Grade A clinical evidence supports nutritional therapy with IMPACT formula

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Grade A clinical evidence supports nutritional therapy with IMPACT formula"

Transcription

1

2 Grade A clinical evidence supports nutritional therapy with IMPACT formula Only IMPACT formula has 8+ published articles supporting its clinical outcomes and economic benefits vs. standard formulas* 4+ 4 Published articles Positive patient outcome studies Supportive mechanistic studies and review articles Meta-analyses Economic analyses IMPACT formula has positive outcome data across multiple patient types*: Surgical elective and emergency Trauma head injury, burns, blunt and penetrating trauma Medical critically ill, cardiac failure, mechanically-ventilated, pneumonia, mild to moderate sepsis, wounds * Data vs. control including standard formulas, total parenteral nutrition (TPN) and nothing by mouth (NPO). For more information on IMPACT trials, or to speak with a Nestlé healthcare specialist call ASK2 (2752).

3 IMPACT nutritional therapy improves clinical outcomes and helps reduce surgical complications 1-8 IMPACT formula reduces the incidence of nosocomial infection 1* IMPACT formula decreases days on ventilator 5 Reduction (%) Up to 61% Reduction (days) Up to IMPACT formula reduces antibiotic use 2-4,, IMPACT formula decreases length of hospital stay (LOS) 1,6*, Reduction (%) Reduction (days) On average Up to 6% 6 6 In addition, IMPACT nutritional therapy has been shown to significantly reduce incidence of complications including: Pneumonia & UTI by 5% 1* 7,8 Ω,ß Wound complications by 77% Abdominal abscesses by 6% 1* Anastomotic leaks by 5% 1* * Versus standard formula. Review of 17 randomized trials to determine the relationship between postsurgical outcomes and pre-, peri- and postoperative nutritional support in patients undergoing elective surgery; n=2,35. 1 Prospective, randomized, double-blind clinical trial assessing perioperative administration of enteral formula to reduce infections vs. standard formulas; n=26. 2 Randomized clinical trial assessing effects of perioperative oral supplementation on length of hospital stay and postoperative complications in malnourished GI surgical cancer patients; n=15. 3 Randomized, controlled trial investigating effects of preoperative oral supplementation on postoperative infection rates and length of hospital stay in malnourished GI surgical cancer patients; n=35. 4 Versus standard formula; p=.7. Prospective, randomized, double-blind, controlled trial investigating median duration of mechanical ventilation days required. 5 Results from a prospective, randomized, multicenter, controlled trial; patients received standard formula. Infections included UTI, SSI and pneumonia. IMPACT formula reduced patients median of stay; n= Ω Prospective, randomized, double-blind, controlled trial investigating early postoperative enteral immunonutrition in surgery patients. Results vs. control formula; n=6. 7 ß Prospective, randomized trial evaluating wound complications in major abdominal surgical patients; n=6. 8

4 Positive outcomes are supported by IMPACT formula s mechanism of action Improves immune response: 7-11 IgG & IgM Total Lymphocyte Count T-Lymphocyte Count Modulates inflammatory response: 2,12-15 C-Reactive Protein Fibrinogen IL-2, IL-6, IL-8 Up to 8% of the body s immunoglobulin-producing tissue are located within the GI tract 16 Enhances tissue repair: 2,7 Colonic microperfusion Gut oxygenation Hydroxyproline levels Only IMPACT formula contains a patented blend of immune-modulating nutrients including arginine, omega-3 fatty acids and dietary nucleotides that help enhance immune response L-Arginine 7,17-21 a nitrogen-rich amino acid; indispensable in stressed states A precursor of polyamines and a regulator of nucleic acid synthesis Supports T-cell replication and growth to enhance immune function Promotes wound healing and reduces infectious complications Omega-3 Fatty Acids 22 EPA & DHA from fish oil Increase immune response by enhancing lymphocyte function Minimize inflammatory response by decreasing production of inflammatory mediators Dietary nucleotides 23 building blocks for DNA and RNA; indispensable in stressed states Required for almost all cell activities & growth Essential for rapidly replicating cells to help support immune function Glutamine 24 amino acid; indispensible in stressed states The preferred oxidative fuel required for rapidly dividing cells, including GI mucosal cells & immune cells Improves GALT, mucosal integrity, and nitrogen transport to promote nutrient absorption Protein 25 High levels support increased demand caused by catabolism during the stress response Supports wound healing, strengthens immune function and promotes anabolism Zinc 26 Stabilizes RNA and DNA structure Deficiency associated with delayed wound healing

5 Nutritional therapy with IMPACT formula is cost effective for hospitals and patients IMPACT formula is a cost effective therapy for managing the risk for infection and length of hospital stay in critically ill patients 27 Investment Potential Savings* Population IMPACT formula Incremental cost of complication Incremental LOS with complication Surgical $152 $25, days Trauma $17 $23, days Medical $17 $81, days Reduced incidence of nosocomial infection and hospital LOS with IMPACT formula results in net cost savings, as demonstrated in a study by Farber MS et al., day course x 17 critically ill ICU patients IMPACT... $11,662 PROMOTE... $ 1,12 Additional cost for IMPACT... $1,65 ICU savings with reduced LOS 5 days x 17 patients... $24, Net Savings...$193,35 * IMPACT has been associated with reduced cost of hospital care despite its higher purchase price vs. standard formulas. Savings are on a per patient basis, based on illness category and at a low baseline infection rate (1%). These results were derived from a national database of over 1 million patients in a variety of health care facilities across the US. Average cost of a perioperative oral regimen in the U.S. is $22 (1 L/d for 5 consecutive days preoperatively plus 2 kcal/d enterally for 7 consecutive days postoperatively). Average cost of a post-admission regimen (2 kcal/d for 7 consecutive days) for medical ICU or trauma patients is $175. The average cost of a standard high nitrogen formula (2 kcal/d for 7 consecutive days) is $68. Pricing not guaranteed and varies per customer. Incidence of nosocomial infections, mortality and the consumption of multiple ICU resources were examined to determine the cost effectiveness of this proprietary immunonutrition enteral formula. 29 Assumes patients receive 8 cans/day of IMPACT 1.5 formula or PROMOTE. Patients with significant, severe illness. Pricing not guaranteed and varies per customer. Assuming cost of incremental care $24/day in ICU. 27

6 Make nutritional therapy with IMPACT formula an important part of your treatment protocols Immune-modulating formulas are appropriate for multiple patient types: 2,32* Major elective GI surgery Trauma (abdominal trauma index score >2) Burns (total body surface area >3%) Head and neck cancer Critically ill on mechanical ventilation (not severely septic) IMPACT formula recommended administration: Deliver enterally or PO: enterally via gastric or jejunal tube 33 (IMPACT formulas) o r orally with IMPACT Advanced Recovery Advanced Nutrition Drink Initiate early: within hours after injury/surgery or as soon as safe to feed 2 Start slowly: 1 3 ml/hour and advance towards goal over next hours 34,35 Duration: after achieving 5% of caloric goal, feed for 5 days 34,36 Continue until the risk of infectious complications is significantly reduced 2 Transition to high-nitrogen standard formula or wean from enteral feeding IMPACT [has] been shown in clinical studies to improve patient outcome, principally by reducing infections and improving wound healing. Other formulas have not been prospectively studied and are dissimilar enough from the tested formulas that no conclusions can be made about their use in trauma patients A.S.P.E.N Nutrition Support Practice Manual * Contraindicated where immunosuppression is desired. Caution is required in patients with severe sepsis. Feed IMPACT formula only to those patients who are hemodynamically stable and where enteral feeding is appropriate. Patients may not receive maximum benefit if used fewer than 5 days and less than.5 1 L/day of IMPACT formula. 1,2,6 Reprinted from Kozar RA et al. Trauma. In: Merritt R ed. The A.S.P.E.N. Nutrition Support Practice Manual. 2 nd ed. 25:271 6., with permission from the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). A.S.P.E.N. does not endorse the use of this material in any form other than its entirety. 25

7 Make an IMPACT with your choice of nutritional therapy Extensive evidence and positive clinical outcomes support the unique formulation found in all IMPACT formulas IMPACT 1. For patients requiring a high-protein, 1. kcal/ml immune-modulating formula IMPACT 1.5 For patients with fluid sensitivity requiring a calorically dense (1.5 kcal/ml), high-protein, immune-modulating formula IMPACT with fiber For patients requiring a high-protein, 1. kcal/ml immune-modulating formula with added fiber to help support normal bowel function IMPACT Glutamine For patients requiring a high-protein, calorically dense (1.3 kcal/ml) immune-modulating formula with high levels of glutamine (15g/L) and added fiber IMPACT Advanced Recovery For patients requiring a high-protein, calorically dense (1.4 kcal/ml) immune-modulating nutritional beverage for use peri-operatively to help decrease incidence of infection and support colonic health

8 Make an IMPACT with nutritional therapy in your ICU Reduced risk for infection Up to 61% 1 Fewer ventilator days, Less antibiotic use Decreased surgical wound complications Up to 4.5 days 5 Up to 6% 2-4 Up to 77% 7 Shorter length of stay On average 3.1 days 1 Lower cost of care Hospital savings over $19, 29 Higher standard of patient care Across multiple patient types Contact Nestlé Nutrition at ASK2 for more information, or visit 1. Waitzberg DL et al. World J Surg 26;3: Braga M et al. Surg 22;132: Braga M et al. Arch Surg 22;137: Gianotti L et al. Gastroenterology 22;122: Atkinson S et al. Crit Care Med 1998;26: Bower RH et al. Crit Care Med 1995;23(3): Farreras N et al. Clin Nutr 25;24: Daly JM et al. Ann Surg 1995;221(4): Kemen et al. Crit Care Med 1995;23(4): Senkal et al. Arch Surg 1999;134: Snyderman et al. Laryngoscope 1999;19: Weimann A et al. Nutrition 1998;14(2): Gianotti et al. Arch Surg 1997;132: Tepaske et al. Lancet 21;358: Nakamura et al. Nutrition 25;21: Phillips-Qualigiata JM et al. Migration of lymphocytes in mucosal immune system. In: Husband AJ, ed. Migration and Homing of Lymphoid Cells. CRC Press 1988;2: Ochoa et al. Nutrition in Clinical Practice 24;19: Basu et al. NCP 22:17: Guoyao et al. Curr Opin Clin Nutr Metabol Care 2;(3)1: Kudsk et al. JPEN 21;25(2):S1 S Stechmiller et al. Am J CC 24;13: Calder et al. Eur J Clin Nutr 26:56:S14 S Grimble et al. Curr Opin Clin Nutr Metabol Care 21;4: Alpers. Gastroenterology 26;13:S16 S Kozar RA et al. Trauma. In: Merritt R ed. The A.S.P.E.N. Nutrition Support Practice Manual. 2nd ed. 25: Anderson JJ. In: Mahan LK et al. Krause s Food, Nutrition and Diet Therapy, 1th ed. Minerals. Philadelphia: WB Saunders, 2: Strickland A et al. JPEN 25;29:S62 S Braga M. Nutrition 25;21: Farber. JPEN 25;29(1):S62 S Braga M et al. JPEN 25;29(1): S57 S Braga M et al. Nutrition 25;21: Montejo JC et al. Clinical Nutrition 23;22(3): Cresci G et al. Nutrition Support in Trauma. In: The Science and Practice of Nutrition Support. A.S.P.E.N./Kendall-Hunt Publishing. 21; Gottschilch MM. Ed. Silver Spring, MD: A.S.P.E.N.;27: Taylor SJ et al. Crit Care Med 1999;27(11): Cresci G JPEN 25;29(1):S92 S95. PROMOTE is a registered trademark of Abbott Laboratories ASK2 (2752) Except as noted, all trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland. IPCT

SINPE trial, Ann Surg 2009. Overall morbidity. Minor Major. Infectious Non infectious. Post-hoc analysis WL < %5 (n=379) WL between 5-10% (n=49)

SINPE trial, Ann Surg 2009. Overall morbidity. Minor Major. Infectious Non infectious. Post-hoc analysis WL < %5 (n=379) WL between 5-10% (n=49) Chinese International Symposium on Nutritional Oncology Changchun, June 20-21 2014 IMMUNONUTRITION IN CANCER PATIENTS IMMUNONUTRITION IN SURGERY OBJECTIVE To get the patient undergoing major surgery for

More information

Omega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine April 2006;34(4):972-9

Omega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine April 2006;34(4):972-9 Omega-3 fatty acids improve the diagnosis-related clinical outcome 1 Critical Care Medicine April 2006;34(4):972-9 Volume 34(4), April 2006, pp 972-979 Heller, Axel R. MD, PhD; Rössler, Susann; Litz, Rainer

More information

FROM START TO FINISH: AN INTEGRATIVE ONCOLOGY CASE STUDY. Tanya Wells

FROM START TO FINISH: AN INTEGRATIVE ONCOLOGY CASE STUDY. Tanya Wells FROM START TO FINISH: AN INTEGRATIVE ONCOLOGY CASE STUDY. Tanya Wells Patient Background Background: 62 yo female Anne Generally well and fit exercises 3-4/7 Pesco-vegetarian diet, alcohol (red wine) 3/7

More information

Applying the 2016 ASPEN/ SCCM Critical Care Guidelines to Your Practice. Susan Brantley, MS, RD, LDN

Applying the 2016 ASPEN/ SCCM Critical Care Guidelines to Your Practice. Susan Brantley, MS, RD, LDN Applying the 2016 ASPEN/ SCCM Critical Care Guidelines to Your Practice Susan Brantley, MS, RD, LDN Objectives: Upon completion of this presentation, participants should be able to: 1. Distinguish the

More information

Early Oral Feeding Following Intestinal Surgery is it Safe?

Early Oral Feeding Following Intestinal Surgery is it Safe? Early Oral Feeding Following Intestinal Surgery is it Safe? * (FICMS) Abstract Background: A period of starvation ( nil by mouth ) is common practice after gastrointestinal surgery during which an intestinal

More information

Cytomegalovirus in the immunocompent: Prevent, Treat, or Ignore?

Cytomegalovirus in the immunocompent: Prevent, Treat, or Ignore? Cytomegalovirus in the immunocompent: Prevent, Treat, or Ignore? Gordon D. Rubenfeld, MD MSc Professor of Medicine, University of Toronto Chief, Program in Trauma, Emergency, and Critical Care Sunnybrook

More information

Nutritional Support of the Burn Patient

Nutritional Support of the Burn Patient Nutritional Support of the Burn Patient Objectives To understand the principles of normal nutrient utilization and the abnormalities caused by burn injury To be able to assess nutrient needs To be able

More information

Dansk Selskab for Klinisk Ernæring Initiativøde 17. januar 2012. Immunonutrition hvad nyt?

Dansk Selskab for Klinisk Ernæring Initiativøde 17. januar 2012. Immunonutrition hvad nyt? Dansk Selskab for Klinisk Ernæring Initiativøde 17. januar 2012 Immunonutrition hvad nyt? Jens Kondrup Rigshospitalet Bone RC. Crit Care Med 1996;24:1125-8. Moore FA. Am J Surg 1999;178:449-53 SIRS: Systemic

More information

The Science of Muscle Growth and Repair By William Cabot M.D., FAAOS

The Science of Muscle Growth and Repair By William Cabot M.D., FAAOS The Science of Muscle Growth and Repair By William Cabot M.D., FAAOS Part 2 - The Role Individual Amino Acids Play in Muscle growth and Repair American Casein Company has been a worldwide leader in supplying

More information

ESCMID Online Lecture Library. by author

ESCMID Online Lecture Library. by author Do statins improve outcomes of patients with sepsis and pneumonia? Jordi Carratalà Department of Infectious Diseases Statins for sepsis & community-acquired pneumonia Sepsis and CAP are major healthcare

More information

Nutritional Management in Esophageal Cancer. Kurt Boeykens Nutrition Nurse Specialist

Nutritional Management in Esophageal Cancer. Kurt Boeykens Nutrition Nurse Specialist Nutritional Management in Esophageal Cancer Kurt Boeykens Nutrition Nurse Specialist 1 Are these patients nutritionally at risk? If surgery: Major surgery Preoperative treatment Chemotherapy and radiation

More information

Canadian Clinical Practice Guidelines 2015 Summary of Revisions to the Recommendations. # Topic Recommendation 2013 Recommendation

Canadian Clinical Practice Guidelines 2015 Summary of Revisions to the Recommendations. # Topic Recommendation 2013 Recommendation 1. The Use of Enteral Nutrition vs. Parenteral Nutrition 4 X When considering nutrition support for critically ill patients, we recommend the use of enteral nutrition over parenteral nutrition in patients

More information

Aims of Nutritional Support in Oncology (Parenteral) Part 2

Aims of Nutritional Support in Oncology (Parenteral) Part 2 Aims of Nutritional Support in Oncology (Parenteral) Part 2 Rachel Barrett MSc, BSc (Hons) RD Principal Haematology-Oncology Dietitian Hong Kong Hospital Authority Commissioned Training November 20 th

More information

ENTERAL. Sincerely, Professor Ferdinand Haschke, MD Chairman Nestlé Nutrition Institute. American Society for Parenteral and Enteral Nutrition

ENTERAL. Sincerely, Professor Ferdinand Haschke, MD Chairman Nestlé Nutrition Institute. American Society for Parenteral and Enteral Nutrition ENTERAL It is with pleasure that I invite you to apply for the 2010 2011 Nestlé Institute Enteral. This competitive and prestigious award is designed to provide an unparalleled educational and clinical

More information

Year in Review 2013 Intensive Care. J.G. van der Hoeven Radboud University Medical Centre Nijmegen

Year in Review 2013 Intensive Care. J.G. van der Hoeven Radboud University Medical Centre Nijmegen Year in Review 2013 Intensive Care J.G. van der Hoeven Radboud University Medical Centre Nijmegen Contents ARDS Ventilator associated pneumonia Tracheostomy and endotracheal intubation General ICU care

More information

Wytyczne European Society for Clinical Nutrition and Metabolism

Wytyczne European Society for Clinical Nutrition and Metabolism Wytyczne European Society for Clinical Nutrition and Metabolism ESPEN guidelines on enteral nutrition: pancreas R. Meier, J. Ockenga, M. Pertkiewicz, A. Pap, N. Milinic, M. MacFie, DGEM: C. Löser, V. Keim

More information

READING MATERIAL: SURGICAL FOUNDATION SEMINAR SERIES

READING MATERIAL: SURGICAL FOUNDATION SEMINAR SERIES READING MATERIAL: SURGICAL FOUNDATION SEMINAR SERIES (CITATIONS ARE FROM SABISTON S TEXTBOOK OF SURGERY, 18 TH EDITION AND ACS SURGERY PRINCIPLES & PRACTICE 2007 UNLESS OTHERWISE NOTED) Note: Session topics

More information

Nutritional support for cancer patients

Nutritional support for cancer patients Nutritional support for cancer patients Patients who are receiving adequate nutrition have a better prognosis, respond better to chemotherapy and can tolerate higher doses of anticancer treatments. It

More information

Periodic Guideline Review and Update

Periodic Guideline Review and Update Special Article Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral

More information

Wound Healing. Outline. Normal Wound Healing. Wounds and nutrition refresher UPHS evidence-based guideline for. wounds

Wound Healing. Outline. Normal Wound Healing. Wounds and nutrition refresher UPHS evidence-based guideline for. wounds Wound Healing Clinical Nutrition Support Service Hospital of the University of Pennsylvania Jung Kim, RD CNSD, LDN Tricia Stefankiewicz, MA, RD, CNSC, LDN Outline Wounds and nutrition refresher UPHS evidence-based

More information

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after

More information

Dietary treatment of cachexia challenges of nutritional research in cancer patients

Dietary treatment of cachexia challenges of nutritional research in cancer patients Dietary treatment of cachexia challenges of nutritional research in cancer patients Trude R. Balstad 4th International Seminar of the PRC and EAPC RN, Amsterdam 2014 Outline Cancer cachexia Dietary treatment

More information

ALESSANDRO PINTO. Dipartimento di Medicina Sperimentale. Sezione di Fisiopatologia Medica, Scienza dell Alimentazione ed Endocrinologia

ALESSANDRO PINTO. Dipartimento di Medicina Sperimentale. Sezione di Fisiopatologia Medica, Scienza dell Alimentazione ed Endocrinologia ALESSANDRO PINTO Alessandro.Pinto@uniroma1.it Dipartimento di Medicina Sperimentale Sezione di Fisiopatologia Medica, Scienza dell Alimentazione ed Endocrinologia metabolic perturbations from inflammatory

More information

Inpatient Treatment of Diabetes

Inpatient Treatment of Diabetes Inpatient Treatment of Diabetes Alan J. Conrad, MD Medical Director Diabetes Services EVP, Physician Alignment Diabetes Symposium November 12, 2015 Objectives Explain Palomar Health goals for inpatient

More information

ESPEN Congress Geneva 2014 ESPEN GUIDELINES. ESPEN Guidelines: nutrition support in cancer J. Arends (DE)

ESPEN Congress Geneva 2014 ESPEN GUIDELINES. ESPEN Guidelines: nutrition support in cancer J. Arends (DE) ESPEN Congress Geneva 2014 ESPEN GUIDELINES ESPEN Guidelines: nutrition support in cancer J. Arends (DE) espen and epaac guidelines nutrition in cancer Jann Arends Tumor Biology Center Freiburg Ethical

More information

- define enteral nutrition - to explore the different types of enteral formulas that are available - describe tube feeding administration guidelines

- define enteral nutrition - to explore the different types of enteral formulas that are available - describe tube feeding administration guidelines Basics of Enteral Feeding 2004 Beth Mills, MS, RD, CNSD, LDN Objectives - define enteral nutrition - to explore the different types of enteral formulas that are available - describe tube feeding administration

More information

PEG (34.9% 16% 52 PEGJ

PEG (34.9% 16% 52 PEGJ Enteral Feeding via Percutaneous Endoscopic Gastrojejunostomy(PEGJ) Tubes Decreases Risk of Aspiration and Tube Dislodgement Related Complications Compared to PEGs. Wali R Johnson, MSIV, L Ray Matthews,

More information

expert Ask the Enteral nutrition Mark H. DeLegge, MD, FASGE

expert Ask the Enteral nutrition Mark H. DeLegge, MD, FASGE Ask the expert Enteral nutrition Mark H. DeLegge, MD, FASGE Ask the expert features questions submitted by members, with answers provided by ASGE physician experts. ASGE s Publications Committee identifies

More information

4.1b(i) Composition of Enteral Nutrition: Fish Oils, Borage Oils and Antioxidants* April 2013

4.1b(i) Composition of Enteral Nutrition: Fish Oils, Borage Oils and Antioxidants* April 2013 4.1b(i) Composition of Enteral Nutrition: Fish Oils, Borage Oils and Antioxidants* April 2013 2013 Recommendation: Based on 2 level 1 studies and 5 level 2 studies, the use of an enteral formula with fish

More information

Bowel Preparation for Colon Resection. Eric Klein, M.D. SUNY Downstate Department of Surgery

Bowel Preparation for Colon Resection. Eric Klein, M.D. SUNY Downstate Department of Surgery Bowel Preparation for Colon Resection Eric Klein, M.D. SUNY Downstate Department of Surgery Historical Perspective During World War II, failure to treat penetrating colon injuries with diversion could

More information

Marasmus. Kwashiorkor

Marasmus. Kwashiorkor Chapter 8 NUTRITION Poor nutrition can negate all the benefits of proper wound care or advanced medical interventions. Studies have shown that malnourished patients often require longer hospitalizations,

More information

TPN/ Enteral nutrition. Salsabil HADIRE Dietitian in Oncology Hematology Center of University Hospital Mohammed VI Marrakech-

TPN/ Enteral nutrition. Salsabil HADIRE Dietitian in Oncology Hematology Center of University Hospital Mohammed VI Marrakech- TPN/ Enteral nutrition Salsabil HADIRE Dietitian in Oncology Hematology Center of University Hospital Mohammed VI Marrakech- Work plan Part 1: Total Parenteral Nutrition (TPN) Part 2: Enteral Nutrition

More information

TPN origin and calculations. Naureen Iqbal 01/09/13

TPN origin and calculations. Naureen Iqbal 01/09/13 TPN origin and calculations Naureen Iqbal 01/09/13 TPN - History Glucose and electrolyte Protein hydrolysates in 30s Fat emulsion- Intralipid in 60s. Vitamins, minerals, trace elements Central venous catheter

More information

Sepsis and the Clinical Laboratory

Sepsis and the Clinical Laboratory Sepsis and the Clinical Laboratory Alison Woodworth, PhD Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville, TN Learning Objectives Outline the Pathogenesis

More information

Liver, Gallbladder, Exocrine Pancreas KNH 406

Liver, Gallbladder, Exocrine Pancreas KNH 406 Liver, Gallbladder, Exocrine Pancreas KNH 406 2007 Thomson - Wadsworth LIVER Anatomy - functions With disease blood flow becomes obstructed Bile All bile drains into common hepatic duct Liver Bile complex

More information

ESPEN guidelines in cystic fibrosis

ESPEN guidelines in cystic fibrosis ESPEN Congress Barcelona 2012 Achieving goals by guidelines: myth or reality? ESPEN guidelines in cystic fibrosis D. Turck (France) Guidelines on the nutritional support in cystic fibrosis WG D Turck (Lille,

More information

LLL Session - Nutritional support in renal disease. E. Fiaccadori (IT)

LLL Session - Nutritional support in renal disease. E. Fiaccadori (IT) ESPEN Congress Leipzig 2013 LLL Session - Nutritional support in renal disease Acute kidney failure E. Fiaccadori (IT) Nutrition support in renal disease Acute Kidney Injury Enrico Fiaccadori, MD, PhD

More information

IHI Expedition Improving Safety and Reliability for Surgical Procedures Session 2

IHI Expedition Improving Safety and Reliability for Surgical Procedures Session 2 Thursday, December 5, 2013 These presenters have nothing to disclose IHI Expedition Improving Safety and Reliability for Surgical Procedures Session 2 Thomas K. Varghese Jr., MD, MS, FACS Kathy Duncan,

More information

Mandated Health Benefit Review

Mandated Health Benefit Review Mandated Health Benefit Review JLARC Review of Senate Bill 866 (2013) SUMMARY OF FINDINGS Pursuant to 30-344 of the Code of Virginia, staff of the Joint Legislative Audit and Review Commission (JLARC)

More information

NUTRITION OF THE BODY

NUTRITION OF THE BODY 5 Training Objectives:! Knowledge of the most important function of nutrients! Description of both, mechanism and function of gluconeogenesis! Knowledge of the difference between essential and conditionally

More information

ENTERAL FORMULAE AND PARENTERAL NUTRITIONAL SOLUTIONS, DME

ENTERAL FORMULAE AND PARENTERAL NUTRITIONAL SOLUTIONS, DME ENTERAL FORMULAE AND PARENTERAL NUTRITIONAL SOLUTIONS, DME Policy NHP only reimburses participating DME vendors for the provision of medically necessary enteral and parenteral formulae and nutritional

More information

Oral Zinc Supplementation as an Adjunct Therapy in the Management of Hepatic Encephalopathy: A Randomized Controlled Trial

Oral Zinc Supplementation as an Adjunct Therapy in the Management of Hepatic Encephalopathy: A Randomized Controlled Trial Oral Zinc Supplementation as an Adjunct Therapy in the Management of Hepatic Encephalopathy: A Randomized Controlled Trial Marcus R. Pereira A. Study Purpose Hepatic encephalopathy is a common complication

More information

Inflammation, Arthritis, and Nutrition

Inflammation, Arthritis, and Nutrition Inflammation, Arthritis, and Nutrition Kristin Baker, PhD Assistant Research Professor ENACT Sargent College at Boston University Email: krbaker@bu.edu ENACT website: www.bu.edu/enact Brief Bio Primary

More information

What is the Sleeve Gastrectomy?

What is the Sleeve Gastrectomy? What is the Sleeve Gastrectomy? The Sleeve Gastrectomy (also referred to as the Gastric Sleeve, Vertical Sleeve Gastrectomy, Partial Gastrectomy, or Tube Gastrectomy) is a relatively new procedure for

More information

Urinary Diversion: Ileovesicostomy/Ileal Loop/Colon Loop

Urinary Diversion: Ileovesicostomy/Ileal Loop/Colon Loop Urinary Diversion: Ileovesicostomy/Ileal Loop/Colon Loop Why do I need this surgery? A urinary diversion is a surgical procedure that is performed to allow urine to safely pass from the kidneys into a

More information

Recommendations: Other Supportive Therapy of Severe Sepsis*

Recommendations: Other Supportive Therapy of Severe Sepsis* Recommendations: Other Supportive Therapy of Severe Sepsis* K. Blood Product Administration 1. Once tissue hypoperfusion has resolved and in the absence of extenuating circumstances, such as myocardial

More information

Over 50% of hospitalized patients are malnourished. Coding for Malnutrition in the Adult Patient: What the Physician Needs to Know

Over 50% of hospitalized patients are malnourished. Coding for Malnutrition in the Adult Patient: What the Physician Needs to Know Carol Rees Parrish, M.S., R.D., Series Editor Coding for Malnutrition in the Adult Patient: What the Physician Needs to Know Wendy Phillips At least half of all hospitalized patients are malnourished,

More information

Surgical Site Infection Prevention

Surgical Site Infection Prevention Surgical Site Infection Prevention 1 Objectives 1. Discuss risk factors for SSI 2. Describe evidence-based best practices for SSI prevention 3. State principles of antibiotic prophylaxis 4. Discuss novel

More information

Feeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014

Feeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Feeding in Infants with Complex Congenital Heart Disease Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Objectives Discuss common feeding issues in patients with

More information

Colocutaneous Fistula. Disclosures

Colocutaneous Fistula. Disclosures Colocutaneous Fistula Madhulika G. Varma MD Associate Professor Chief, Colorectal Surgery University of California, San Francisco Honoraria Applied Medical Covidien Disclosures 1 Colocutaneous Fistula

More information

Rheumatoid Arthritis. Treating Inflammation. Sequoia Education Systems, Inc http://www.functionalmedicineuniversity.com 1. How is RA Diagnosed?

Rheumatoid Arthritis. Treating Inflammation. Sequoia Education Systems, Inc http://www.functionalmedicineuniversity.com 1. How is RA Diagnosed? Rheumatoid Arthritis Causes, Assessment and Treatment How is RA Diagnosed? The following labs make up the basics of ruling in or out RA. Citrullinated Peptide (anti-ccp) Antibodies Rheumatoid factor Erythrocyte

More information

NHRMC General Surgery Specialists. Minimally Invasive Gastrointestinal Surgery Phone: 910-662-9300 Fax: 910-662-9303

NHRMC General Surgery Specialists. Minimally Invasive Gastrointestinal Surgery Phone: 910-662-9300 Fax: 910-662-9303 Minimally Invasive Gastrointestinal Surgery Phone: 910-662-9300 Fax: 910-662-9303 W. Borden Hooks III, MD 1725 New Hanover Medical Park Drive Wilmington, NC 28403 Thank you for choosing NHRMC General Surgery

More information

NUTRITIONAL SUPPORT IN SURGICAL PATIENTS

NUTRITIONAL SUPPORT IN SURGICAL PATIENTS DISCLAIMER: These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center. They are intended to serve as a general statement regarding appropriate patient care

More information

Refeeding syndrome in anorexia nervosa

Refeeding syndrome in anorexia nervosa ESPEN Congress Barcelona 2012 Is there a role for nutrition in psychiatric disorders? Refeeding syndrome in anorexia nervosa V. Haas (Germany) ESPEN - 2012 - Barcelona The refeeding syndrome in Anorexia

More information

Restricted permission granted by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) from the following: Journal of Parenteral and

Restricted permission granted by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) from the following: Journal of Parenteral and Restricted permission granted by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) from the following: Journal of Parenteral and ENteral Nutrition (JPEN); Canadian Clinical Practice

More information

Expert Commentary. A response to the recent JAMA meta analysis on omega 3 supplementation and cardiovascular events

Expert Commentary. A response to the recent JAMA meta analysis on omega 3 supplementation and cardiovascular events Expert Commentary A response to the recent JAMA meta analysis on omega 3 supplementation and cardiovascular events Dr. Bruce J. Holub, Ph.D., Professor Emeritus, University of Guelph Expert Commentary:

More information

Cancer Treatment Centers of America Treating the Whole Patient. Presented by: Jill Schuman, RD, CNSC, CSP, LCN Date: Spring 2012

Cancer Treatment Centers of America Treating the Whole Patient. Presented by: Jill Schuman, RD, CNSC, CSP, LCN Date: Spring 2012 Cancer Treatment Centers of America Treating the Whole Patient Presented by: Jill Schuman, RD, CNSC, CSP, LCN Date: Spring 2012 What is Cancer Two types of tumors Liquid tumor Leukemia Lymphoma Aplastic

More information

New strategies in anticancer therapy

New strategies in anticancer therapy 癌 症 診 療 指 引 簡 介 及 臨 床 應 用 New strategies in anticancer therapy 中 山 醫 學 大 學 附 設 醫 院 腫 瘤 內 科 蔡 明 宏 醫 師 2014/3/29 Anti-Cancer Therapy Surgical Treatment Radiotherapy Chemotherapy Target Therapy Supportive

More information

How do Patients Take THE GIFT from Mother Earth, BEST FULVIC and Humic and Fulvic Based Supplements?

How do Patients Take THE GIFT from Mother Earth, BEST FULVIC and Humic and Fulvic Based Supplements? How do Patients Take THE GIFT from Mother Earth, BEST FULVIC and Humic and Fulvic Based Supplements? Patients typically start taking THE GIFT from Mother Earth. THE GIFT from Mother Earth is a highly-concentrated

More information

What s new in cancer. NHMRC Evidence hierarchy. Evidence Based Guidelines 12/06/2013. Level I: systematic review of all RCTs

What s new in cancer. NHMRC Evidence hierarchy. Evidence Based Guidelines 12/06/2013. Level I: systematic review of all RCTs What s new in cancer treatment? Dr Liz Isenring, AdvAPD Email: e.isenring@uq.edu.au Clinical Academic Fellow, Princess Alexandra Hospital Conjoint Senior Lecturer University of Queensland, Australia Evidence

More information

CARDIAC SURGERY INTRAVENOUS INSULIN PROTOCOL PHYSICIAN ORDERS INDICATIONS EXCLUSIONS. Insulin allergy

CARDIAC SURGERY INTRAVENOUS INSULIN PROTOCOL PHYSICIAN ORDERS INDICATIONS EXCLUSIONS. Insulin allergy Page 1 of 5 INDICATIONS EXCLUSIONS 2 consecutive blood glucose measurements greater than 110 mg per dl AND NPO with a continuous caloric source AND Diagnosis of : Cardio-thoracic Surgery NOTE: This protocol

More information

Blood Transfusion Therapy in Trauma and Massive Hemorrhage Putting the Patient First

Blood Transfusion Therapy in Trauma and Massive Hemorrhage Putting the Patient First FACULTY OF MEDICINE, DENTISTRY AND HEALTH SCIENCES Blood Transfusion Therapy in Trauma and Massive Hemorrhage Putting the Patient First ALBERT FARRUGIA Historical Background Over last 40 years, transfusion

More information

Prevention and Recognition of Obstetric Fistula Training Package. Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula

Prevention and Recognition of Obstetric Fistula Training Package. Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula Prevention and Recognition of Obstetric Fistula Training Package Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula Early detection and treatment If a woman has recently survived a

More information

CANCER OF THE OESOPHAGUS

CANCER OF THE OESOPHAGUS CANCER OF THE OESOPHAGUS What is the oesophagus (gullet) The oesophagus is a muscular tube that connects the mouth to the stomach. It descends behind the trachea (windpipe) against the backbone. It propels

More information

Sepsis: Identification and Treatment

Sepsis: Identification and Treatment Sepsis: Identification and Treatment Daniel Z. Uslan, MD Associate Clinical Professor Division of Infectious Diseases Medical Director, UCLA Sepsis Task Force Severe Sepsis: A Significant Healthcare Challenge

More information

VITAMIN C AND INFECTIOUS DISEASE: A REVIEW OF THE LITERATURE AND THE RESULTS OF A RANDOMIZED, DOUBLE-BLIND, PROSPECTIVE STUDY OVER 8 YEARS

VITAMIN C AND INFECTIOUS DISEASE: A REVIEW OF THE LITERATURE AND THE RESULTS OF A RANDOMIZED, DOUBLE-BLIND, PROSPECTIVE STUDY OVER 8 YEARS 39 Chapter 3 VITAMIN C AND INFECTIOUS DISEASE: A REVIEW OF THE LITERATURE AND THE RESULTS OF A RANDOMIZED, DOUBLE-BLIND, PROSPECTIVE STUDY OVER 8 YEARS Maxine Briggs TABLE OF CONTENTS I. Review of the

More information

How to do a Vitamin C (Ascorbate) Flush

How to do a Vitamin C (Ascorbate) Flush How to do a Vitamin C (Ascorbate) Flush Use only Beyond Health Vitamin C Buffered Powder, a 100% l-ascorbate, fully reduced, buffered mineral ascorbate form of vitamin C that contains the proper balance

More information

NUTB 316 ADVANCED MEDICAL NUTRITION THERAPY MNSP Tufts University, Friedman School of Nutrition Science and Policy

NUTB 316 ADVANCED MEDICAL NUTRITION THERAPY MNSP Tufts University, Friedman School of Nutrition Science and Policy NUTB 316 ADVANCED MEDICAL NUTRITION THERAPY MNSP Tufts University, Friedman School of Nutrition Science and Policy SUMMER 2015 (May 20, 2015 - August 16, 2015) Instructors: Kathy Prelack, PhD, RD kprelack@tufts.edu

More information

Many treatment and diagnostic options found in veterinary medicine today started

Many treatment and diagnostic options found in veterinary medicine today started New Treatment Options for Kidney Disease By William E. Feeman III, DVM Many treatment and diagnostic options found in veterinary medicine today started originally as treatment or diagnostic options for

More information

INTERNAL MEDICINE RESIDENTS NOON CONFERENCE: INPATIENT GLYCEMIC CONTROL

INTERNAL MEDICINE RESIDENTS NOON CONFERENCE: INPATIENT GLYCEMIC CONTROL INTERNAL MEDICINE RESIDENTS NOON CONFERENCE: INPATIENT GLYCEMIC CONTROL Presented by: Leyda Callejas PGY5 Endocrinology, Diabetes and Metabolism Acknowledgements: Dr. P Orlander Dr. V Lavis Dr. N Shah

More information

Critically Ill Patients

Critically Ill Patients Critically Ill Patients Aimée D. Garcia, MD, CWS, FACCWS Associate Professor, Department of Medicine, Geriatrics Section Program Director, Geriatric Medicine Baylor College of Medicine Medical Director,

More information

Weight Loss Surgery Information Session. WFBH Bariatric Surgery Program

Weight Loss Surgery Information Session. WFBH Bariatric Surgery Program Weight Loss Surgery Information Session WFBH Bariatric Surgery Program What makes us different? Center of Excellence (COE) High volume center > 1000 procedures since 2003 Less complications than non-coe

More information

Laparoscopic Colectomy. What do I need to know about my laparoscopic colorectal surgery?

Laparoscopic Colectomy. What do I need to know about my laparoscopic colorectal surgery? Laparoscopic Colectomy What do I need to know about my laparoscopic colorectal surgery? Traditionally, colon & rectal surgery requires a large, abdominal and/or pelvic incision, which often requires a

More information

Nutrition and Parkinson s Disease: Can food have an impact? Sarah Zangerle, RD, CD Registered Dietitian Froedtert Memorial Lutheran Hospital

Nutrition and Parkinson s Disease: Can food have an impact? Sarah Zangerle, RD, CD Registered Dietitian Froedtert Memorial Lutheran Hospital Nutrition and Parkinson s Disease: Can food have an impact? Sarah Zangerle, RD, CD Registered Dietitian Froedtert Memorial Lutheran Hospital Importance of Nutrition & Parkinson s Disease Good nutrition

More information

ESPEN Congress Geneva 2014 LLL LIVE COURSE: NUTRITION IN OBESITY

ESPEN Congress Geneva 2014 LLL LIVE COURSE: NUTRITION IN OBESITY ESPEN Congress Geneva 2014 LLL LIVE COURSE: NUTRITION IN OBESITY Pre-operative medical assessment, post-operative follow-up and clinical outcome in bariatric surgery patients A. Thorell (SE) Nutrition

More information

The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy

The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy Cindy Goodrich RN, MS, CCRN Content Description Sepsis is caused by widespread tissue injury and systemic inflammation resulting

More information

Heidi Ganzer, MS, RD, CSO, LD Minnesota Oncology Hematology PA Kim Jordan, MHA, RD, CNSD Seattle Cancer Care Alliance

Heidi Ganzer, MS, RD, CSO, LD Minnesota Oncology Hematology PA Kim Jordan, MHA, RD, CNSD Seattle Cancer Care Alliance Heidi Ganzer, MS, RD, CSO, LD Minnesota Oncology Hematology PA Kim Jordan, MHA, RD, CNSD Seattle Cancer Care Alliance Overview 2010 ACCC article Great information Ideal set up/goal March/April 2012 ACCC

More information

8.470 HOSPITAL BACK UP LEVEL OF CARE PAGE 1 OF 10. Complex wound care means that the client meets the following criteria:

8.470 HOSPITAL BACK UP LEVEL OF CARE PAGE 1 OF 10. Complex wound care means that the client meets the following criteria: 8.470 HOSPITAL BACK UP LEVEL OF CARE PAGE 1 OF 10 8.470 HOSPITAL BACK UP LEVEL OF CARE 8.470.1 DEFINITIONS Complex wound care means that the client meets the following criteria: 1. Has at least one of

More information

Mean Duration (days) ± SD b. n = 587 n = 587

Mean Duration (days) ± SD b. n = 587 n = 587 Online Table 1. Length of stay in matched cohorts of patients with VA and patients without VA a MS-DRG opulation (Code) ECMO or tracheostomy with mechanical ventilation 96 hours or principal diagnosis

More information

Decreasing Sepsis Mortality at the University of Colorado Hospital

Decreasing Sepsis Mortality at the University of Colorado Hospital Decreasing Sepsis Mortality at the University of Colorado Hospital Maureen Dzialo, RN, BSN - Nurse Manager, Cardiac Intensive Care Unit Olivia Kerveillant, RN Clinical Nurse III, Medical Intensive Care

More information

APPENDIX B SAMPLE PEDIATRIC CRITICAL CARE NURSE PRACTITIONER GOALS AND OBJECTIVES

APPENDIX B SAMPLE PEDIATRIC CRITICAL CARE NURSE PRACTITIONER GOALS AND OBJECTIVES APPENDIX B SAMPLE PEDIATRIC CRITICAL CARE NURSE PRACTITIONER GOALS AND OBJECTIVES The critical care nurse practitioner orientation is an individualized process based on one s previous experiences and should

More information

Benign Esophageal Perforations: Better Keep a Surgeon in the Toolkit

Benign Esophageal Perforations: Better Keep a Surgeon in the Toolkit Benign Esophageal Perforations: Better Keep a Surgeon in the Toolkit Bryan F. Meyers MD MPH Patrick and Joy Williamson Professor of Surgery Background Esophageal perforation is a difficult problem to characterize,

More information

Nosocomial Infections in the ICU. Gonzalo Bearman MD,MPH Associate Hospital Epidemiologist

Nosocomial Infections in the ICU. Gonzalo Bearman MD,MPH Associate Hospital Epidemiologist Nosocomial Infections in the ICU Gonzalo Bearman MD,MPH Associate Hospital Epidemiologist Nosocomial Infections 5-10% of patients admitted to acute care hospitals acquire infections 2 million patients/year

More information

Nasal Antiseptic Swabs

Nasal Antiseptic Swabs Nasal Antiseptic Swabs Decolonize the nose without the risk and complexity of antibiotics* Shown to safely and efficiently reduce S. aureus. Can be used as part of a bundled intervention for patient decolonization.

More information

483.25(i) Nutrition (F325) Surveyor Training: Interpretive Guidance Investigative Protocol

483.25(i) Nutrition (F325) Surveyor Training: Interpretive Guidance Investigative Protocol 483.25(i) Nutrition (F325) Surveyor Training: 1 With regard to the revised guidance F325 Nutrition, there have been significant changes. Specifically, F325 and F326 were merged. However, the regulatory

More information

Insulin s Effects on Testosterone, Growth Hormone and IGF I Following Resistance Training

Insulin s Effects on Testosterone, Growth Hormone and IGF I Following Resistance Training Insulin s Effects on Testosterone, Growth Hormone and IGF I Following Resistance Training By: Jason Dudley Summary Nutrition supplements with a combination of carbohydrate and protein (with a ratio of

More information

Why Do Some Antibiotics Fail?

Why Do Some Antibiotics Fail? Why Do Some Antibiotics Fail? Patty W. Wright, M.D. April 2010 Objective To outline common reasons why antibiotic therapy is not successful and how this can be avoided. And to teach you a little bit about

More information

Chronic Critical Illness: Can it be prevented? Carmen C Polito, MD Pulmonary & Critical Care Medicine Emory University Atlanta, GA cpolito@emory.

Chronic Critical Illness: Can it be prevented? Carmen C Polito, MD Pulmonary & Critical Care Medicine Emory University Atlanta, GA cpolito@emory. Chronic Critical Illness: Can it be prevented? Carmen C Polito, MD Pulmonary & Critical Care Medicine Emory University Atlanta, GA cpolito@emory.edu Data free zone Disclosures A (Very) Old Case 65 year-old

More information

Blood Transfusion. There are three types of blood cells: Red blood cells. White blood cells. Platelets.

Blood Transfusion. There are three types of blood cells: Red blood cells. White blood cells. Platelets. Blood Transfusion Introduction Blood transfusions can save lives. Every second, someone in the world needs a blood transfusion. Blood transfusions can replace the blood lost from a serious injury or surgery.

More information

Core Competency: Patient care

Core Competency: Patient care Rotation: Resident Level: Essential Content Areas/Expertise: VAI/VAII (General Surgery) PGY1 Abdomen and its contents; Alimentary tract (including bariatric surgery); Breast, Skin and Soft tissue; Surgical

More information

IINTRODUCTION TO THE DUMONT-UCLA INTESTINAL TRANSPLANT PROGRAM IN THE DUMONT-UCLA TRANSPLANT CENTER

IINTRODUCTION TO THE DUMONT-UCLA INTESTINAL TRANSPLANT PROGRAM IN THE DUMONT-UCLA TRANSPLANT CENTER IINTRODUCTION TO THE DUMONT-UCLA INTESTINAL TRANSPLANT PROGRAM IN THE DUMONT-UCLA TRANSPLANT CENTER Property of The Dumont-UCLA Transplant Center May not be reproduced or distributed in any form without

More information

Nutr 341: Medical Nutrition Therapy: A Case Study Approach 3 rd ed. Case 32 Esophageal Cancer Treated with Surgery and Radiation

Nutr 341: Medical Nutrition Therapy: A Case Study Approach 3 rd ed. Case 32 Esophageal Cancer Treated with Surgery and Radiation Nutr 341: Medical Nutrition Therapy: A Case Study Approach 3 rd ed. Case 32 Esophageal Cancer Treated with Surgery and Radiation Name: Julianne Edwards Instructions: This is not a group case study; it

More information

Guide to Abdominal or Gastroenterological Surgery Claims

Guide to Abdominal or Gastroenterological Surgery Claims What are the steps towards abdominal surgery? Investigation and Diagnosis It is very important that all necessary tests are undertaken to investigate the patient s symptoms appropriately and an accurate

More information

Blood & Marrow Transplant Glossary. Pediatric Blood and Marrow Transplant Program Patient Guide

Blood & Marrow Transplant Glossary. Pediatric Blood and Marrow Transplant Program Patient Guide Blood & Marrow Transplant Glossary Pediatric Blood and Marrow Transplant Program Patient Guide Glossary Absolute Neutrophil Count (ANC) -- Also called "absolute granulocyte count" amount of white blood

More information

FORMULA & SPECIALIZED FOOD

FORMULA & SPECIALIZED FOOD FORMULA & SPECIALIZED FOOD ADMINISTRATIVE POLICY Policy Number: HOME 005.16 T2 Effective Date: December 1, 2014 Table of Contents CONDITIONS OF COVERAGE... COVERAGE RATIONALE BENEFIT CONSIDERATIONS...

More information

Nutri&on support of the pa&ent with cancer

Nutri&on support of the pa&ent with cancer Nutri&on support of the pa&ent with cancer Dr Liz Isenring, AdvAPD Email: e.isenring@uq.edu.au Clinical Academic Fellow, Princess Alexandra Hospital Conjoint Senior Lecturer University of Queensland, Australia

More information

Anaemia Patient information

Anaemia Patient information Anaemia Patient information What is anaemia? Anaemia is the result of either not having enough red cells to take oxygen around the body, or having faulty red cells that are unable to carry enough oxygen.

More information

Surgical Management of Acute Pancreatitis

Surgical Management of Acute Pancreatitis Surgical Management of Acute Pancreatitis Steven J. Hughes, MD, FACS Cracchiolo Family Professor of Surgery and Chief, General Surgery Overview Biliary pancreatitis a cost effective algorithm Key concepts

More information

SYNOPSIS. 2-Year (0.5 DB + 1.5 OL) Addendum to Clinical Study Report

SYNOPSIS. 2-Year (0.5 DB + 1.5 OL) Addendum to Clinical Study Report Name of Sponsor/Company: Bristol-Myers Squibb Name of Finished Product: Abatacept () Name of Active Ingredient: Abatacept () Individual Study Table Referring to the Dossier (For National Authority Use

More information

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Journal of Parenteral and Enteral Nutrition Volume 33 Number 3 May/June 2009 277-316 2009 American

More information