A.S.P.E.N.

The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of clinical nutrition and metabolism. To read more about A.S.P.E.N., please visit their website www.nutritioncare.org.

Clinical Nutrition

Clinical nutrition is the proper management of a patient’s energy balance, providing sufficient amounts of proteins, fluids, vitamins and minerals, which is fundamental for health and resistance to disease.

_{T. Cederholm, ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition 36 (2017) 49-64}

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Disease-Related Malnutrition (Categorization)

• Acute Disease Related Malnutrition: when inflammation is acute and of severe degree such as in cases of sepsis, burns or trauma.
• Chronic Disease Related Malnutrition: when inflammation is chronic and of mild to moderate degree, e.g. rheumatoid arthritis, organ failure, chronic diseases in older patients, sarcopenic obesity.

_{Jensen GL, Mirtallo J, Compher C et al. Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN 2010;34(2):156-159.}

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Enteral Nutrition

Enteral nutrition (EN) includes oral nutritional supplements (ONS) and sip or tube feed via the gastrointestinal (GI) tract. 

ESPEN

The aims of The European Society for Clinical Nutrition and Metabolism (ESPEN) are to encourage the rapid diffusion of knowledge and its application in the field of Parenteral and Enteral Nutrition or, more broadly, Clinical Nutrition and Metabolism. To read more about ESPEN, please visit their website www.espen.org.

Glomerular filtration rate

Glomerular filtration rate (GFR) is a measure of how well the kidneys are working. Specifically, it estimates how much blood passes through the glomeruli each minute. Glomeruli are the tiny filters in the kidneys that filter waste from the blood.

Good Nutrition Practice

Good Nutrition Practice (GNP) is a program introduced by Fresenius Kabi that sets new international standards in the nutrition therapy of patients. In collaboration with an international team of experts, Fresenius Kabi is working on a series of measures aimed at creating a simple and practical procedure to identify patients at malnutrition risk, determine their nutrition needs and monitor their nutrition status. To read more about good nutrition practice, please click here

Hospital malnutrition

Malnutrition which can develop as a consequence of insufficient nutrient intake, impaired absorption or loss of nutrients due to illness or trauma, or increased metabolic demands during hospitalization." 

_{Correia MI, Perman MI, Linetzky D, et al. Hospital malnutrition in Latin America: A systematic review. Clinical Nutrition 2017;36:958-967}  

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Malnutrition

A state of nutrition in which a deficiency, excess or imbalance of energy, protein, and other nutrients causes measurable adverse effects on tissue/body form (body shape, size, and composition), function, and clinical outcome. 

_{Stratton R, Green C, Elia M. Disease-related malnutrition: an evidence based approach to treatment. Wallingford: CABI Publishing 2003}

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NRS 2002

The Nutritional Risk Screening 2002 (NRS 2002) is a screening tool to detect undernutrition. Please click here for more information about screening tools.

Oral Nutrition Supplement

An oral nutrition supplement (ONS) is a non-invasive approach to tackle malnutrition. An ONS is a multi-nutrient liquid, semi-solid or powder product that provides macronutrients and micronutrients with the aim of increasing oral nutritional intake.

_{Lochs H, Allison SP, Meier R et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics. Clin Nutr 2006;25(2):180-186.}

Parenteral Nutrition

Parenteral nutrition (PN) is the intravenous infusion of nutrients directly into the systemic circulation, bypassing the gastrointestinal (GI) tract. PN infusion is generally delivered via peripheral or central venous catheter insertion. To read more about parenteral nutrition, please click here

Refeeding Syndrome

Refeeding syndrome can develop in malnourished patients during oral, enteral or parenteral feeding after a period of starvation. When re-introducing nutrition, a metabolic shift from starvation to feeding lowers serum electrolyte levels. This can be life-threatening and can progress to acute circulatory fluid overload, respiratory decline, cardiac failure, and electrolyte disorders, especially hypophosphatemia.

_{Rio A, Whelan K, Goff L et al. Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study. BMJ Open 2013;3(1):1-9.}

SCCM

The Society of Critical Care Medicine (SCCM) is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. To read more about SCCM, please visit their website www.sccm.org.

SGA

The Subjective Global Assessment (SGA) is used to screen patients but can also be used for a more in-depth analysis as an assessment tool. Please click here for more information about screening tools.

Surgical Intensive Care Unit (SICU)

The Surgical Intensive Care Unit (SICU) is a special hospital unit designated for care of critically ill surgical patients.

United for clinical nutrition

Hospital malnutrition and caloric deficit is a widespread health problem of major concern impacting patients all over the world.

Malnutrition has significant negative impact on physical health as well as recovery from illness and surgery. In addition, it increases the use of health care resources and

treatment costs. This is especially true for the high risk surgical patients.

To overcome hospital malnutrition in countries around the world, Fresenius Kabi established in 2015 the initiative “United for clinical nutrition” in Latin America. As of 2018 the commitment is being continued in Asia with a special focus on surgical patients.

This multinational initiative seeks to reduce the prevalence of this condition through education, data collection, and clinical assessment in key geographical regions.

To read more about the initiative “United for clinical nutrition”, please click here