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Nutritional Assessment and

Techniques

LLL ESPEN

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Nutritional Screening and Assessment

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Assessment

Hal yang perlu diperhatikan dalam pembuatan

Assessment meliputi :

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Body Composition

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Changes in body composition in

starvation and disease/starvation

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Measure Body Composition Simple Method:

1. Anthropometry2. Fuctional test

3. Creatinin Ecretion rate

4. Nitrogen Balance

5. Bioelectrical impedance (vector) analysis (BIA and BIVA)

Sophisticated Method :1. Dual Energy X-ray Absorptiometry (DEXA)

2. Magnetic Resonance Imaging (MRI) and ComputedTomography(CT)

3. Dilution Methods

4. Underwater Weighing (UWW) and Air DisplacementPlethysmography (ADP)

5. Total body Potassium

6. In vivo Neutron Activation Analysis (IVNAA)

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Energy Expenditure

Total energy expenditure :1. Resting energy expenditure

2. Diet induced energy expenditure

3. Activity Induced energy expenditure

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Methods for Measurement of Energy

Expenditure

Direct Calorimetry

Indirect Calorimetry

Estimation of Energy Expenditure

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Energy Intake and Energy Balance

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Enteral Nutritional

One Form of the so-called artificial nutritionand includes both feeding via nasogastric/enteralor percutaneous (gastric or jejunal) tube and oralnutritional supplementation.

Indication Enteral nutritionTo maintain or improve nutritional statusirrespective of the underlying disease or clinicalsetting :

- Anticipated inadequate oral food intake for morethan days

- Present or imminent malnutrition

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Contraindications EN

Gastrointestinal complications of EN:

- Diarrhoe

- Nausea and Vomiting- Constipation

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Other Complication

Aspiration

Tube related complications

Metabolic Complication

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Monitoring Of EN

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Routes Of Enteral Access

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Short-term Enteral Feeding

Long-term enteral nutrition

Nasogastric Tube (NG)

Nasoenteral Tube (NET)

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Indication Of Free amino acid formulae Some forms Of congenital metabolic disease

Severe alergy to dietary protein Nutritional treatment of CrohnsDisease

Diabetes Formulae: High MUFA diabetes formulae

Formula for patients with liver disease :

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Formulae for patients with renal

failure

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Contraindications to parenteral

nutrition

If gastrointestinal tract fully fuctional with

adequate absorption of macro and

micronutrients

Inability to obtain venous access

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Vascular access used for PN1. Subclavian Vein Catheterization

2. Internal Jugular Vein Catheterization

3. Femoral vein Catheterization

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Complications in relation to insertion

of CVC

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Complication

Metabolic Complication

Technical Complication

Infectious Complication

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