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ARTIFICIAL NUTRITION OF SERIOUSLY INFECTED PATIENTS
Odilova Gulzina
Surkhandarya Region Denov
Abu Ali ibn Sino Public Health Technical School
Abstract:
This article provides information about the methods of artificial nutrition of
critically ill patients, their advantages and disadvantages, as well as their effects on the
patient’s div. Enteral and parenteral types of artificial nutrition, conditions for their use
and beneficial effects on patients are covered. The article also discusses modern methods of
artificial nutrition, rules and problems of their use.
Keywords:
artificial nutrition, enteral nutrition, parenteral nutrition, critically ill patients,
clinical nutrition, nutritional therapy.
Patients who are seriously ill, especially those in a coma, suffering from stroke, trauma, or
chronic diseases, naturally lose their ability to eat. Artificial feeding methods are used to
provide such patients with nutrition. This article provides detailed information about the
types of artificial feeding, their benefits and risks.
According to the recommended norm for a healthy person, the amount of animal protein is
100-200 g, vegetable protein 40 g, animal fats 85-90 g, vegetable oils 10-15 g, carbohydrates
400-500 g and glucose and sucrose in the form of disaccharides 50-100 g, and water 1700-
2000 g. The ratio of proteins, fats, carbohydrates and various other substances in the
patient’s diet is changed depending on the type of disease.
For example: in diabetes mellitus, carbohydrates are reduced in the composition of food for
one night.
In addition to medical personnel, kitchen staff also participate in the preparation of patients’
meals in medical institutions. The doctor prescribes a specific diet based on the patient’s
illness. The ward nurse draws up a food order. The dietician, based on the number of
patients and the type of diet, monitors the patients’ meals and is responsible for their quality
and type. Depending on the patient’s condition, there are 3 types of feeding: active, slow and
artificial.
Artificial nutrition is a combination of methods of providing the human div with necessary
substances in a situation where independent nutrition is impossible. The main tasks of
nutrition are both to maintain the div’s water balance and to satisfy its energy and plastic
needs. Principles of artificial nutrition: periodicity; deadlines; compliance with the patient's
condition. Indications for artificial nutrition: unconsciousness; facial injuries; metabolic
disorders; postoperative periods; sepsis; diseases of the digestive system; some psychiatric
diseases; anorexia; some diseases and human condition.
Artificial nutrition is divided into two main types:
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1. Enteral nutrition
Enteral nutrition is a method of administering special nutrients through the gastrointestinal
tract. This method is usually carried out in the following ways:
Through a nasogastric tube - food is fed through the nose into the stomach or intestines.
Through a gastrostomy - feeding is carried out using a tube inserted through the abdominal
wall into the stomach.
Through a jejunostomy - a tube is inserted directly into the small intestine.
Advantages:
• Preserves the function of the gastrointestinal tract.
• Fewer complications.
• Closer to natural nutrition.
Disadvantages:
• In some patients, the intestines may not function normally.
• Can cause discomfort when feeding with a tube.
2. Parenteral nutrition
Parenteral nutrition is a method in which nutrients are administered directly to the div
through a vein.
This method is carried out as follows:
• Through a central vein (total parenteral nutrition - TPN)
• Through a peripheral vein (partial parenteral nutrition - PPN)
Advantages:
• Suitable for patients who cannot digest food.
• Provides rapid and effective absorption of nutrients.
Disadvantages:
• High risk of infection.
• Expensive method.
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• Pressure on blood vessels and problems may occur.
Artificial nutrition plays an important role in the recovery process after serious illnesses.
Proper nutritional therapy:
• Improves the general condition of the patient.
• Strengthens the immune system.
• Prevents ulcers and pressure sores.
• Protects muscles from weakening.
Some complications may occur with artificial nutrition:
• Enteral nutrition - diarrhea, constipation, vomiting, aspiration pneumonia.
• Parenteral nutrition - sepsis, hyperglycemia, electrolyte imbalance.
Prevention measures are as follows:
• Compliance with hygiene rules.
• Adjusting nutrients according to the patient’s needs.
• Regular medical examination and monitoring.
• Artificial nutrition is the introduction of nutrients into the div through a gastric tube
• (feeding tube), gastrostomy (surgical opening), enema, intravenously or intramuscularly.
Necessary materials:
1. sterile thin rubber probe
2. Vaseline or glycerin
3. funnel or syringe
4. liquid food (sweets, eggs, boiled soup, mineral water, milk, etc.) in a volume of 600-800
ml.
5. Water (30-50 ml) and a tube for drinking
6. Stethoscope, adhesive plaster, safety clamp, syringe with a stopper for the probe.
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In addition, special preparations (solutions) are prepared for feeding the patient. Nutrients
are administered fractionally 5-6 times a day or drip slowly over a long period of time.
Method of artificial feeding of patients through a gastric tube.
1. 1-1.5 hours before feeding, the tube in the case is placed in the refrigerator.
2. Hands are washed.
3. The patient is explained the procedure and the necessary items are placed on the table.
4. The distance to which the tube is inserted is determined (100 is subtracted from the
height).
5. The tip of the tube is treated with glycerin.
6. The patient is helped to take a half-sitting position and a towel or white cloth is placed on
the chest.
7. The tube is inserted through the lower nostril by 15-18 cm (the patient's head is tilted
back).
8. We help the patient to take a sitting position.
9. The patient is asked to drink water and swallow the tube. To reduce nausea, ice cubes are
attached to the probe.
10. Air is drawn into the syringe and attached to the probe.
11. The head of the stethoscope is placed in the stomach area and air is sent into the stomach
through the probe.
In addition, when feeding the patient through a probe using a Jani syringe, the following
steps must be performed.
1. Prepare all the necessary items and check the place where the probe will be inserted.
2. The patient is given a semi-sitting position.
3. A stethoscope is placed in the stomach area, 30-40 ml of air is injected through the probe
using a syringe. Make sure that the probe is in the stomach by listening to certain sounds.
4. Clamp the probe with a clamp, placing the free end in the tray.
5. Liquid food is drawn into the Jani syringe and the syringe is connected to the gastric
probe. Holding the syringe with the left hand, remove the clamp from the probe.
6. The syringe is inserted into the probe to change its balance.
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7. The place where the syringe is connected to the probe is held with the left hand, and the
food is slowly injected with the right hand.
8. After feeding the patient, the probe should be washed with water using another syringe
and the syringe should be disconnected. Before the next feeding, it is necessary to make sure
that the probe is in place. To do this, air is again blown through the probe and heard with a
stethoscope. The composition and energy value of food. The div needs energy from
proteins, fats, carbohydrates, mineral salts and other substances for normal life.
Proteins are the basis of cells and cell-cell interactions. They are part of enzymes, hormones,
participate in the transmission of genetic information, in cell respiration, in muscle
contraction and relaxation, and are a source of oxygen
Protects the div from microorganisms and viruses. Proteins are part of animal products
(milk, meat, fish) and plant products (bread, nuts, cereals, legumes). They are made up of
amino acids, some of which cannot be replaced. Therefore, 60% of the daily diet should be
animal protein, 40% plant protein. Proteins make up 14% of the daily diet. They are a source
of proteins, amino acids in food.
The div does not have protein reserves. After complex operations, large burns, and serious
illnesses, the daily need for proteins is 1.5-2 g.kg. Fats are an important source of energy for
the div and are an important component of cell membranes, nervous tissue, and the adrenal
glands. Without fats, the div cannot absorb proteins, some mineral salts, and fat-soluble
vitamins. The daily diet should contain 70% animal fat and 30% vegetable fat. Fats are
found in milk, cottage cheese, full-fat yogurt, cheese, meat, poultry, and fish eggs.
Carbohydrates account for more than half of the energy needed for normal life in the human
div. They are mainly abundant in plant products. Carbohydrates improve the functioning
of the muscles, nervous system, and heart during normal absorption of fats. The daily need
of an adult for carbohydrates is 400-500 g. Water makes up 60% of div weight. Since vital
processes in cells or intercellular fluids occur in an aqueous environment, life without water
is unimaginable. The daily need of an adult is 2.5 liters. Mineral substances are important for
the normal functioning of all organs and systems. For example: calcium is part of bone and
muscle tissue.
Participates in muscle contraction and relaxation. Phosphorus is part of bone, nerve, muscle
tissue and participates in providing cells with energy. Sodium participates in the
transmission of nerve impulses to various organs. Potassium participates in muscle
contraction and relaxation.
Vitamins are an important and irreplaceable component of the diet. They ensure the normal
functioning of the div, participate in the absorption of nutrients. Vitamins should be
present in sufficient quantities in the daily diet. However, vitamin deficiency may occur due
to monotonous nutrition or impaired absorption in the digestive tract. The diet of a healthy
person or those who need to eat a special diet should not only have sufficient energy value.
Proteins, fats, carbohydrates should be in a ratio of 1:1:4. Patients’ products should be rich
in carbohydrates, vitamins, proteins and fats.
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Diet therapy is a therapeutic diet. It primarily involves the use of one type of product instead
of another to prevent chemical and mechanical damage to the diseased organ, the use of
other types of products to restore impaired functions, or the introduction of essential
nutrients that the patient’s div lacks. Each diet is described in detail, and the following
indicators are reflected in it. The purpose of the appointment is indicated, the general
description, chemical composition and its calories, diet, list of permitted and prohibited
products and dishes.
It is compiled in the following order: protein, fat, carbohydrate, seasoning products and
drinks. According to the approved nomenclature, diets from 1 to 15 are used.
Also, Gastrostomy (from the Greek. gastrom - stomach and somo - opening, passage) is a
surgical procedure that consists in creating an artificial entrance to the stomach cavity
through the abdominal wall to feed the patient when it is impossible to eat food through the
mouth. This is the most common palliative operation used for esophageal obstruction both in
Russia and abroad. Depending on the pathological process (tumor, stricture, etc.), this
operation can be performed for various purposes: for feeding patients, for retrograde
esophageal varices, for plastic surgery of the esophagus, for the use of radiation and
combination therapy.
It should also be said that the patient’s nutrition. Artificial feeding of the patient The nurse
should know:
1.Basic principles of rational nutrition;
2.Basic principles of clinical nutrition;
3.Features of treatment schedules;
4.Feeding patients in the hospital;
5.Types of artificial nutrition, indications for its use;
6.Contraindications to the introduction of a gastric tube;
7.Problems that may arise when feeding the patient.
In any case, the slower the nutritional mixture is introduced, the better it is absorbed and the
fewer side effects develop. Therefore, the usual practice is to administer it continuously at
the same rate for 24 hours, regardless of the intended volume. The decision to suspend or
withdraw artificial nutrition and hydration raises intellectual, philosophical and emotional
conflicts for many people. In physiology and medicine, it is often useful for people who are
faced with difficult decisions related to artificial nutrition and hydration at the end of life.
1
Singer, P., & Blaser, A. R. (2021). Modern Approaches to Nutritional Support in Intensive Care Units. Clinical Nutrition,
41(1), 45-67.
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In conclusion, artificial nutrition of critically ill patients is an important method for
maintaining their health and accelerating the recovery process. Enteral and parenteral
nutrition are selected depending on the medical conditions and the patient’s condition.
Doctors and nurses should monitor this process and provide nutrition in a way that is
appropriate for the needs of the patient’s div.
References
1.
Arora, Z., & Rockey, D. C. (2019). Enteral vs. Parenteral Nutrition in Critically Ill
Patients: An Evidence-Based Review. Journal of Clinical Nutrition, 36(2), 123-135.
2.
Heyland, D. K., & Dhaliwal, R. (2020). Best Practices in Nutritional Support for
Critically Ill Patients. Critical Care Medicine, 48(5), 730-741.
3.
McClave, S. A., et al. (2016). Guidelines for Nutrition Therapy in Critically Ill
Patients. Journal of Parenteral and Enteral Nutrition, 40(2), 159-211.
4.
Singer, P., & Blaser, A. R. (2021). Modern Approaches to Nutritional Support in
Intensive Care Units. Clinical Nutrition, 41(1), 45-67.
