopic (GS) - Gastrostomy
                                  1. Contraindications -Morbid obesity - Peritonitis - Ascitis - Nephrological patients
                                  2. Surgical gastrostomy
                                    1. Indications: - When you perform other abdominal surgery - Contraindication for endoscopy
                              2. Risk of bronco aspiration?
                                1. Yes
                                  1. Jejunal
                                  2. No
                                    1. Gastric
                                  3. What formula?
                                    1. Polymeric Oligomeric Elemental Energy 1 kCal/mL
                                      1. Patients who need > proteins:
                                        1. Undernutrition, - catabolic patients - kidney with dialysis
                                        2. Patients who need < proteins
                                          1. Kidney without dialysis
                              3. Contraindications
                                1. Peritonitis, GI tract perforation, Incohesive vomit, GI obstruction GI ischemia GI bleeding Hemodynamic instability Pregnant lady Hypovolemic shock Enterocutaneous fistula
                                2. Benefits
                                  1. -Preserve structure and physiology -Less complications -Maintain GAP junctions -Produce hormones and enzymes -Maintain micro biome -MALT and GALT (IgA) -Trophism
                              4. No
                                1. Parenteral nutrition
                                  1. Indications
                                    1. Doesn't pr he won't achieve nutritional goal by enteral route for more than 7 days 1. Short Bowel syndrome 2. Preoperative 10 days before surgery with undernutrition 3. Abdominal sepsis 4. Chron's disease
                                    2. Contraindications
                                      1. Functional GI trac Hemodynamic instability Less than 10 days (transferrin)
                                      2. Access
                                        1. < 4 weeks
                                          1. Temporal access
                                            1. Central
                                              1. Subclavian PICC Yugular Femoral
                                              2. Peripheral
                                                1. Cephalic Basilic
                                            2. > 4 weeks
                                              1. Permanent access
                                                1. All central catheters
                                        2. Complications Enteral and parenteral nutrition
                                          1. Mechanical
                                            1. Enteral: perforation, laceration Pneumo/hemo/quilotorax Laceration of vein/artery/heart Obstruction Malposition
                                            2. Infectious
                                              1. Sepsis associated with catheter Diarrhea
                                              2. GI complications
                                                1. Paralytic ileus, atrophy translocation vomit diarrhea distention pain
                                                2. Metabolic
                                                  1. Glicemia changes Electrolytic changes < Tiamine, Mg, K, P (Refeeding syndrome) > Osmolarity
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